No referral needed for CGHS beneficiaries | Fusion - WeRIndia

Good news for the beneficiaries of Central Government Health Scheme (CGHS) as there is no need of referral letter for their treatment at any enrolled private hospital from now on.

In order to simplify the treatment process under the CGHS, Indian government decided to allow beneficiaries without any referral letter for their treatment in private hospitals.

So far, the central government employees or pensioners and their dependents have been allowed to undergo examination and medical treatment at CGHS approved hospitals only after the prescription of CGHS medical officers and their specification about the requirement of such treatment.

Not just that, they have to consult at a local dispensary and get a referral to a bigger government hospital from which they have to obtain the permission of a specialist to get their treatment done at any CGHS empaneled private hospital. All this is a difficult process.

Hence, government has decided to ease the process and simplify it. A decision has been taken on this.

A new order has been issued by the Health Ministry in this regard. The government sent a letter dated November 9, 2017 to all the ministries and central government departments.

As per the new order, all the beneficiaries of CGHS including pensioners, freedom fighters, regular employees, ex-MPs and others who are eligible for credit facility are allowed for the treatment at the empaneled private hospitals on cashless basis.

It also states that government employees who are serving shall enclose the prescription issued by a government specialist or a CGHS medical officer to get reimbursement.

They should submit the original medical claim to the concerned ministry or department or office.

Reimbursement of expenses is available to buy artificial limbs, hearing aids, appliances etc. that are mentioned in the order.

The CGHS medical officer shall not refer any specific private hospital name, but just specify treatment procedure.

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