WHO IS ELIGIBLE FOR CENTRAL GOVERMENT HEALTH SCHEME ?GREAT

 

If Someone Gets Divorced After Retirement Then Is the Wife Eligible for Cghs Facility–

Introduction

If someone gets divorced after retirement then is the wife eligible for the CGHF facility? This is a common question asked by many individuals. The answer to this question is Yes and No. The only condition where you can access this facility is if you are eligible for the CGHF facility and the couple is eligible to access this facility.

If the individual or the couple is eligible for this facility, the other eligibility criteria of the scheme also apply. You will be eligible for this facility only if you have a terminal illness. If you are an individual or a couple and you are eligible to access the facility and the eligible spouse is also eligible to access this facility, then you can access this facility. Let’s understand in detail.

What is CGHF?-–

The Central Government Health Scheme (CGHF) is a healthcare insurance scheme launched by the Central Government to provide a healthcare cover up to Rs.5 lakh per annum to the beneficiaries. The scheme is open to the employees of the Central Government, State Government and Central Government of State Universities and Hospitals.

The CGHF is an insurance scheme and it provides healthcare cover for Hospitalisation and charges, Major Surgery, Doctor’s attendance during illness and up to Rs.5 lakh per annum for medical expenditure.

1-Question: What are the different options for availing CGHS services to pensioners?

    Answer:    Pensioners residing in CGHS covered areas:–

• They can get themselves registered in the CGHS dispensary after making the requisite contribution and can avail both OPD and IPD facilities.
• Such Pensioners are not eligible for Fixed Medical Allowance instead of CGHS.
• Pensioners residing in non-CGHS areas have the following option – They can opt for availing Fixed Medical Allowance (FMA) @ Rs. 1000/- per month.
• They can also avail benefits of CGHS (OPD and IPD) by registering themselves in the nearest CGHS city after making the required subscription. In such cases, no Fixed Medical Allowance is given.
• They also have the option to avail of FMA for OPD treatment and CGHS only for IPD treatments after making the required subscriptions as per CGHS guidelines.

2- Question:  What is the grace period for getting a CGHS card for availing of a treatment facility/reimbursement for indoor treatment by pensioners immediately after retirement?

• Answer;-Pensioners are permitted three months from the date of superannuation to obtain a CGHS pensioner Card for consideration of reimbursement for the treatment taken during the grace period, subject to the condition that the Application complete with all documents and requisite CGHS subscription is submitted to the office of Additional Director during the fourth month after retirement for the issue of CGHS pensioner card. In case, the CGHS pensioner card is not made in the 4th month after retirement, no reimbursement for the expenditure incurred for treatment during the period before making the CGHS card, including the grace period.

3-Question: My husband/wife retired in 2009. He /she was paying a CGHS subscription every year. After his death can I get the card transferred in my name? Do have I to pay extra? Shall I get a Life Time Valid card?

• Answer: Yes, the ownership of the card can be transferred in the name of the spouse on the submission of required documents. Additional Director of the concerned city shall transfer the ownership of the Card in the computer database and the same CGHS plastic cards with the same Beneficiary ID can be used.

• No extra payment is to be made, in the case of lifetime cards.

• However in other cases, one has to pay a total of 10 years of subscription for a lifetime card. For example, if the spouse had contributed for seven years before he expired, the balance payment for the remaining three years is to be paid for a lifetime card.
  

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4-Question: My husband/wife retired in 2009. He /she was paying a CGHS subscription every year. After his death can I get the card transferred in my name? Do have I to pay extra? Shall I get a Life Time Valid card?

• Answer: Yes, the ownership of the card can be transferred in the name of the spouse on the submission of required documents. Additional Director of the concerned city shall transfer the ownership of the Card in the computer database and the same CGHS plastic cards with my Beneficiary ID can be used.

• Application in prescribed format
  

• Proof of Family Pension with its break up from the bank having his/her pension account.

Who is Eligible for CGHF?–

The scheme applies to all the employees of the Central Government, State Government and Central Government of State Universities and Hospitals.

If you are an employee with the Central Government, State Government and Central Government of State Universities and Hospitals, you are eligible for this facility.

If you are self-employed and you have income from other sources like rental income, profit, interest income, commission etc, you are eligible to access this facility.

If Someone Gets Divorce After Retirement Then Is the Wife Eligible for Cghf Facility–

The CGHF is an insurance scheme and the health cover provided under the scheme is limited to a maximum of Rs.5 lakh per annum. The medical expenses incurred after the retirement of the employee are not eligible for this facility. The sum insured may not exceed Rs.5 lakh for each annum.

If someone gets a divorce after retirement and the wife is eligible under this scheme, then she will be eligible for medical coverage up to Rs.5 lakh.

The amount of Rs.5 lakh is not inclusive of any other facility extended by the scheme like CHF benefit, SSAF, etc.

Conclusion–

Extension of validty of CGHS emp

As per the scheme, the eligible spouse will be able to avail of medical cover up to Rs.5 lakh per annum. If an individual gets divorced after retirement and the spouse is eligible for this facility, then she will be eligible for medical coverage up to Rs.5 lakh.

The amount of Rs.5 lakh is not inclusive of any other facility extended by the scheme like CHF benefit, SSAF, etc. Hence, if someone gets divorced after retirement and if the wife is eligible under this scheme, then she will be eligible for medical coverage up to Rs.5 lakh per annum.

sources-For more information about the CGHF scheme, you can visit the official website the scheme i.e. https://www.cgsholidays.gov.in/sitepage/cghf.htm>.

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