CGHS eligibility rules changed: Geographical restriction removed for serving Central Government employees

In a major relief for Central Government employees, the Ministry of Health and Family Welfare has officially removed all existing geographical restrictions for CGHS (Central Government Health Scheme) eligibility.

In an Office Memorandum dated September 17, 2026, on the subject “Eligibility of serving Central Government employees for availing CGHS facilities”, the Ministry said the matter had been reviewed in view of difficulties faced by serving Central Government employees residing or posted outside the prescribed geographical coverage of CGHS or in a city not covered by CGHS.

“It has been decided to totally dispense with the existing geographical criterion for determining eligibility of serving Central Government employees, for availing CGHS facilities,” the Ministry said.

Previous rule

As outlined in the Ministry's earlier Office Memorandum dated April 6, 2018: "CGHS coverage was restricted to serving beneficiaries, residing/working within 5 km radius of a CGHS Wellness Centre. Where such demarcations were not specified, the Additional Director, CGHS of concerned city shall notify such areas covered under CGHS Wellness Centres. Employee living within the limits of the Municipal Corporation concerned but beyond 5 km radius of a CGHS Wellness Centre and is otherwise a CS(MA) beneficiary, has the option to avail CGHS facility."

The memorandum said that serving Central Government employees residing outside the prescribed area and presently availing facilities under the CS(MA) Rules, 1944, solely on account of their residence or posting outside the geographical coverage of CGHS, “may exercise one-time option to be a CGHS beneficiary”, subject to fulfilment of other applicable eligibility conditions and payment of the prescribed CGHS contribution/subscription.

Employees who do not exercise the option to come under CGHS, where such option is available under the memorandum, will continue to be governed by the CS(MA) Rules, 1944, as applicable, the Ministry said.

Conditions for exercising the option

• The option will be a one-time option and, once exercised, will be final and binding, subject to the applicable eligibility criteria.

• The option exercised by the principal beneficiary will apply to all dependents. The entitlement will not be split between the two systems within the family.

• An employee opting for CGHS will continue to pay the prescribed CGHS contribution/subscription, irrespective of the place of residence or posting.

• An employee/family covered under CGHS will not simultaneously avail or claim medical facilities under the CS(MA) Rules, and vice versa.

• No TA/DA will be applicable on account of availing treatment and procurement of medicine under CGHS Rules.

• The employee will have to furnish an undertaking that neither the employee nor any eligible family member will avail benefits under both systems.

• Any inadmissible benefit availed under both systems will be liable for recovery in accordance with the applicable rules.

CGHS mandatory within covered area

The Ministry said serving Central Government employees residing or posted within the CGHS Covered Area, defined as the limits of district headquarters in which a CGHS Wellness Centre is situated, “shall mandatorily be covered under CGHS”.

Action for incorrect information

The Office Memorandum states that any employee or beneficiary furnishing “false, incorrect, suppressed or misleading information” for obtaining or continuing CGHS benefits will be liable for appropriate disciplinary action under the Central Civil Services (Conduct) Rules, 1964, and other applicable rules, as amended from time to time.

It also states that any inadmissible benefit availed on the basis of such information will be liable for recovery.

The Ministry said the provisions of the Office Memorandum “shall come into force with immediate effect.”

The memorandum was issued by the Government of India, Ministry of Health & Family Welfare, EHS Section, on September 17, 2026, with the approval of the competent authority.