New CGHS guidelines for pensioners: Rules changed for OPD and FMA facility; check here

In a major relief for pensioners, the CGHS has made changes to the rules related to the fixed medical allowance and OPD facility. The changes have been made to the current one-time system, through which a pensioner can opt for either fixed medical allowance or the OPD facility. Let's know in detail the current provisions for pension holders at the CGHS:

CGHS new guidelines for pensioners: What's the current rule?  

As per the existing rules, pensioners or family pensioners residing in an area not covered by CGHS have the option to avail of fixed medical allowance (FMA) of Rs 1,000 per month in lieu of OPD facility under CGHS. The pensioners or family pensioners can change the option from FMA to OPD facility under CGHS or vice versa once during their lifetime.

What are the new CGHS guidelines for pensioners?

Now, with the changed rules, a pensioner or family pensioner in receipt of FMA can opt for 'Out Patient Department (OPD)' facility and vice-versa.  

How people availing FMA may opt for 'Out Patient Department (OPD)' facility?

- A person, willing to take the OPD facility, may apply to the concerned pension disbursing bank for discontinuation of FMA.

- Thereafter, the pension disbursing bank shall discontinue the payment of FMA and issue a certificate to this effect within three working days from the date of receipt of the application.

- Thereafter, the pensioner can apply to the concerned CGHS authorities for issue of CGHS card after paying requisite CGHS contributions, if not already paid.

- Thereafter, the authorities will issue a provisional CGHS card to the pensioner or family pensioner within four working days from the date of completion of all formalities and deposit of contributions till the issue of a regular CGHS card.

How availing 'Out Patient Department (OPD)' facility can avail the FMA?

- If a pensioner or family pensioner, who is availing CGHS or medical facility for both In-Patient Department (IPD) and OPD, intends to avail FMA while residing in a non-CGHS area or on shifting of residence from a CGHS area to a non-CGHS area, he can apply to the CGHS authorities for the surrender of OPD facility under CGHS, said the Ministry.

- The CGHS authorities will make a necessary endorsement on the CGHS card and issue a certificate within four working days from the date of receipt of the application, that the pensioner or family pensioner is not availing of the OPD facility.

- Thereafter, the pensioner or family pensioner can submit an application to the Head of Office along with a copy of the surrender certificate for the issue of a revised pension payment authority for payment of FMA.

- The revised Pension Payment Authority will be issued within two months from the date of submission of application by the pensioner/family pensioner, said the Ministry, adding the payment of FMA in such cases will be made from the date of issue of the surrender certificate by the CGHS authorities.