Central Government Health Scheme (CGHS): Complete 2026 Guide

What is CGHS?

What is the Central Government Health Scheme?

CGHS is a contributory health scheme for serving and retired Central Government employees (except Railways and Defence personnel, who have their own separate medical schemes) that provides cashless treatment at empanelled hospitals and free consultations, diagnostics, and medicines at CGHS Wellness Centres across more than 80 Indian cities.

Who is eligible for CGHS?

• Central Government employees (excluding Railway and Armed Forces personnel, who fall under separate schemes) and their dependent family members in cities where a CGHS Wellness Centre exists
• Central government pensioners and family pensioners, including widows receiving family pensions
• Dependent family members meeting the scheme’s income and residency criteria, typically spouse, dependent children, and dependent parents
• Certain autonomous bodies, freedom fighters, and specific categories were notified separately by the ministry from time to time
• If you live in a city with no CGHS Wellness Centre, you are generally not eligible to enrol in CGHS itself; pensioners in that situation instead receive a Fixed Medical Allowance in lieu of CGHS coverage.

CGHS Monthly Contribution Slabs

How much does CGHS cost per month? CGHS contribution is a flat monthly amount determined by your 7th Central Pay Commission pay level, it does not depend on family size or how much treatment you actually use, and a single subscription covers the employee and all eligible dependents.

These rates have been applied since the 7th Pay Commission implementation and were last confirmed in the Ministry’s office memorandum of 28 October 2022; rates are revised whenever a new Pay Commission takes effect, so always cross-check the current slab on cghs.mohfw.gov.in before making a payment, especially with 8th Pay Commission-linked revisions under discussion.

What CGHS Covers

• OPD consultations and free medicines dispensed from CGHS Wellness Centres
• Cashless inpatient treatment at CGHS-empanelled government and private hospitals
• Diagnostic tests, including lab investigations and imaging, at empanelled diagnostic centers
• AYUSH treatment (Ayurveda, Yoga, Unani, Siddha, Homoeopathy) through designated centres
• Reimbursement for emergency treatment taken at a non-empanelled hospital, subject to CGHS-prescribed rates, which means high-end treatment beyond those rates can still leave a gap the beneficiary pays out of pocket

Ward Entitlement in Private Hospitals

How is ward entitlement decided under CGHS? When a CGHS beneficiary is referred to an empanelled private hospital for inpatient treatment, the ward category; General, Semi-Private, or Private, is determined by the beneficiary’s monthly basic pay, not by their CGHS contribution slab.

These thresholds have been applied since the ministry's revision order dated 28 October 2022. A common misunderstanding we see: pensioners assume that paying the higher lifetime contribution (say, the Level 12 slab) automatically entitles them to a private room. It does not; ward entitlement follows the basic pay drawn at the time, a separate criterion from the contribution slab itself.

How to Apply for a CGHS Card

• Download and fill out the CGHS application form from cghs.mohfw.gov.in or collect it from your nearest CGHS Wellness Centre
• For serving employees, get the form countersigned/sponsored by your office’s administrative section, along with salary deduction confirmation for the CGHS contribution.
• For pensioners, attach pension payment order (PPO) details and proof of the last drawn basic pay.
• Attach identity proof, address proof, and family details (spouse, dependent children, and dependent parents) with supporting documents.
• Submit passport-size photographs of the employee/pensioner and all dependents.
• Pay the applicable contribution; monthly/annually, or the one-time lifetime amount for pensioners; and submit the receipt with the application
• Collect the CGHS card once processed, or use the digital card option where available in your city

CGHS for Pensioners: Lifetime Card vs. Annual Renewal

Pensioners can choose between paying the contribution every year (or monthly, deducted from pension) or making a single lump-sum payment equal to 120 months of the applicable slab for a card valid for the pensioner’s lifetime. Mathematically, the lifetime card breaks even at exactly the 10-year mark, pay once and if you use CGHS for more than 10 years after retirement, which most retirees do, the lifetime option works out cheaper. The one detail pensioners often miss: the contribution is fixed to the pay level at the time of retirement, so a pensioner does not need to pay a higher slab even if pay levels are later revised for serving employees, though the Ministry can still revise pensioner rates through a fresh notification when Pay Commission changes take effect.

Key Takeaways

• CGHS monthly contribution ranges from ₹250 to ₹1,000 based on 7th CPC pay level, covering the employee and all eligible dependents under one subscription.
• Ward entitlement in privately empanelled hospitals depends on basic pay, not on the contribution slab paid.
• Pensioners can pay a one-time lifetime amount (120 months’ contribution) instead of renewing annually; this breaks even at 10 years of coverage.
• Pensioners in non-CGHS cities receive a fixed medical allowance of ₹1,000 a month instead of CGHS coverage; you cannot claim both.
• Always verify current contribution rates and ward thresholds on cghs.mohfw.gov.in, since rates are revised with each Pay Commission cycle.

FAQs

How much is the CGHS monthly contribution?

CGHS monthly contribution ranges from ₹250 for Pay Levels 1–5 up to ₹1,000 for Pay Level 12 and above, based on the 7th Central Pay Commission pay matrix, and these rates have applied since the Ministry’s 2022 revision order.

Can a CGHS beneficiary also claim Fixed Medical Allowance?

No. A pensioner in a CGHS-covered city must subscribe to CGHS and cannot opt for Fixed Medical Allowance instead; FMA is available only to pensioners residing in areas without a CGHS Wellness Centre.

Is CGHS available to Railway and Defence employees?

No. Railway employees and Armed Forces personnel are covered by their own separate medical schemes and are generally not eligible for CGHS.

How is CGHS ward entitlement in a private hospital decided?

Ward entitlement, General, semi-private, or Private; is based on the beneficiary’s basic pay at the applicable thresholds, not on the CGHS contribution slab paid.

Should a pensioner choose the lifetime CGHS card or pay annually?

The lifetime card, priced at 120 months of the applicable monthly contribution, breaks even at exactly 10 years of retirement; since most pensioners live well beyond that, the lifetime option is usually more economical, though annual payment suits those who prefer smaller periodic outflows.

Do CGHS contribution rates change with a new pay commission?

Yes. CGHS subscription rates are revised whenever a new Pay Commission’s recommendations are implemented; always check the latest circular on cghs.mohfw.gov.in rather than relying on older figures.

Talk to Growthora

While CGHS itself is a government scheme for Central Government employees, many of our MSME and startup clients are current or former government employees navigating both personal compliance and business registration simultaneously. Book a free consultation with Growthora Advisory for clear, no-jargon guidance on your compliance and registration needs.