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CGHS Eligibility: Who Can Get a CGHS Card in 2026
Serving Employees
- Serving employees apply online on the CGHS website. The Head of Department or Head of Office sponsors the request (MoHFW OM 28.06.2024, para A(a) and (b), PDF p. 1).
- From 17.09.2026, the old geographical criterion (5 km of a Wellness Centre) has been totally dispensed with for serving employees (MoHFW OM 17.09.2026, paras 1 and 2, PDF p. 1).
- If you live or are posted within the CGHS covered area, that is the limits of the district headquarters where a Wellness Centre is situated, you must be covered by CGHS and cannot opt for CS(MA) (MoHFW OM 17.09.2026, para 4, PDF p. 1).
- If you are now under CS(MA) only because you live or work outside CGHS coverage, you may make a one-time, final option to join CGHS. The option covers all your dependants (MoHFW OM 17.09.2026, paras 3 and 5(i)-(ii), PDF p. 1).
- If you opt in, you keep paying CGHS contribution wherever you live, cannot use both CGHS and CS(MA), and get no TA/DA for treatment (MoHFW OM 17.09.2026, para 5(iii)-(v), PDF p. 2).
Pensioners and Family Pensioners
- Retired employees and family pensioners drawing pension from Central Civil Estimates, and their dependants, can get a CGHS card if they are not drawing Fixed Medical Allowance (FMA) (MoHFW OM 28.06.2024, para B(a), PDF p. 1).
- You can keep FMA and still take an 'IPD only' card by paying the full subscription. It covers cashless indoor treatment at empanelled private hospitals and designated government hospitals (MoHFW OM 28.06.2024, para B(b), PDF p. 2).
- You pay 12 months' contribution for an annual card or 120 months' for a lifetime card, through Bharat Kosh (MoHFW OM 28.06.2024, para B(d), PDF p. 2):
| Pay Level | One year | Lifetime |
|---|---|---|
| 1 to 5 | Rs 3,000 | Rs 30,000 |
| 6 | Rs 5,400 | Rs 54,000 |
| 7 to 11 | Rs 7,800 | Rs 78,000 |
| 12 and above | Rs 12,000 | Rs 1,20,000 |
- You can apply for a pensioner card with your pension papers, six months before retirement (MoHFW OM 28.06.2024, para B(f), PDF p. 2). Since July 2026, you can also apply through the Bhavishya portal, as an additional mode (MoHFW OM 17.07.2026, paras 1, 2 and 4, PDF p. 1).
Which Family Members Are Covered
The CGHS definition of family includes (MoHFW OM 28.06.2024, Definition of Family, PDF p. 7):
- Husband or wife (first wife only).
- Either dependent parents or dependent parents-in-law.
- Son: until he starts earning or turns 25, whichever is earlier.
- Daughter: until she starts earning or marries, with no age limit.
- Son or unmarried brother with a permanent disability: no age limit.
- Dependent divorced, abandoned, separated or widowed daughters, and dependent unmarried, divorced, abandoned, separated or widowed sisters: no age limit.
- Dependent minor brothers, and minor children of widowed or separated daughters: until majority.
A family member other than the spouse is dependent if income is less than Rs 9,000 plus DA a month, and normally lives with you (MoHFW OM 28.06.2024, Dependency, PDF p. 8).
Changes in 2025 and 2026
- Parents or parents-in-law: both male and female employees may choose either their parents or parents-in-law (MoHFW OM 26.07.2023, enclosed with OM 13.05.2026, para 2, PDF p. 3). A male employee gets a one-time option only, and cannot switch later, even if the parents die (MoHFW OM 13.05.2026, paras 4 and 5, PDF p. 1).
- Sons and brothers with critical or terminal illness: cover may continue for life, subject to dependency and assessment by a Medical Board (MoHFW OM 01.09.2026, para 4, PDF p. 1). Marriage does not end such cover, but it does not extend to his spouse or children (MoHFW OM 01.09.2026, para 4(v)-(vi), PDF p. 2).
- Transgender children and siblings: covered irrespective of age if wholly dependent and holding a certificate from the District Magistrate under the 2019 Act (MoHFW OM 16.09.2025, para 1, PDF p. 1).
Where to Check
Start with the MoHFW card guidelines of 28.06.2024 (MoHFW OM 28.06.2024, PDF p. 1), then the OMs of 13.05.2026 (MoHFW OM 13.05.2026, PDF p. 1), 01.09.2026 (MoHFW OM 01.09.2026, PDF p. 1) and 17.09.2026 (MoHFW OM 17.09.2026, PDF p. 1).
Other categories such as MPs, ex-MPs, eligible autonomous institutions and accredited journalists follow their own instructions (MoHFW OM 28.06.2024, para E, PDF p. 3). If you are not a central civil employee or pensioner, for example in Railways or the armed forces, check the medical rules of your own organisation.
Related Questions
Can I get CGHS if I live in a city without a Wellness Centre?
Yes, if you are a serving employee. The 17.09.2026 OM removed the geographical criterion. If you are now under CS(MA) only for that reason, you can make a one-time option to join CGHS.
Can I cover both my parents and my parents-in-law?
No. You must choose either parents or parents-in-law. A male employee's choice is one-time and cannot be changed later (OM 13.05.2026).
Up to what age is a son covered under CGHS?
Until he starts earning or turns 25, whichever is earlier. A son with a permanent disability is covered without age limit (OM 28.06.2024).
Can a pensioner draw FMA and still use CGHS?
Only through an 'IPD only' card, by paying the full subscription. It covers indoor treatment, not OPD (OM 28.06.2024, para B(b)).
What is the income limit for a dependant under CGHS?
Income below Rs 9,000 plus DA a month, for family members other than the spouse (OM 28.06.2024).
Official Sources
- MoHFW OM No. S.11012/1/2024-EHS dated 28.06.2024: Guidelines for issue of CGHS card to serving and retired employees · Ministry of Health and Family Welfare (CGHS), Government of India
- MoHFW OM No. Z.16025/227/2026/CGHS-III/EHS(8421134) dated 17.09.2026: Eligibility of serving Central Government employees for CGHS · Ministry of Health and Family Welfare (CGHS), Government of India
- MoHFW OM No. S.14025/15/2024-EHS(8270534) dated 13.05.2026: Option to cover parents or parents-in-law (with enclosed OMs of 2023 and 2024) · Ministry of Health and Family Welfare (CGHS), Government of India
- MoHFW OM No. S.11030/54/2023-EHS(8248513) dated 01.09.2026: Relaxation of age and marital status criteria for dependent sons and brothers · Ministry of Health and Family Welfare (CGHS), Government of India
- MoHFW OM No. 2-1/2025-CGHS(HQ)/C&P/EHS(8328809) dated 16.09.2025: Dependent transgender children and siblings · Ministry of Health and Family Welfare (CGHS), Government of India
- MoHFW OM No. S.11012/1/2024-EHS(8283407) dated 17.07.2026: Integration of CGHS with Bhavishya portal · Ministry of Health and Family Welfare (CGHS), Government of India
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This article explains the official rules as published; it is not legal advice. Check the cited document, and your own department's orders, before acting.