75 Years and above CGHS Beneficiaries getting more relaxation on referral rules
Consultation from Specialists at CGHS empanelled Hospital for beneficiaries aged 75 years and above
“CGHS beneficiaries aged 75 years and above shall be permitted to seek direct OPD Consultation from Specialists of private hospitals empanelled under CGHS without referral from CGHS Wellness Centre”
Government of India Ministry of Health & Family Welfare
Department of Health & Family Welfare
Nirman Bhawan, New Delhi
Dated the 29th May, 2019.
Sub: Consultation from Specialists at CGHS empanelled hospitals in respect of CGHS beneficiaries aged 75 years and above -regarding
With reference to the above mentioned subject the undersigned is directed to state that the matter related to relaxation of consultation norms in respect of elderly CGHS beneficiaries was under consideration of this Ministry and it has now been decided that hereinafter, CGHS beneficiaries aged 75 years and above shall be permitted to seek direct OPD Consultation from Specialists of private hospitals empanelled under CGHS without referral from CGHS Wellness Centre.
2.If any investigations / procedures are advised and are required in emergency, no other authorization is required and the same may be undertaken.
However, in non-emergency conditions approval of competent authority is required if any non-listed investigations/procedures are advised. Medicines prescribed are to be procured from CGHS Wellness Centre.
3.Private hospitals empanelled under CGHS shall provide such facilities on cashless basis at CGHS rates to pensioners, ex-MPs , Members of Parliament and such other Categories of CGHS beneficiaries, who are eligible for treatment /investigations on credit basis.
More than 75 year old dependents of serving CGHS beneficiaries, who are otherwise not eligible for Cashless treatment shall claim the reimbursement from concerned Ministry /Department.
Beneficiaries of Autonomous Bodies /Statutory Bodies covered under CGHS shall claim reimbursement from the respective organization.
4.These orders are in supersession of the earlier guidelines on the subject.