The ministry has invited quotes for premium payments from non-life/health insurance companies, while an expert group advising the ministry on the scheme’s contours has met several times.
The insurance plan substantially adds to the current Central Government Health Scheme that covers only 24 districts and that too only for outpatients. It has a cumbersome system under which a CGHS-empanelled doctor can prescribe hospitalisation.
The introduction of Central Government Employee and Pensioners Health Insurance Scheme (CGEPHIS) will change all that.
“We have already floated the request for quotes from insurers on February 28. We expect the scheme to be finalised soon. The employee and his family will be covered for hospitalisation and surgical procedures for an amount of Rs 5 lakh,” said a ministry official close to the development.
There are an estimated 1.7 million families of serving employees and 700,000 retired employees under the CGHS. Sanjay Pande, managing director, Amicus Advisory said, employees will now have access to 3,000 hospitals and nursing homes under the new scheme.
The new scheme is being made compulsory for new entrants as well as those who retire after the launch of the planned scheme. It is optional for those retiring before the scheme is launched.
STATE WISE DETAILS OF CENTRAL GOVERNMENT
PENSIONERS
| S.No. | Name of State | No. of Pensioners |
|---|---|---|
| 1. | Assam | 19,034 |
| 2. | Delhi | 1,57,937 |
| 3. | Jharkhand | 12,361 |
| 4. | Goa | 1,959 |
| 5. | Maharashtra | 72,475 |
| 6. | Tamilnadu | 35,324 |
| 7. | West Bengal | 74,140 |
| 8. | Bihar | 26,907 |
| 9. | Gujarat | 16,139 |
| 10. | Karnataka | 23,308 |
| 11. | Rajasthan | 33,758 |
| 12. | Uttar Pradesh | 56,352 |
| 13. | Andhra Pradesh | 33,763 |
| 14. | Kerala | 40,033 |
| 15. | Uttranchal | 34,378 |
| 16. | Himachal Pradesh | 23,117 |
| 17. | Madhya Pradesh | 20,849 |
| 18. | Daman & Diu | 4 |
| 19. | Jammu & Kashmir | 10,603 |
| 20. | Manipur | 3,301 |
| 21. | Orissa | 9,458 |
| 22. | Chattirgarh | 2,100 |
| 23. | Nepal | 7,514 |
| 24. | Tripura | 4,893 |
| 25. | Andaman & Nicobar | 12,909 |
| 26. | Meghalaya | 3,087 |
| 27. | Chandigarh | 9,506 |
| 28. | Haryana | 40,219 |
| 29. | Mizoram | 344 |
| 30. | Pondicherry | 1,405 |
| 31. | Sikkim | 624 |
| 32. | Arunachal Pradesh | 2,451 |
| 33. | Nagaland | 1,979 |
| 34. | Punjab | 32,754 |
|
| Total | 8,24,958 |
Note: CGHS Card Holders (Pensioners): 2,53,868 (as on 31.3.08)
Appendix-D
City wise CGHS package rates applicable on States
| S.No. | CGHS Rates | State |
|---|---|---|
| 1. |
| A&N Islands |
| 2. | Hyderabad | Andhra Pradesh |
| 3. | Guwahati | Arunachal Pradesh |
| 4. | Guwahati | Assam |
| 5. | Patan | Bihar |
| 6. | Chandigarh | Chandigarh |
| 7. | Bhopal | Chattishgarh |
| 8. | Ahmadabad | Dadra & Nagar Haveli |
| 9. | Ahmadabad | Daman & Diu |
| 10. | Delhi | Delhi & Diu |
| 11. | Pune | Goa |
| 12. | Ahmadabad | Gujarat |
| 13. | Chandigarh | Haryana |
| 14. | Chandigarh | Himachal Pradesh |
| 15. | Chandigarh | Jammu & Kashmir |
| 16. | Randhi | Jharkhand |
| 17. | Bangalore | Karnataka |
| 18. | Thiruvanthapuram | Kerala |
| 19. | Thiruvanthapuram | Lakshadweep |
| 20. | Bhopal | Madhya Pradesh |
| 21. | Mumbai | Mumbai including Navi Mumbai |
|
| Pune | Rest of Maharashtra |
| 22. | Guwhati | Manipur |
| 23. | Guwhati | Meghalaya |
| 24. | Guwhati | Mizoram |
| 25. | Guwhati | Nagaland |
| 26. | Bhubaneswar | Orissa |
| 27. | Chennai | Pondicherry |
| 28. | Chandigarh | Punjab |
| 29. | Janipur | Rajasthan |
| 30. | Guwahati | Sikkim |
| 31. | Chennai | Tamilnadu |
| 32. | Guwahati | Tripura |
| 33. | Lucknow | Uttar Pradesh |
| 34. | Deharadoon | Uttarkhand |
| 35. | Kolkata | West Bengal |
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