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Minister
Satyendar Jain
DGEHS
Sanction Orders issued in DGEHS
Important Office Memorandums and Office Orders
Government Hospitals or Dispensaries or Empanelled hospitals and diagnostic centers in Delhi and NCR
Approved rates for treatment and investigative procedures
Downloadable forms
Important Links
Frequently Asked Questions
DGEHS

 

List of Hospitals of Government Beneficial Scheme under DGEHS

 
S.No.Description
1. List of Delhi Government Hospitals
2. List of Delhi Government Dispensaries
3.

List of Empanelled Hospitals, Diagnostic Centres in Delhi (District wise) and NCR

4
Essential Medical List

 

DELHI GOVERNMENT  EMPLOYEES HEALTH SCHEME
Delhi Government Employees Health Scheme (DGEHS) was launched in April 1997 with a view to provide comprehensive medical facilities to Delhi Government employees and pensioners and their dependants on the pattern of Central Government Health Scheme. All health facilities (hospitals/dispensaries) run by the Govt. of NCT of Delhi and autonomous bodies under Delhi Government, local bodies viz. MCD, NDMC, Delhi Cantonment Board, Central Government and other Government bodies such as AIIMS, Patel Chest Institute (University of Delhi) etc. are recognized under the scheme. In addition, some Private Hospitals/Diagnostic centers notified from time to time are also empanelled/ empanelled as referral health facilities. The scheme has been modified for the benefit of beneficiaries vide Office Memorandums dated 06.10.2003, dated 21.2.2005, dated 25.10.2007, dated 28.07.2010, 31.01.2012 and 27.04.2012. 

OBJECTIVE OF SCHEME


    It is a welfare scheme with the objective to provide comprehensive medical care facilities to the Delhi Government employees/ pensioners and members of their families on the lines of CGHS.
 
  SALIENT FEATURES OF THE SCHEME

     
  • Comprehensive health Care services to employees and pensioners of Delhi Government through network of Delhi Government dispensaries, Hospitals and Govt./Private empanelled Hospitals and Diagnostic Centers.
  •  
  • All Hospitals/Dispensaries under Delhi Govt., its autonomous bodies and under local self Governance Bodies (viz. Municipal Corporation of Delhi, New Delhi Municipal Council and Delhi Cantonment Board) are recognized for the purpose of medical attendance. Under the scheme it is envisaged to empanel Private Hospitals and Diagnostic Centers in addition to already existing Government facilities for the beneficiaries for availing hospital care and diagnostic facilities. These Private Hospitals/ Diagnostic centers are also envisaged to provide cashless facility in case of medical emergencies to the beneficiaries.
  •  
  • Based upon CGHS pattern
  •  
  • Membership is compulsory for all eligible serving employees of GNCTD and for retired employees they have to opt the scheme or Fixed Medical Allowance at the time of retirement.
  •  
  • Each beneficiary (employee/pensioner) to get attached to Delhi Government Allopathic Dispensary/ Hospital and that would be his/her AMA for all the purpose.
  •  
  • Benefits of the scheme are prospective in nature.
  •  
  • On the basis of prescribed rate of Contribution for its membership.
  •  
  • vide O.M dated 17/08/2015: the need for Authorization/Referral for entitled treatment for self and dependent family members in private recognized hospitals for all subscribers/beneficiaries of DGEHS is not required for serving employees and pensioner beneficiaries.
  •  
  • Treatment facilities – cashless facility for all beneficiaries during emergency in empanelled private hospitals, and for pensioners’ cashless facility is available even in non emergent conditions.
  •  
  • Prevailing CGHS rates for availing treatment/diagnosis in private empanelled hospitals/diagnostic centers.

FACILITIES PROVIDED TO MEMBERS

  The following facilities are being provided to the beneficiaries through the recognized health facilities under DGEHS i.e Govt. dispensaries/ hospitals &Private empanelled hospitals:

  • Out Patient care facilities in all systems.
  •  
  • Emergency services in Allopathic system.
  •  
  • Free supply of necessary drugs.
  •  
  • Lab. and Radiological investigations.
  •  
  • Super specialty treatment i.e. Kidney transplant, CABG, Joint replacement etc.
  •  
  • Family Welfare Services.
  •  
  • Specialized treatment/Diagnosis in hospitals, both in Govt. and private empanelled hospitals /Diagnostic centers under DGEHS.

FACILITIES NOT ADMISSIBLE FOR THE PENSIONERS

     
  • Treatment outside India.
  •  
  • Administration of routine injections, dressing at one’s residence.
  •  
  • Orthodontic treatment.
  •  
  • Treatment for obesity due to inogenous factors.

PERSONS ELIGIBLE TO OPT FOR DGEH SCHEME:

     
  • All Delhi Government working and retired employees (including family pensioners)
  •  
  • Sitting and Ex-MLAs and Ex-Metropolitan councilors and their dependents,.
  •  
  • Sitting and retired judges of High Court of Delhi.
  •  
  • Retired officers of Indian Administrative Service/Indian Forest Service of AGMUT Cader, officers of DANICS/UTCS cadre including their family pensioners.
  •  
  • Autonomous/Statutory bodies fully funded by Delhi Government
  •  
  • Families of IAS AGMUT Cadre /DANICS officers posted outside Delhi on deputation/short term transfers on payment of DGEHS subscription in advance on yearly basis.

ELIGIBILITY 

  • All Delhi Government working and retired employees (including family pensioners) and their dependent family members (As per CS (MA) rules are eligible for becoming the member of Delhi Govt. Employees Health Scheme.
  •  
  • The family pensioners are also eligible to become the members of the scheme.
  •  
  • The scheme has been made open ended i.e the pensioner can become the member of the scheme at any time.
  •  
  • As per CSMA rules/CGHS Guidelines for Serving Employees “Family” means:
  •  
       
    • Husband or wife as the case may be
    •  
    • Wholly dependent/minor children,(Unmarried son- up to age limit of 25 yrs, Unmarried daughter & widowed daughters( Not their children) - No age limit.
    •  
    • Sisters – unmarried or widowed sister – No age limit.
    •  
    • Brothers - Minor
    •  
    • Step children and parents.
    •  
    • Grand parents, grand children, daughter in law etc are not eligible as dependent under the scheme under any circumstances.
  • For availing medical facilities under DGEH Scheme spouse, children, parents, sisters, widowed/ divorced / separated daughters, minor brothers, stepmother shall be deemed to be dependent on the government servant if they are normally residing with him/her and their income from all sources including pension and pension equivalent to DCRG benefit/family pension, does not exceed Rs. 3500 plus amount of dearness relief thereon drawn as on the date of consideration (w.e.f. 1.1.2009), as per provisions contained in CS(MA) and CGHS rules issued from time to time.
  •  
  • Delhi Govt. employee which are getting fixed medical allowance, have to opt either for membership of Delhi Govt. Employees Health Scheme by surrendering the fixed medical allowance facility or they can opt fixed medical allowance. Dual benefits are not allowed under Delhi Govt. Employees Health Scheme.
  •  
  • In case the retired employee is getting FMA and wants to opt the scheme then he has to first apply for stopping the FMA then he has to deposit the requisite subscription of the DGEHS at the prevailing rates .Only one time switchover is permissible in lifetime.
  •  
  • As per CS (MA) rules in Case spouse of employee is also Govt. servant then if only one of the spouses wants to avail the benefits of the scheme, the other spouse being considered dependent for the purpose of medical benefits may be beneficiary provided he/she is not getting any type of medical benefit/allowance in this regard from his/her office. A joint declaration in this regard that both of them will be getting the benefits under the scheme may be obtained from them while issuing the membership/health card.
  •  

PROCEDURE FOR ISSUING OF MEDICAL CARD 

  • An employee / pensioner of Delhi Govt. first may approach to his respective administrative office from where he/she is drawing his/her salary/pension to get DGEHS membership.
  •  
  • Respective administrative office would issue the Medical Index forms to the applicant which is to be filled up by the applicant.
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  • Respective administrative office shall verify all the details as per the service record and as per CS(MA) rules of the applicant.
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  • Respective administrative office shall ask the applicant pensioner to submit the requisite prevailing subscription as per the provisions of the scheme.
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  • The Medical Facility Card will be issued by respective administrative office after verifying the records and as per eligibility and depositing of requisite amount (If any).
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  • There are three copies of Medical Index Form, after issuance of the card to the applicant, one copy of Index Form has to be retained by the card issuing authority, Second copy has to be submitted to the AMA and third copy of index form has to submit to SPO (DGEHS) by the card issuing authority.
  •  
  • Applicant has choice to choose his AMA i.e. Delhi Govt. Allopathic Dispensary or Delhi Govt. Allopathic Hospital to which he wants to attach as per his convenience. Changing of the AMA is not permissible under normal circumstances except on change of residence of the card holder or any valid reason to the satisfaction of issuing authority.
  •  
  • The subscription of the applicant would be submitted to the concerned deptt from the date applicant applies for the membership.
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  • Respective administrative office must decide the entitlement of the beneficiary on the basis of the basic pay drawn by the employee or the last basic pay drawn in case of pensioner as per the provisions of the scheme.
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  • Respective administrative office must mention the validity of card and entitlement of ward of the beneficiary on the card.
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  • The subscription amount deposited by the pensioner shall be clearly mentioned on the card.
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  • When there is a change of residence necessitating change of AMA, the Govt. Servant concerned should submit an application in duplicate to the card issuing Authority together with DGEHS Medical Facility Card. The card issuing authority shall make entry in the DGEHS Medical facility Card and index form and attest the same. The Medical Officer I/c will make entry in the records and shall hand over the index form to the card holder with the directions to hand over the same to the Medical Officer I/c of the new dispensary i.e new AMA.
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  • The admn deptt may ensure that DGEHS card issued to that employee while in service must be surrendered at the time of retirement.
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  • Issuance of any DGEHS card not as per the provisions of the scheme would be the responsibility of card issuing authority.
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  • Any addition / deletion in family must be informed immediately by the beneficiary to his / her office, Authorized Medical Attendant (AMA) and SPO , DGEHS.
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  • The card issuing authority would be responsible for all the entries entered on the card.
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  • The Medical facility card for Ministers shall be issued by GAD, for MLAs and EX-MLA and Ex-Metropolitan Councilors shall be issued from Delhi Legislative Assembly and for Sitting and retired Judges of High Court of Delhi shall be issued by Registrar High Court.
  •  
  • The Medical facility card for Families of IAS AGMUT Cadre /DANICS officers posted outside Delhi on deputation/short term transfers shall be issued from DGEHS Cell at DHS(HQ).
SUBSCRIPTION FOR THE SCHEME

 The following are the current rates of subscription on the basis of Pay / pension of the Delhi Government Employees/ Pensioners: wef July 2009
                                                                               
Sr.No.

Grade pay drawn per month

Rate of monthly Subscription

1

Up to Rs. 1,650

Rs.50.00

2

Rs.1,800, Rs.1,900 and Rs.2400,
Rs.2,400 and Rs.2,800

Rs.125.00

3

Rs.4,240

Rs.225.00

4

Rs.4,600, Rs.4,800 Rs.5,400 and
Rs.6,600

Rs.325.00

5

Rs.7600 and above

Rs.500.00

  • The subscription to the scheme in case of employees would be deducted from salary on monthly basis.

CONTRIBUTION BY PENSIONERS

  Pensioners/Family pensioners have an option to get the membership of the scheme and get their DGEHS Pensioner card made by paying a lump sum amount equivalent to 10 years contribution as due on the date of becoming life time member of the scheme. The beneficiary is not covered under the scheme during the period for which contribution has not been paid. The scheme has been made open ended for the pensioners i.e. the Pensioners who are not members of the scheme can opt for scheme at any stage by paying it’s contribution at the prevailing rates.

     
  • The subscription for the pensioners for the scheme would be applicable from the date of application
  •  
  • The Subscription is to be deposited by the pensioner in the concerned office and a TR5 is issued in this regard. This subscription is further deposited under the budget ‘Major head ‘210’ Medical & Public Health 01- Urban Health Services, 800 – Other receipts’ by the concerned DDO. For any clarification the PAO may be contacted in this regard.
  •  
  • The subscription fees deposited by the pensioner and its validity shall be clearly mentioned on the card.
  •  
  • Subscription for families of IAS AGMUT Cadre /DANICS officers posted outside Delhi on deputation/short term transfers can be deposited on yearly basis in advance payable to Director, Health Services, Delhi
Entitlement of ward for indoor treatment in empanelled hospitals
               
Sr.No.

Pay in pay band/Pension/Family
Pension drawn per month

Ward entitlement

1

Up to Rs. 13,950

General ward

2

Rs.13960 to Rs.19,530

Semi-Private ward

3

Rs.19,540 and above

Private ward


ADDITION OR DELETION OF DEPENDENTS –

  Addition to the family may be required in following cases

     
  • Marriage of the DGEHS beneficiary (requiring inclusion of spouse’s name)
  •  
  • Birth of a child
  •  
  • Parents becoming dependents.

The beneficiary shall submit a request in his/her office for addition of a name in the list of dependents along with required documents. The administrative department shall take a decision in view of dependency rules. The name shall be added by the concerned administrative office in the family and intimation of the same shall be sent to AMA and DGEHS branch at DHS (Head Quarters).

 

DELETION FROM THE FAMILY
 
  Addition to the family may be required in following cases: 

  • Deletion of the name of a member shall ber required, in the following circumstances-
  •  
  • Death of eligible member in the family
  •  
  • Member becoming ineligible to be included (i.e. falling outside the scope of dependency). It is the responsibility of the beneficiary to get the name of the dependent deleted from DGEHS card when such an eventuality occurs. The name shall be deleted by the concerned administrative department. Intimation for the same shall be sent to AMA and DGEHS branch at DHS (Head Quarters). Failure to do so shall entail disciplinary proceedings being initiated against the beneficiary in terms of CCS (CCA) Rules 1965.

IN CASE OF LOSS OF CARD

  In case of loss of health card the issuing department shall issue duplicate health card on receiving an application, a copy of FIR / Complaint lodged with police regarding loss of health card, payment of Rs. 10 for issue of duplicate card and two latest family photographs of the beneficiary.

INSTRUCTIONS FOR GOVERNMENT SERVANTS

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Last Updated : 10 Apr,2018