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R K Rao
15-01-2013, 08:29 PM
A colleague of mine (residing in Mumbai suburban) has represented that he has no CGHS dispensary within 2 KMs of his residence and as such, he need not subscribe for the same. He has also said that in his earlier unit (at Hyderabad) the staff there have told him that if there is no CGHS dispensary within 8 KMs, one need not contribute.

Is it so?

Any orders?

RK Rao

[He is my friend and I am dealing the CGHS case. Hence it is a Catch-22 state for me].

SrCMO
17-01-2013, 11:02 PM
Rao Saheb, the current Eligibility for CGHS for a Government Servant is determined by the residence of the individual. He has to be resident in the covered area of the concerned CGHS City/Wellness Center, the details of covered areas may be secured from the concerned CGHS center/HQ. Distance from the CGHS center is not a criterion. For Pensioners he may choose a center depending on his convenience, but may not be attached to heavy load Wellness Center/ VIP Wellness Center, distance is not a criteria even here. e.g.: He my be living in Medchal and be Attached to any center in Hyderabad other than Begumpet which is classified as a heavy Wellness Center. On the Other side if a Government Servant is living in Ramamurthy nagar to the North of the Ring Road in Bangalore he is not covered by CGHS at Bangalore, and has to claim as per CSMA. The Admin Officers dealing with issue of CGHS Cards are well aware of this Rule but generally turn a blind eye to favour certain individuals to help them.

neon007
15-07-2013, 08:33 PM
I AM SERVING CGHS BENEFICIARY. BUT ON URGENT NEED, I VISITED NEARBY GOVERNMENT HOSPITAL OPD FOR MY WIFE AND CHILD. AS REQUIRED FOR URGENTLY, I HAVE PURCHASED THE MEDICINE FROM OUTSIDE AND LATER CLAIM FOR REIMBURSEMENT. BUT THE DEALING CLERK REJECTED THE BILL AND TOLD NO REIMBURSEMENT. I HAVE SEARCHED FOR RELEVANT ORDER AND FOUND THAT ON 1995 THERE IS ORDER REGARDING NO REIMBURSEMENT OF OPD CLAIM FOR CGHS BENEFICIARY.
UNDER THIS CIRCUMSTANCES, WHETHER THERE IS ANY NEW CLARIFICATION REGARDING REIMBURSEMENT OF OPD BILL FROM OUTSIDE INSTEAD OF CGHS DISPENSARY? AGAIN, WHETHER THERE IS ANY PROVISION TO GET THOSE AMOUNT FROM MY SERVING OFFICE?
kINDLY CLARIFY.

SrCMO
16-07-2013, 07:41 AM
Dear neon007
If you are a member of the CGHS then you have no option but to collect the medicines from CGHS unit to which you are attached. With the extended working hours of CGHS till 3 pm and the provision of visiting any CGHS unit nearest to you, you are expected to go and collect the same from nearest Wellness Center. If after working hours, you could have gone to the shop of the Authorised Local Chemist and collected the medicines for one day and visit the balance days from your Center. Govt. does not reimburse medicines purchased for OPD consultations, there is no provision for reimbursement of the same. Hope this clarifies your point.

neon007
04-08-2013, 11:26 PM
THANX FOR UR REPLY. NOW THERE ARE TWO QUESTIONS: FIRST ONE IS AS MY WIFE UNDERGOES PREGNANCY WHETHER I CAN ADMIT HER TO ANY CGHS APPROVED HOSPITAL OR SHE CAN BE ADMITTED INTO GOVT. APPROVED HOSPITAL FOR REIMBURSEMENT PURPOSE ? ALSO IS THERE ANY OPTION FOR PRE NATAL SCREENING TEST UNDER CGHS COVERAGE. kINDLY CLARIFY

SrCMO
05-08-2013, 08:14 PM
Dear Sir,
Please attend CGHS where antenatal Check up is done by the Lady Medical Officers, posted there. If Same is not available you may be referred to the Gynecologist in your city's Polyclinic, if such a facility is not available, you may be referred to the Gynecologist at a Govt. Hospital for preliminary evaluation and on their advise you can get the tests done at empanelled Center/Hospital through you concerned department. Thereafter close to term, The doctors at the CGHS would give you a referral letter for admitting at empanelled Hospital for confinement. In an Emergency you may admit at any Empanelled Hospital near your residence/ In-law's residence and claim as per Rules. If wife is going to ntive place for confinement intimation /permission from HoD would be in order