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  1. New health insurance for Central Govt employees: What 7th Pay Commission, 6th and 4th CPCs said

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New health insurance for Central Govt employees: What 7th Pay Commission, 6th and 4th CPCs said

Upstox

3 min read | Updated on April 09, 2025, 16:25 IST

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SUMMARY

7th Pay Commission said that health insurance would be the “most optimal route” for providing complete coverage to all employees, pensioners, and their dependents in the long run.

health insurance plan

The 7th CPC strongly recommended the introduction of health insurance scheme. | Image source: Shutterstock

Three pay commissions in the past recommended a new health insurance plan for Central Government employees and pensioners. However, it is yet to be realised, even as the government has shown interest in having such a scheme.

Currently, the Central Government employees and pensioners are covered by the Central Government Health Scheme (CGHS), which has a limited reach. Therefore, it has been felt by pay commissions in the past that the government should introduce a separate health insurance scheme.

Let's look at what the previous pay commissions said on this issue:

4th Pay Commission: It suggested that the government should consider the feasibility and modalities of an insurance scheme for government employees, instead of medical reimbursement.
6th Pay Commission: It also recommended the introduction of a health insurance scheme for Central Government employees and pensioners. The 6th CPC said such a scheme should be available for employees voluntarily, subject to their paying the prescribed contribution. It had also recommended that the health insurance scheme should be compulsory for new government employees who would be joining service after the introduction of the Scheme.

The 6th CPC further recommended medical cover for those retiring after the introduction of the insurance scheme.

7th Pay Commission: The 7th CPC noted that health insurance would be the “most optimal route” for providing complete coverage to all employees, pensioners, and their dependents in the long run.

"The Commission strongly recommends the introduction of health insurance scheme for Central Government employees and pensioners," 7th CPC said in its report.

Till the introduction of such a scheme, the 7th CPC suggested a move for the benefit of pensioners residing outside the CGHS areas.

"The Commission recommends that CGHS should empanel those hospitals which are already empaneled under CS (MA)/ECHS for catering to the medical requirement of these pensioners on a cashless basis."

"This would involve strengthening of administrative capacity of the nearest CGHS centres. However, this step will go a long way in ameliorating the pending grievances of these pensioners," it added.

In January 2025, The Indian Express reported that the health ministry was planning to replace CGHS with an insurance-based scheme named Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS).

The scheme is likely to be implemented by insurance companies registered with the Insurance Regulatory and Development Authority (IRDAI). However, there is no official confirmation about the scheme from the Government yet.

Now that the 8th Pay Commission is about to be formed, all eyes will be on the incoming pay panel for a decision on this long-pending issue.
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