The Centre has removed the geographical limit for serving Central Government employees seeking CGHS benefits. Check eligibility, options and key rules.
Serving Central Government employees who were unable to access Central Government Health Scheme (CGHS) facilities because they lived or worked outside the prescribed geographical area can now opt for CGHS coverage.
The Centre has removed the existing geographical criterion for determining CGHS eligibility of serving Central Government employees, allowing eligible employees residing outside the earlier coverage area to become CGHS beneficiaries.
The decision is aimed at addressing difficulties faced by employees who are posted or residing outside areas covered by CGHS, including those living in cities where CGHS facilities are not available.
What has changed under the new CGHS rule?
Earlier, CGHS coverage for serving beneficiaries was linked to their location. The 2018 guidelines restricted coverage to employees residing or working within a 5-km radius of a CGHS Wellness Centre, with provisions for certain employees living within the limits of the concerned municipal corporation.
The new order removes this geographical restriction for serving Central Government employees.
This means employees who are currently relying on medical facilities under the Central Services (Medical Attendance) Rules, 1944 (CS(MA) Rules) solely because their residence or posting falls outside the CGHS geographical coverage can now exercise a one-time option to join CGHS.
They must, however, meet the other applicable eligibility requirements and pay the prescribed CGHS contribution or subscription.
Who is eligible to opt for CGHS?
The option is available to serving Central Government employees who are otherwise eligible for CGHS but are currently outside the prescribed geographical coverage and are therefore availing medical facilities under the CS(MA) Rules.
The key change is that living or working beyond the earlier geographical limit will no longer by itself prevent an eligible serving employee from becoming a CGHS beneficiary.
Employees who choose CGHS will have to continue paying the applicable CGHS contribution, regardless of where they subsequently reside or are posted.
Who cannot opt out of CGHS?
The order also makes CGHS coverage mandatory for serving Central Government employees residing or posted within the CGHS-covered area, defined in the order as the limits of the district headquarters where a CGHS Wellness Centre is located.
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Such employees will not be allowed to choose CS(MA) medical facilities instead of CGHS.
One-time choice: What happens after an employee opts for CGHS?
The decision to switch to CGHS, where the option is available, is not reversible under the order.
The option can be exercised only once and will be final and binding, subject to the applicable eligibility conditions.
The choice will also apply to the employee's dependents. A family cannot split its medical coverage between CGHS and the CS(MA) system.
In other words, an employee cannot opt for CGHS while eligible family members continue to claim medical benefits under CS(MA), or vice versa.
Can CGHS and CS(MA) benefits be used together?
No.
An employee or family covered under CGHS cannot simultaneously claim medical facilities under the CS(MA) Rules. The same restriction applies in the opposite direction.
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Employees opting for CGHS will also have to submit an undertaking confirming that neither they nor eligible family members will claim benefits under both systems.
If inadmissible benefits are obtained from both systems, the amount can be recovered under the applicable rules.
What about TA/DA for CGHS treatment?
The order makes clear that TA/DA will not be payable for treatment or procurement of medicines under CGHS Rules.
What if an employee does not choose CGHS?
Where an employee is eligible to exercise the one-time option but chooses not to move to CGHS, they will continue to be governed by the CS(MA) Rules, 1944, as applicable.
The order also states that providing false, incorrect, suppressed or misleading information to obtain or continue CGHS benefits can lead to disciplinary action under the applicable Central Civil Services rules, apart from recovery of any inadmissible benefits.
The revised provisions come into force with immediate effect.
Published: 18 Sept 2026, 05:50 pm IST
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