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CGHS beneficiaries aged 75 years and above shall be permitted to seek direct OPD Consultation

Admin May 31, 2019

CGHS beneficiaries aged 75 years and above shall be permitted to seek direct OPD Consultation

Z 15025/35/2019/DIR/CGHS/ CGHS(P)
Government of India
Ministry of Health & Family Welfare
Department of Health & Family Welfare

Nirman Bhawan, New Delhi
Dated the 29th May, 2019.

OFFICE MEMORANDUM

Sub: Consultation from Specialists at CGHS empanelled hospitals in respect of CGHS beneficiaries aged 75 years and above -regarding

With reference to the above mentioned subject the undersigned is directed to state that the matter related to relaxation of consultation norms in respect of elderly CGHS beneficiaries was under consideration of this Ministry and it has now been decided that hereinafter, CGHS beneficiaries aged 75 years and above shall be permitted to seek direct OPD Consultation from Specialists of private hospitals empanelled under CGHS without referral from CGHS Wellness Centre.

2. If any investigations / procedures are advised and are required in emergency, no other authorization is required and the same may be undertaken. However, in non-emergency conditions approval of competent authority is required if, any non-listed investigations / procedures are advised. Medicines prescribed are to be procured from CGHS Wellness Centre.

3. Private hospitals empanelled under CGHS shall provide such facilities on cashless basis at CGHS rates to pensioners, ex-MPs , Members of Parliament and such other Categories of CGHS beneficiaries , who are eligible for treatment /investigations on credit basis. More than 75 year old dependents of serving CGHS beneficiaries, who are otherwise not eligible for Cashless treatment shall claim the reimbursement from concerned Ministry /Department. Beneficiaries of Autonomous Bodies /Statutory Bodies covered under CGHS shall claim reimbursement from the respective organization.

2. These orders are in supersession of the earlier guidelines on the subject.

(Dr. Manoj Jain)
Addl. DDG(HQ), CGHS

Signed Copy

Filed Under: Central Government Health Scheme (CGHS)

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  1. venkataraobatchu says

    August 21, 2019 at 12:52 pm

    Refer para 2 of the above order. In case the tests recommended by the expert are listed investigation and procedures is it required to go to the wellness centre to get their approval or the experts prescription is sufficient to get them done.

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