CGHS or Central Government Health Scheme is like a backbone for central government employees and pensioners. In the last ten years, there have been many major changes in this scheme. During the 7th Pay Commission (2016–2025), the government has constantly tried to make it digital and easy. Now that the discussion of the implementation of the 8th Pay Commission is in full swing, the biggest question among central government employees is whether CGHS will be abolished and a new insurance-based scheme will be introduced.

Reforms brought so far?

Recently, many reforms have come to the fore regarding CGHS. For example, the eligibility for general, semi-private, and private wards in private hospitals was decided according to the basic salary of the employees. An attempt was made to link the CGHS card to the Ayushman Bharat Health Account (ABHA), although later the decision to make it mandatory was postponed.

For those employees whose salary is deducted for CGHS contribution, the card started getting issued automatically. The referral process has also been simplified. Now treatment can be availed in government hospitals without referral. In private hospitals, consultation with three specialists has been provided on a single referral, and the age limit for senior citizens has been reduced to 70 years.

New CGHS rules implemented in 2025

This year, the government also took several steps to make CGHS completely digital. Now, the approval process of medical devices like CPAP, BiPAP, and oxygen concentrators has become online. The payment system has been changed, and a new HMIS portal has been implemented. Now all payments will be made from this portal.

MyCGHS app was launched, which provides facilities like card transfer and adding dependents. Photo rules have also been simplified. Now the patient's photo will be required only at the time of admission and discharge.

The process of delivering physiotherapy services at home has started. Medical equipment approval is now done in 5 days, and information about the application status is received through SMS and email.

Expectations from the 8th Pay Commission

The 8th Pay Commission has been announced, but the Terms of Reference (ToR) and the appointment of the chairman and members are pending. In such a situation, the change in the salary of employees and pensioners will be visible only by 2028. However, the matter of relief is that even though the 8th Pay Commission implementation date may be delayed, it will be considered effective from January 1, 2026.

New insurance-based scheme

Meanwhile, there is a discussion that a new insurance-based scheme, i.e., CGEPHIS, can be brought in place of CGHS, which will make health services more advanced.

The employees demand that till the new scheme is implemented, CS(MA) and ECHS hospitals should be included in CGHS. Also, after the increase in the fitment factor, the health contribution will increase, so the facility should also be better in the same proportion.

CGHS has become quite modern and digital-friendly in the last ten years. Especially the changes made in 2025 have made it more transparent and faster. Now all eyes are on the 8th Pay Commission, which is expected to not only increase salary and pension, but also expand the scope of health services can also expand.

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