In a recent development, Central Government Health Scheme (CGHS) beneficiaries are now entitled to cashless treatment at All India Institute of Medical Sciences (AIIMS) across the country. Dr Bharati Pravin Pawar, the Minister of State, Ministry of Health and Family Welfare, announced this decision on December 5, 2023.
Eligibility Criteria and Guidelines:
1. Eligible Beneficiaries: CGHS pensioners and other entitled beneficiaries such as ex-MPs, ex-Governors, former judges of the Supreme Court and high courts, freedom fighters, etc., holding a valid CGHS card.
2. Verification Process: AIIMS will establish a special desk for CGHS beneficiaries. Valid CGHS cardholders can present their cards at the dedicated desk for verification, after which they will be referred to OPD, investigations, or indoor treatment, as required.
3. Submission of Documents: CGHS beneficiaries must submit a self-attested copy of their CGHS card. In the case of treatment for a dependent family member, a copy of both the CGHS card of the beneficiary and the family member needs to be submitted.
4. Billing Process: AIIMS will send physical bills along with a copy of the CGHS card to the CGHS office in the last week of the month. Bills for room rent during indoor treatment will be sent to CGHS as per prescribed rates for empanelled hospitals.
5. Reimbursement Process: AIIMS will create separate bank accounts for CGHS beneficiaries to reimburse the bills. The Additional Director, CGHS of the concerned city, will process the bills, and payments will be credited to the designated bank accounts.
6. Referral Requirement: CGHS pensioners and other eligible beneficiaries can avail treatment without a mandatory referral from CGHS.
This initiative is a step towards providing convenient and efficient healthcare services to CGHS beneficiaries and aligns with the broader goal of enhancing the country’s healthcare infrastructure.
