Removal of Geographic Limits for CGHS Coverage of Serving Central Government Employees
The Ministry of Health and Family Welfare has issued a new Office Memorandum (O.M. No. Z.16025/227/2026/CGHS-III/EHS) dated 17-09-2026, announcing a major update regarding the eligibility of serving Central Government employees to avail Central Government Health Scheme (CGHS) facilities.
The new rules completely dispense with the previous 5 km geographical limit, allowing employees residing outside CGHS-covered areas to opt into the scheme, subject to the conditions specified in the Office Memorandum.
Key Highlights
- The geographical criterion for determining CGHS eligibility has been entirely removed.
- Employees previously relying on CS(MA) Rules due to residing outside CGHS areas can now exercise a one-time option to join CGHS.
- Coverage is mandatory for employees residing or posted within the district headquarters limits of a CGHS Wellness Centre.
- Employees must pay the prescribed monthly CGHS contribution regardless of their posting or residence location.
- No Travelling Allowance (TA) or Dearness Allowance (DA) will be granted for travel related to CGHS treatment or medicine procurement.
Main Rules and Conditions
Under the previous O.M. dated 06.04.2018, CGHS coverage was restricted to employees residing or working within a 5 km radius of a CGHS Wellness Centre or within specified municipal limits.
The government has reviewed this policy to ease difficulties faced by employees posted in non-CGHS areas.
1. Mandatory Coverage
If an employee lives or is posted within a district headquarters limit containing a CGHS Wellness Centre, the employee is mandatorily covered by CGHS.
Such employees cannot opt out of CGHS in favour of the CS(MA) Rules, 1944.
2. Conditions for Opting In
- The option to join CGHS is a one-time choice and becomes final and binding once exercised.
- The medical entitlement system cannot be split within a family. The principal beneficiary's choice applies to all eligible dependents.
- Employees and their dependents cannot simultaneously claim medical facilities under both CGHS and CS(MA) Rules.
- A formal undertaking must be submitted stating that the employee and family will not claim dual medical benefits.
- Employees who choose not to exercise the option will remain governed by the CS(MA) Rules, 1944.
3. Penalties for Incorrect Information
Furnishing false, misleading, or suppressed information to obtain CGHS benefits will lead to the recovery of inadmissible benefits.
Such conduct may also invite disciplinary action under the Central Civil Services (Conduct) Rules, 1964 and other applicable rules.
CGHS vs CS(MA) Guidelines Overview
| Parameter | Previous Rule | New Rule (Effective 17-09-2026) |
|---|---|---|
| Geographic Limit | Restricted to a 5 km radius or specified municipal limits. | Geographical restriction completely dispensed with. |
| Travel Allowance (TA/DA) | Not specified in the stated comparison. | Strictly not applicable for travel related to CGHS treatment or medicine procurement. |
| Mandatory Enrolment | Applicable for employees within the specified covered areas. | Mandatory for employees residing or posted within district headquarters limits containing a CGHS Wellness Centre. |
| Employees Outside CGHS Areas | Generally governed by CS(MA) Rules, subject to applicable provisions. | Eligible employees may exercise the prescribed one-time option to join CGHS. |
| Family Coverage | Subject to applicable CGHS/CS(MA) provisions. | The principal beneficiary's choice applies to eligible dependents; dual medical benefits are not permitted. |
The one-time option becomes final and binding once exercised. Employees should therefore carefully consider the applicable rules and conditions before submitting the option.
Download Official Office Memorandum
The complete Office Memorandum and related details can be accessed from the official CGHS website.
📄 Download PDFConclusion
The new Office Memorandum removes the earlier geographical restriction for serving Central Government employees seeking CGHS coverage.
Eligible employees posted in non-CGHS areas may exercise the prescribed one-time option to join CGHS, subject to the applicable conditions.
Employees wishing to switch from CS(MA) Rules to CGHS should submit the prescribed Option and Undertaking Form to their Head of Office or DDO to initiate the applicable monthly CGHS subscription deductions.
Disclaimer
Educational Purpose Only: The information provided in this article is for general informational and educational purposes only.
Accuracy & Mistakes: While every effort has been made to ensure accuracy, human errors or omissions may occur.
No Liability: Under no circumstances shall the author or this website be held liable for any loss arising from the use of this information.
Readers are advised to refer to the official Office Memorandum and applicable government rules before taking any action.
Are you a Central Government Employee?
Don’t stay in the dark! Vital updates on Service Rules, Pension policies, and your career are happening right now.
Add as Preferred Source on Google
Follow us to ensure our latest exclusive reports appear first in your Google Search and Discover feed.
Comments
Post a Comment