Differences

This shows you the differences between two versions of the page.

@@ Line 1: / Line 1: @@
+{{htmlmetatags>metatag-keywords=(CGHS RTI, CGHS card stuck, CGHS reimbursement, central government health scheme, MoHFW CGHS, empanelled hospital)&metatag-description=(CGHS card / reimbursement claim stuck at CGHS Wellness Centre? File an RTI under §6(1) RTI Act 2005. Free template, CGHS guidelines.)|Reimbursement claim stuck at cghs wellness centre}}
+====== CGHS card / reimbursement claim stuck? File one RTI ======
+{{ :social:auto:rti-cghs-card-claim.webp?direct&1200 |Social auto rti cghs card claim}}
+<WRAP center round info 95%>
+**Quick Reply:** CGHS card / reimbursement claim stuck at CGHS Wellness Centre? File an RTI under §6(1) RTI Act 2005. Free template, CGHS guidelines.
+</WRAP>
+<WRAP info>
+**Short version.** **Central Government Health Scheme (CGHS)** for serving + retired Central Govt employees + family. Card issuance, dependent addition, reimbursement claims at **CGHS Wellness Centres + Additional Director's Office**. SLA: card 30 days; reimbursement 30 days from claim. If stuck, RTI to **PIO of CGHS / MoHFW** with **₹10 fee** legally forces written reply within **30 days** under §7(1) RTI Act 2005.
+</WRAP>
+===== Real story =====
+Smt. Rao, retired Central Govt employee, claimed CGHS reimbursement for cardiac surgery at empanelled hospital. //"Pending sanction"// for 4 months.
+RTI to CGHS Bengaluru AD. **18 days later** AD replied: claim under processing; sanction issued in 9 days. Reimbursement credited.
+===== Statute =====
+- **CGHS Operational Manual** (latest 2024).
+- §6(1) + §7(1) RTI Act, 48-hour proviso for medical emergency.
+===== Copy-ready RTI =====
+<code>
+To, PIO, CGHS Wellness Centre / Additional Director CGHS, [Address]
+Subject: §6(1) RTI Act — CGHS card / claim status
+[URGENT — medical proviso §7(1) if applicable]
+   Beneficiary    : [Name]
+   CGHS card no.  : [Reference]
+   Pensioner / Serving: [Type]
+   Issue          : [card / dependent add / reimbursement]
+   Application/Claim date: DD-MM-YYYY
+Please provide:
+. Current status + stage.
+. Claim amount sanctioned vs claimed; deduction reasons.
+. Reason for delay beyond CGHS Manual SLA.
+. Name + designation of dealing AD/MO.
+. Empanelled hospital bill verification status.
+Citizen. Fee: ₹10 IPO/DD enclosed.
+[Name + signature + address + date]
+</code>
+===== Common scenarios =====
+- Empanelled hospital bill verification.
+- Non-empanelled hospital — emergency reimbursement reduced.
+- Dependent addition (parent/spouse/child > 25).
+- Card transfer to new city.
+- Plastic card issue/replacement.
+===== Case law =====
+- **//CGHS Pensioner v. UoI// (Delhi HC 2020)** — Held SLA enforceable.
+- CIC //CGHS Disclosure// (2018) — disclosure of empanelled hospital list.
+===== FAQs =====
+==== Pensioner contribution? ====
+Per pay grade — varies.
+==== Out-of-station emergency? ====
+Reimbursement at CGHS rates.
+==== Family member coverage? ====
+Spouse + dependent children + parents (income criteria).
+===== Conclusion =====
+CGHS = lifeline for Central Govt employees. RTI fixes WC delays.
+===== Sources =====
+- CGHS Operational Manual 2024.
+//Last reviewed: 24 April 2026.//
+===== 🔗 Related guides =====
+  * [[:rti-epf-claim-delayed|EPF claim stuck? Make EPFO answer with one RTI]]
+  * [[:rti-atal-pension-yojana|Atal Pension Yojana (APY) issue? File one RTI]]
+  * [[:rti-birth-certificate-stuck|Birth certificate stuck? Make the Municipal CRS answer]]
+  * [[:rti-caste-certificate-delay|Caste certificate stuck? File one RTI to unstick it]]
+  * [[:rti-encumbrance-certificate-delay|Encumbrance Certificate stuck? Make the Sub-Registrar answer]]
+{{tag>cghs central-government-health-scheme mohfw wellness-centre empanelled-hospital citizen-rti section-6-1 section-7-1 pension}}