The central government has expanded access to the Central Government Health Scheme, providing serving employees posted outside CGHS-covered cities with a new healthcare option. Under the revised rules, geographical location will no longer automatically prevent an eligible central government employee from choosing CGHS coverage.
The change was communicated through an office memorandum issued by the Ministry of Health and Family Welfare on September 17, 2026. It is expected to benefit employees serving in smaller cities, rural districts and other locations where a CGHS Wellness Centre is not available nearby.
However, joining the scheme will be a one-time and irreversible decision for the employees covered by the new option. They must also agree not to claim medical benefits simultaneously under CGHS and the Central Services (Medical Attendance) Rules, 1944.
What has changed in the CGHS eligibility rules?
Under the earlier arrangement, CGHS eligibility for serving central government employees was closely connected to their place of residence or posting. Employees outside the geographical coverage of a CGHS city generally received medical benefits under the Central Services (Medical Attendance) Rules, commonly known as the CS(MA) Rules.
The earlier framework also included a distance-related condition associated with CGHS-covered areas and Wellness Centres. Employees living beyond the applicable geographical limit could face restrictions in obtaining CGHS membership.
The new office memorandum removes this geographical barrier. An otherwise eligible serving central government employee can now opt for CGHS even if the employee is posted or resides outside a CGHS-covered area.
According to a report explaining the office memorandum, the revised option is available regardless of an employee’s geographical location and comes into effect immediately. The Economic Times reported that employees who do not choose CGHS will continue to receive benefits under the existing CS(MA) framework.
Is CGHS membership now automatic?
No. The removal of the geographical condition does not mean that every central government employee outside a CGHS city will automatically be transferred to the scheme.
Eligible employees will have to choose CGHS voluntarily and complete the prescribed application process. They may also be required to submit an undertaking confirming that they understand the conditions attached to the option.
Employees who prefer to remain covered by the CS(MA) Rules can continue with that arrangement. Therefore, the change provides an additional choice rather than imposing compulsory CGHS membership on every employee.
The CGHS option will be final
One of the most important conditions is that an employee’s decision to join CGHS under the revised arrangement will be treated as a one-time option.
Once the employee chooses CGHS, the decision will be final and cannot ordinarily be reversed merely because accessing a Wellness Centre or empanelled hospital later becomes inconvenient.
Employees should therefore examine the availability of CGHS services, hospitals, diagnostic centres and medicines near their residence or place of posting before submitting the option.
They should also check whether frequent travel would be required for consultations, referrals or collection of medicines. Reports indicate that the memorandum does not clearly provide a separate travel or daily allowance for visiting CGHS facilities.
Double medical benefits will not be permitted
An employee opting for CGHS cannot claim medical expenses under the CS(MA) Rules for the same period. The employee must provide a written undertaking that neither the employee nor eligible dependent family members will use both systems simultaneously.
This condition is intended to prevent duplicate claims and overlapping government medical benefits.
Employees should also disclose the healthcare coverage of eligible dependants correctly. Any attempt to receive reimbursement or treatment benefits under both arrangements could lead to recovery of the amount and action under the applicable government service rules.
Employees must pay the prescribed CGHS contribution
Choosing CGHS also requires payment of the contribution fixed under the scheme. The amount is generally linked to the employee’s level in the Central Pay Matrix.
The required contribution may be deducted from salary according to the applicable procedure. Employees should confirm the amount with their department’s administrative or accounts section because the contribution can vary according to pay level and may be revised through government orders.
The payment should not be confused with a PF contribution. It is a separate healthcare-scheme contribution required for CGHS membership.
What benefits could employees receive?
After obtaining a valid CGHS card and completing the necessary formalities, beneficiaries can access services available under the scheme, subject to CGHS rules. These may include:
- Consultations at CGHS Wellness Centres
- Medicines available through the prescribed system
- Diagnostic tests at authorised centres
- Specialist consultation after the required referral
- Treatment at government facilities
- Treatment at CGHS-empanelled hospitals
- Cashless or reimbursement facilities where permitted
- Coverage for eligible dependent family members
Cashless treatment should not be assumed to be available for every procedure or at every hospital. It depends on the beneficiary category, hospital empanelment, treatment package, referral or authorisation requirements and the rules applicable at the time of treatment.
Employees should verify a hospital’s active CGHS empanelment before admission, particularly for planned procedures.
Why is the rule change important?
The earlier location-based arrangement created unequal access between employees posted in major CGHS-covered cities and those serving in remote or non-covered locations.
An employee could be entitled to central government medical support but unable to choose CGHS merely because no Wellness Centre operated nearby. The revised policy removes that eligibility barrier and gives employees greater continuity of healthcare coverage.
This can be especially useful for employees whose families live near a CGHS-covered city even when their official posting is elsewhere. It may also help those who regularly require specialist treatment at CGHS-empanelled institutions.
What should employees check before opting for CGHS?
Before making the one-time selection, employees should examine:
- Distance to the nearest CGHS Wellness Centre
- Availability of empanelled hospitals and diagnostic centres
- Treatment needs of dependent family members
- Monthly contribution applicable to their pay level
- Referral and authorisation requirements
- Medicine-collection arrangements
- Emergency-treatment rules
- Whether travel costs will be reimbursed
- The benefits currently available under the CS(MA) Rules
Employees should obtain the office memorandum and application instructions from their department instead of relying only on social-media messages.
The removal of the geographical restriction is a significant expansion of choice, but employees should evaluate the practical availability of services before giving their final undertaking. Once CGHS is selected under the new arrangement, returning to the previous system may not be permitted.
