In a significant development for central government pensioners, there is a new proposal to provide Pradhan Mantri Jan Arogya Yojana (PM-JAY) benefits to Central Government Health Scheme (CGHS) and Ex-Servicemen Contributory Health Scheme (ECHS) beneficiaries. According to a report by Financial Express, this move aims to offer pensioners and senior citizens more extensive healthcare coverage.
The proposal was put forward by Shiva Gopal Mishra, Secretary of the National Council (Staff Side) Joint Consultative Machinery for Central Government Employees, who formally approached Prime Minister Narendra Modi regarding the matter. Mishra's request outlines the need to provide more healthcare options for government employees who retire and face financial challenges related to healthcare benefits.
However, it is important to note that beneficiaries will have to choose between their current benefits under CGHS or ECHS and the new PM-JAY benefits. This new scheme is designed to ensure that senior citizens with private health insurance or those covered under the Employees’ State Insurance Scheme (ESIS) can also take advantage of the PM-JAY benefits.
One of the critical points addressed in Mishra's letter to the Prime Minister is the financial burden faced by retiring employees when they are required to make a significant one-time contribution to avail themselves of CGHS benefits after retirement. This cost is determined based on the 7th Central Pay Commission (CPC) Pay Matrix, with the following contribution amounts:
Level 1 to 5: ₹30,000
Level 7 to 11: ₹78,000
Level 12 and above: ₹1,20,000
Mishra argues that it is unfair to compel pensioners to choose between CGHS and AB PM-JAY, especially when the cost of post-retirement healthcare can be a financial strain. He emphasized that the option to retain both benefits would provide much-needed relief to retirees who are already under significant financial pressure.
The proposal highlights the need for a more flexible approach to healthcare coverage for central government employees and ex-servicemen after retirement. Many retirees face a dilemma when choosing between healthcare schemes due to the high one-time contribution required for CGHS. With the introduction of PM-JAY as an additional option, beneficiaries can receive enhanced medical benefits without being forced into a difficult financial decision.
Mishra's request could pave the way for a new era of dual healthcare coverage, ensuring that pensioners are not left vulnerable to high medical costs as they age. By offering both CGHS and PM-JAY benefits, the government could provide retirees with more comprehensive healthcare options that cater to their medical needs and financial capabilities.
The Central Government Health Scheme (CGHS) is a comprehensive health insurance scheme offered by the Government of India to its employees and their eligible dependents. It provides cashless medical treatment and reimbursement facilities at various government and empanelled private hospitals across the country.
Cashless treatment: CGHS cardholders can avail cashless medical treatment at empanelled hospitals without upfront payment.
Reimbursement: For treatments not available at empanelled hospitals, CGHS reimburses eligible expenses upon submission of necessary documents.
Wide network of hospitals: CGHS has a vast network of empanelled hospitals across India, ensuring easy access to medical care.
Comprehensive coverage: The scheme covers a wide range of medical expenses, including consultations, diagnostics, medicines, and hospitalization.
Family coverage: CGHS extends benefits to eligible family members of the central government employee, including spouse, dependent children, and parents.
Central government employees: Regular and contractual central government employees are eligible for CGHS.
Eligible dependents: Spouse, dependent unmarried children (up to a certain age), and parents can be included as eligible dependents under the scheme.
Eligibility verification: Employees need to verify their eligibility for CGHS through their respective departments.
Registration: Once eligibility is confirmed, employees can register for CGHS and obtain a CGHS card.
Additional benefits:
Emergency medical treatment: CGHS provides emergency medical treatment even outside the scheme's geographical coverage.
Dental and optical care: The scheme covers certain dental and optical expenses.
Rehabilitation services: CGHS may provide reimbursement for rehabilitation services in certain cases.
CGHS is a valuable benefit for central government employees, providing them with access to quality healthcare facilities and financial protection in case of medical emergencies.