CGHS clarifies medical reimbursement rules, ₹3,000 test threshold, referral requirements

The Central Government Health Scheme, or CGHS, is a program that helps government workers and retired government workers pay for doctor visits and medical tests.

The people in charge of this program recently explained some new rules about how to get money back for medical costs.

If a doctor at an approved hospital tells you to get a test that costs ₹3,000 or less, you should get that test at the same hospital.

If you want to get the test somewhere else, you need a special referral first.

For tests that cost more than ₹3,000, like CT scans or MRI scans, you always need a referral.

A doctor's visit is valid for seven days, so you can go back for follow-ups within that week.

Eye check-up fees already include some tests, like checking eye pressure, so you should not be charged extra for them.

If a doctor suggests a test that is not on the official list, you need to get permission before doing it.

The ₹3,000 amount is not a limit on how much money you can get back.

It just tells you where you can do the test and whether you need a referral.