The government has removed the geographical restriction for CGHS eligibility for serving Central government employees, allowing eligible employees outside covered areas to make a one-time switch to CGHS. According to reports from Mint and Zee News, this development was announced by the Ministry of Health and Family Welfare in an Office Memorandum dated 17 September 2026. The new rules permit eligible employees to exercise a one-time and final option to join CGHS, subject to applicable conditions and contribution requirements. The Centre has removed the existing geographical criterion for determining CGHS eligibility of serving Central Government employees, allowing eligible employees residing outside the earlier coverage area to become CGHS beneficiaries. Earlier, CGHS coverage was restricted to employees residing or working within a 5-km radius of a CGHS Wellness Centre under 2018 guidelines, with provisions for certain employees living within municipal corporation limits.
The Central Government Health Scheme (CGHS) is a government healthcare programme launched in Delhi on 1 July 1954, primarily to provide medical care and address difficulties employees faced in claiming reimbursement for outpatient medicines. As reported by Mint, CGHS has expanded significantly over the past few decades and now provides services through Wellness Centres, polyclinics, laboratories and empanelled hospitals. According to the Ministry of Health and Family Welfare's 2024-25 annual report, CGHS had spread to 81 cities, serving nearly 46.87 lakh beneficiaries. The decision is aimed at addressing difficulties faced by employees who are posted or residing outside areas covered by CGHS, including those living in cities where CGHS facilities are not available.
The revised CGHS eligibility rules eliminate the previous geographical criteria that restricted CGHS access based on employee residence or posting. According to Mint and Zee News, the salient features include removal of geographical restrictions, one-time option availability for employees outside covered areas, continued CGHS contribution requirements, and the principal beneficiary's choice applying to eligible dependants. The key change is that living or working beyond the earlier geographical limit will no longer by itself prevent an eligible serving employee from becoming a CGHS beneficiary. Employees who choose CGHS will have to continue paying the applicable CGHS contribution, regardless of where they subsequently reside or are posted. However, employees within covered areas remain mandatorily covered under CGHS and cannot opt for Central Services (Medical Attendance) benefits instead. The order also makes CGHS coverage mandatory for serving Central Government employees residing or posted within the CGHS-covered area, defined as the limits of the district headquarters where a CGHS Wellness Centre is located. Under the new rules, employees can now choose CGHS even if their place of residence or posting fell outside the earlier CGHS coverage area, subject to all applicable eligibility conditions.
The option is not reversible once exercised, and eligible employees must provide an undertaking that neither they nor eligible family members will claim medical benefits under both CGHS and the Central Services (Medical Attendance) Rules, 1944. As reported by Mint and Zee News, incorrect or misleading information can result in serious consequences, disciplinary action, and recovery of inadmissible benefits. The order makes clear that TA/DA will not be payable for treatment or procurement of medicines under CGHS Rules. A family cannot split its medical coverage between CGHS and the CS(MA) system - an employee cannot opt for CGHS while eligible family members continue to claim medical benefits under CS(MA), or vice versa. The revised provisions take effect immediately, with all eligible employees affected by earlier geographical restrictions advised to check their eligibility before proceeding. The government has clarified that the choice made by the principal beneficiary will apply to all eligible dependents, and if any inadmissible benefit is claimed or received under both systems, the amount will be liable to recovery under the applicable rules.
