Deletion of the name of ineligible Dependent & Opting out of the CGHS Scheme

Govt. Servant responsible for Deletion of the name of an ineligible Dependent

The undersigned is directed to state that in accordance with the definition of ‘family’ mentioned in Ministry of Health Memo. No. F.6(1) 1-54-H, dated the Ist May, 1954 the family of a beneficiary for the purpose of CGHS scheme includes husband/wife of the CGHS card-holder, as the case may be, wholly dependent children or step-children and parents, who are mainly dependent on and residing with the Government Servant. While it is incumbent upon the card issuing. Authorities, i.e. various departments and offices participating in the scheme, to ensure that the names of only genuine and eligible persons are included in the CGHS token cards, it is the responsibility of the employees concerned to apply for a deletion of the name of the dependent from the CGHS card, when the ward is no more entitled to the benefit eligible under the scheme. The failure on the part of a cardholder to get the name of a child deleted from the CGHS token-card when he is no more dependent on him is a good and sufficient reason for initiating disciplinary proceedings against him in terms of the CCS (CCA) Rules, 1965.

All Ministers/Departments of the Government of India are requested kindly to ensure that the above said provisions are complied with fully. These instructions may also be brought to the notice of all employees concerned.

Opting out of the C.G.H. Scheme

Spouse employed outside Central Government and availing Medical Facilities provided by his/her Employer

Central Government Servants covered under Central Govt. Health Scheme and whose spouse is employed in Defence or Railway Services, State Government or Corporations or Bodies financed partly or wholly by the Central or State Government, Local Bodies and private organizations which provide medical facilities to the employees and their family members, can opt out of the CGH Scheme and avail medical facilities so provided by the above mentioned organizations.

It is to be ensured that neither of the two nor their family members avail medical facilities from both the sources at the same time and for this purpose, the concerned Central Government employee shall give an undertaking to the authority issuing the CGHS Card.

Re-admission under CGHS after ‘opting out’

Such Government Servants, who have opted out of CGHS, may apply for readmission and avail the benefit of CGHS in case their spouse dies or resigns or is dismissed from the office/organization, which provided medical facilities.

Availability of ‘Opting Out’ Facility

The facility of opting out of CGHS can only be availed twice during the whole service career of the employee. Administrative Ministry/Department shall record the same by making an entry in the employee’s Service Book.

Source: http://cghsmumbai.gov.in/http://cghsmumbai.gov.in/htmldocs/circulars.htm