Contribution is based on Level Pay on Government Pay Scales (CDA Scale) as per 7th Pay Commission. MTNL Pay Scales have been mapped to Govt. pay scales (CDA) as per 7th Pay Commission and given on Page-4 of PPO or in a certificate form pasted on first page of PPO. If it is not mentioned, approach AO(PDA) at Curry Road and update the PPO.

Level 1 to Level 5 (All Non-Executives) - Rs.250/- pm (Life Time 120 months = Rs.30000/-)

Level 6 Partially Non-Executives & Partially (Executives) -Rs.450/- pm (Life Time 120 months =Rs.54000/-)

Level 7 to Level 11 - All Executives -Rs.650/- pm (Life time 120 months Rs.78000/-)

Level 12 and Above - All Executives - Rs.1000/- pm (Life time 120 months Rs.120000/-)

For detailed PAy Scales and Corresponding Level Pay Ref CGHS OM on Level Pay.

WARD ENTITLEMENT depends upon basic pay at the time of retirement :

General Ward : Basic Pay up to Rs. 28530
Semi Private Ward : Basic pay from Rs.28540 to Rs.37750
Private ward : Rs.37760 and above

1. Pensioners are given preferential treatment.

2. Covers whole Family viz., dependent parents, sisters, brothers, sons, daughters, grandchildren etc. with some conditions. The amount of contribution is same regardless of number of beneficiaries.

3. Whole process of prescription, giving medicines etc. computerised.

4. At request, Doctors prescribe the same medicines if the prescription chit of family doctor is shown. For chronic diseases medicines are given for one month at a time. At request, the medicines are given even for three months; given even for six months while going out of India.

5. If medicines are not in stock either same medicines of other brand is given or local purchase is done and given on third day. SMS is given requesting to collect medicines of local purchase.

6. If any specialist doctor is to be consulted, reference is given either to other CGHS dispensary where specialist visits or to any empanelled hospital even for OPD Consultation.

7. There is no ceiling on entitlement amount for Medicine / Testing /Consultations / Procedure etc.

8. During Periods of disturbance when not in a position to move out of home Tele-medicine facility is offered for consulting Doctors at the welness Center for medicine and references for testing and consulting outside Private Hospitals /Doctors / Test Centers.

1. The wellness centre may not be nearby; expenses may be incurred on conveyance.

2. Wellness centre is open from 8 am to 2 pm only. There might be queue at counters for registration, pharmacy or to consult doctor.

3. A general complaint is that doctors don’t diagnose properly and don’t issue hard copy of prescription.

4. Sometimes the favourite doctor may not be available.

5. Some staff or doctor may not treat you as you expected.

Planned treatment :- Wellness Centre issues reference memo mentioning required treatment. No name of hospital is mentioned. Beneficiary may choose any panelled hospital and avail treatment cashless.

Emergent conditions :- Treatment may be availed at any empanelled hospital or at any nearby non-empanelled private hospital without any reference from wellness centre. The cost of treatment at private hospital is reimbursed at CGHS Rates on submission of claim.

Demerits due to poor present status :- The empanelled hospitals are not many. Only a few multi-speciality hospitals are empanelled. Diagnostic centres for pathology, X-Ray etc. are very few.

REMEDY IN SIGHT: The hospitals at Mumbai are unwilling to get empanelled as the CGHS rates at Mumbai are far low. The CGHS rates are different in Delhi and Mumbai. At Mumbai the rates of 2010 are still applied due to some court case. Now the court case is over. Upwardly revised rates are to be released soon. Many hospitals may be willing to get empanelled at new rates which may be acceptable to them. Let us hope the revised rates are released soon and more multispeciality hospitals (at least one in every locality) and more diagnostic centres are empanelled.

CGHS – CHANGE OF MAIN BENEFICIARY:

Procedure to be adopted for changing main CGHS beneficiary after original main beneficiary expired.     It is essential to renew the card after the death of main beneficiary when the spouse is having a card in his\her name.     Medical facilities will continue to other CGHS beneficiaries even if the main beneficiary is dead.  Spouse is allowed to claim reimbursement only after changing his/her name as the main beneficiary if the main beneficiary died. Hence change is required.                                    

Documents required: 

1.Original PPO after getting the family pension change.

2.Photo copy of PPO book 

3.Death Certificate                    

4.Application form to be uploaded from CGHS website                                       

5.Photos of the spouse, dependents as per rules, Photo copy of Aadhar Card of spouse, dependants pasted on the application.                    

6.Photo copy of PAN card         

7.Crossed cheque of spouse     

8.Carry the CGHS cards of Husband/wife  with you and visit the CGHS Marineline Office near Churchgate.  After doing the needful, both the cards will be returned back.  It will take  few minutes for all the work.

 In case of any problem please call or whatsapp to Shri Ravindra Kumar, AGS.