IndiaPosted at: Sep 19 2026 5:24PM


Centre scraps geographical criterion for CGHS eligibility for serving employees

New Delhi, Sep 19 (UNI) The Centre has done away with the geographical criterion for determining the eligibility of serving Central government employees to avail facilities under the Central Government Health Scheme (CGHS), enabling eligible employees posted or residing outside CGHS-covered areas to opt for the scheme.
In an Office Memorandum, the Ministry of Health and Family Welfare said the decision is taken after reviewing difficulties faced by serving Central Government employees residing or posted outside the prescribed geographical coverage of CGHS or in cities not covered by the scheme.
“It has been decided to totally dispense with the existing geographical criterion for determining eligibility of serving Central government employees, for availing CGHS facilities,” the memorandum said.
Under the earlier arrangement referred to in the order, CGHS coverage is restricted to serving beneficiaries residing or working within a five-km radius of a CGHS Wellness Centre. Where such geographical demarcation is not specified, the Additional Director, CGHS, of the city concerned is to notify the areas covered by CGHS Wellness Centres.
An employee living within the limits of the municipal corporation concerned but beyond five km of a CGHS Wellness Centre, and otherwise covered under the Central Services (Medical Attendance) Rules, 1944, had the option to avail CGHS facilities.
Under the revised provisions, serving Central government employees residing outside the prescribed area and presently availing facilities under the CS(MA) Rules, 1944 solely because their residence or posting is outside the geographical coverage of CGHS may exercise a one-time option to become a CGHS beneficiary.
The option will be subject to fulfilment of other applicable eligibility conditions and payment of the prescribed CGHS contribution or subscription.
However, serving Central government employees residing or posted within a CGHS-covered area — defined in the memorandum as the limits of district headquarters in which a CGHS Wellness Centre is situated — will mandatorily be covered under CGHS and will not be entitled to opt out of the scheme in favour of medical facilities under the CS(MA) Rules, 1944.
The government has stipulated that the option for eligible employees outside CGHS-covered areas will be available only once and, once exercised, will be final and binding, subject to the applicable eligibility criteria.
The option exercised by the principal beneficiary will apply to all dependants. Medical entitlement cannot be split between CGHS and the CS(MA) system within a family.
An employee opting for CGHS will have to continue paying the prescribed CGHS contribution or subscription irrespective of the place of residence or posting.
The order also makes it clear that an employee or family covered under CGHS cannot simultaneously avail or claim medical facilities under the CS(MA) Rules, and vice versa.
No travelling allowance or daily allowance will be admissible for availing treatment or procuring medicines under CGHS rules.
Employees opting for the scheme will also have to furnish an undertaking that neither they nor any eligible family member will avail benefits under both systems. Any inadmissible benefit availed under both systems will be liable to recovery under the applicable rules.
Employees who do not exercise the option to come under CGHS, where such an option is available under the memorandum, will continue to be governed by the CS(MA) Rules, 1944.
The memorandum further says that any employee or beneficiary furnishing false, incorrect, suppressed or misleading information to obtain or continue CGHS benefits will be liable to appropriate disciplinary action under the Central Civil Services (Conduct) Rules, 1964 and other applicable rules, besides recovery of any inadmissible benefit obtained on the basis of such information.
The provisions have come into force with immediate effect, according to the memorandum issued by Sonika Khattar, Deputy Secretary to the Government of India.
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