7th Pay Commission CGHS Recommendations on monthly subscription, eligibility of wards – Orders issued

7th Pay Commission CGHS related recommendations on revision of rate of subscription, eligibility for wards on the basis of revised pay – Govt issues Orders

No. S.11011/11/2016- CGHS (P)/EHS

Government of India Ministry of Health and Family Welfare EHS Section Nirman Bhawan, New Delhi
Dated the 9th January, 2017

Sub: Revision of rates of subscription under Central Government Health Scheme due to revision of pay and allowances of Central Government employees and revision of pension/ family pension on account of implementation of recommendations of the Seventh Central Pay Commission.

The undersigned is directed to refer to this Ministry’s OM No. S.11011/2/2008-CGHS(P) dated 2oth May, 2009 vide which orders were issued revising the rates of monthly subscription for availing CGHS facility, as also the entitlement for free diet, entitlement of accommodation in private empanelled hospitals under CGHS, etc.

2. Consequent upon revision of pay on the basis of the implementation of the recommendations of the 7th Central Pay Commission, it has been decided to revise the rates of subscriptions, to be made by employees pensioners, for availing benefits under the CGHS, with effect from 1st January, 2017. It has also been decided to revise the monetary ceiling limits for various entitlements of the beneficiaries for availing CGHS facilities.

3. In supersession of all earlier instructions, the following revisions are being made, in so far as it relates to the facilities mentioned below:
(A) Monthly Contributions for availing CGHS facility:
Sl. No.Corresponding levels in the Pay Matrix as per 7th CPCContribution (Rs. Per month)
1.Level: 1 to 5250
2.Level: 6450
3.Level: 7 to 11650
4.Level 12 & above1000 (B)

Entitlement of wards in Private hospitals empanelled under CGHS: Corresponding Basic Pay drawn by the Ward entitlement Sl. No.Corresponding Basic Pay drawn by the officer in 7th CPC per monthWard entitlement
1.Up to Rs. 47,600/-General
2.Rs. 47,601/- to Rs. 63,100/-Semi-Private 3.Rs. 63,101/- and abovePrivate

(C) Monetary Ceiling for Free Diet: The monetary ceiling for free diet for CGHS beneficiaries is revised to pay/ pension /family pension of Rs. 44,900/- per month.

(D) Monetary ceiling for free diet [or beneficiaries suffering from TB or mental disease): The monetary ceiling for free diet in case of beneficiary suffering from TB or Mental disease is revised to pay/ pension /family pension of Rs. 69,700/- per month.

(E) Pay slab for determining the entitlement of Nursing Home facilities in Government / State Government / Municipal Hospitals: The monetary ceiling for determining the entitlement of nursing home facilities in Central Government / State Government / Municipals Hospitals is revised to pay / pension / family pension Rs. 47,600/- per month and above.

(F) Monetary Ceiling for direct consultation with Specialists in Central Government [State Government / Municipal Hospitals: The monetary ceiling for determining the entitlement for direct consultation with Specialists in Central Government / State Government/Municipal Hospitals will continue at the existing rates until revision of the same after consultation with Ministry of Finance.

(G) Pay slab for determining the entitlement of accommodation in AIIMS, New Delhi. The revised entitlement, as per the pay drawn by the officials, is as follows:
Sl. No.Corresponding Basic Pay drawn by the officer in 7th CPC per monthWard entitlement
1.Up to Rs. 63,100/-General
2.Rs. 63,101/- to Rs. 80,900/-Private 3.Rs. 80,901/- and aboveDeluxe/Private

4. It is clarified that the reference to pay in this order relates to the pay drawn in the level of pay.

5. Pensioners have an option to get their CGHS pensioner card made by either making CGHS contribution on an annual basis (twelve months) or by making contribution for 10 (ten) years (120 (one hundred and twenty) months) for getting a pensioner CGHS card with life-time validity. It is clarified that:
(i) Contribution to be made by pensioners / family pensioners would be the amount that they were subscribing at the time of their retirement or at the time of death of the Government servant;
(ii) Pensioner beneficiaries, who have already obtained CGHS card with life time validity by paying a lump sum amount equivalent to 10 years’ contribution, will not be required to pay any additional amount as a result of the revision in the rates of contribution for availing CGHS facility;
(iii) Entitlement of pensioners / family pensioners, who have already deposited their contribution for life time CGHS facility, will not be changed.
(iv) Pensioners / family pensioners who are contributing to the CGHS on an annual basis and wish to continue to avail CGHS benefits will have to contribute at the revised rates up to the time of contribution needed to cover a period of a total of ten years from the time pensioner CGHS card was issued for the first time to them. The revised rate of contribution for the remaining period would be with reference to the level of pay that he / she would have drawn in the post held by him / her (at the time of his / her retirement / death) had he / she continued to be in service now but for his / her retirement/ death; and
(v) Any pensioner / family pensioner who is entitled to avail CGHS facility has not so far got his / her pensioner CGHS card made, the rate of contribution in such cases will be with reference to the level of pay that he / she would have drawn in the post held by him / her (at the time of his / her retirement / death) had he / she continued to be in service now but for his/ her retirement / death.

6. This issues with the concurrence of the Department of Expenditure vide their I.D. Note No. 18(1)/EV/2016, dated 24/11/2016.
7. Hindi version will follow.

sd/- (Sunil Kumar Gupta)
Under Secretary to the Government of India
Download EHS, Ministry of Health and Family Welfare order No. S.11011/11/2016- CGHS (P)/EHS dated 09.01.2017