CGHS for Pensioners

CGHS for pensioners is the set of rules under which a central government pensioner joins the Central Government Health Scheme after retirement: a pensioner in a CGHS city pays the contribution for the pay level they held at retirement, either annually or as a one-time payment of 120 months for a whole-life card, and in return holds the same medical cover in retirement that came with the job, for life.

For most retiring employees the CGHS pensioner card is the single most valuable benefit of a government career after the pension itself. In service the medical cover comes automatically, with the contribution deducted from salary; at retirement that automatic cover ends, and the retiree has to take a positive step to carry it into retirement. The step is worth taking, because in old age, when medical needs are greatest and private cover is dearest and hardest to get, the CGHS card gives outpatient care, free medicines and hospitalisation at CGHS rates, for a one-time payment that the medicines alone often repay within a few years.

This article is the pensioner’s guide to that step. It covers who can join and when, the choice between an annual card and a whole-life card, the one-time amounts and why the whole-life card is usually the better value, the slab the payment is worked out on, the requirement to surrender the Fixed Medical Allowance first, paying through the Bharatkosh portal under the 2024 guidelines, the top-up and spouse-transfer rules, the ward entitlement of a pensioner, and the position of a pensioner who lives in a place with no CGHS Wellness Centre. The general design of the scheme is in the CGHS cornerstone article ; this article is the pensioner’s slice of it.

Joining CGHS as a pensioner

A central government pensioner residing in a CGHS city can join the scheme by applying for a pensioner CGHS card. The application is made to the CGHS authorities of the city, with the pension payment order and the supporting documents, and, since the move to the online system, it is largely handled through the CGHS portal with payment through Bharatkosh. The best practice is to apply as retirement approaches, so that the pensioner card is ready when the serving-employee card lapses on the last day of service, and there is no gap in cover.

The pensioner card replaces the serving-employee card, and it covers the pensioner and the dependants who were covered in service, subject to the dependant test continuing to be met. A pensioner who did not use CGHS in service, because they were posted in a non-CGHS city, can still join on retirement if they settle in a CGHS city, and a pensioner who moves to a CGHS city later can join then. The scheme is open to the pensioner throughout retirement, not only at the moment of retiring.

Both the Old Pension Scheme pensioner and the retiree under the National Pension System framework can join, because CGHS membership follows from having been a central government employee, not from the particular pension scheme. The Unified Pension Scheme retiree is in the same position. What matters for CGHS is the central government service and the pay level held at retirement, which fixes the contribution slab.

The annual card and the whole-life card

A pensioner has a choice between two ways of paying, and the choice is the main decision in joining. The first is the annual card: the pensioner pays twelve months of contribution at a time and renews each year. The second is the whole-life card, also called the rest-of-life card: the pensioner pays 120 months, that is ten years, of contribution once, and holds a card valid for the rest of their life with no further payment.

The one-time whole-life amount is 120 times the monthly slab, so it depends only on the slab for the pay level held at retirement. The four amounts are set out below.

The whole-life card is, for a pensioner who expects to remain in a CGHS city, almost always the better choice. It buys ten years of contribution in exchange for cover that runs for a retirement commonly lasting two or three decades, so the cost per year of cover falls the longer the pensioner lives. The free medicines for a single chronic condition, managed month after month at the Wellness Centre, usually add up to more than the one-time payment within a few years, after which the card continues at no further cost, and a single major hospitalisation at CGHS package rates repays it many times over. The annual card is the sensible choice only for a pensioner who is genuinely unsure whether they will stay in a CGHS city, since it avoids committing the whole-life amount to a scheme they may leave.

The contribution slab: the last pay level

The slab a pensioner pays, whether annually or as the whole-life payment, is the contribution for the pay level they held at the time of retirement. This is the point that most often surprises pensioners: the CGHS contribution is not worked out on the pension. A pensioner who retired from Level 7 pays the Level 7 slab of Rs. 650, and the whole-life amount is 120 times that, Rs. 78,000, even though the pension is a different, lower figure than the last basic pay.

The logic is that the slab tracks the level in service, not the income in retirement, so a pensioner continues on the same contribution band they were in as an employee. This keeps the pensioner contribution aligned with the serving-employee contribution for the same level, and it means a pensioner can work out their whole-life amount simply by taking the slab for their last level and multiplying by 120. The contribution and ward entitlement article sets out the slab for each level.

Surrendering the Fixed Medical Allowance

There is one condition that must be cleared before a pensioner can take a CGHS card. A pensioner who is drawing the Fixed Medical Allowance , the Rs. 1,000 a month paid to a pensioner in a non-CGHS area for outpatient care, must surrender it before taking the card, because the allowance and a CGHS card cannot be held together.

The reason is that the two benefits answer the same need, outpatient medical care, in two different ways: the Fixed Medical Allowance gives a cash sum where there is no CGHS Wellness Centre to use, and CGHS gives the care in kind where there is. A pensioner cannot draw the cash allowance for outpatient care and also hold a card that provides that same outpatient care, so the rules require a choice. The choice can be changed once in a lifetime, under the Department of Pension and Pensioners’ Welfare Office Memorandum dated 23 March 2022, so a pensioner who moves from a non-CGHS area to a CGHS city, or the other way, can switch between the allowance and the card once.

Paying through Bharatkosh and the 2024 guidelines

The procedure for a pensioner card was consolidated in the Ministry of Health and Family Welfare Office Memorandum No. S.11012/1/2024-EHS dated 27 June 2024, the guidelines for the issue of CGHS cards to serving employees and pensioners. Under these guidelines the contribution is paid through the government’s Bharatkosh payment portal, so a pensioner makes the payment online rather than by a physical challan, and the card is issued against the payment.

The 2024 guidelines confirmed the whole-life option, the annual option, and two practical facilities that matter to pensioners. The first is the top-up: a pensioner who holds an annual card, or a card for a limited number of years, can move to a whole-life card by paying only the balance of the 120 months, rather than the full amount again, so the years already paid for are credited. The second is the spouse transfer, described below. The guidelines also confirmed that a pensioner drawing the Fixed Medical Allowance must surrender it before the card is issued.

Top-up and the spouse card

The top-up facility means the whole-life card is not an all-or-nothing decision at retirement. A pensioner who is unsure at first can take an annual card, use the scheme for a year or two, and then convert to a whole-life card by paying the balance of the 120 months, with the years already paid counted. This lets a pensioner defer the full commitment without losing the value of what they have already paid.

The spouse transfer means the whole-life card continues for the family. Under the 2024 guidelines a whole-life pensioner card can continue for the spouse, so on the death of the pensioner the surviving spouse, who draws the family pension , keeps the CGHS cover on the same card rather than having to buy a fresh one. The scheme is designed to follow the family through the whole arc of a career and beyond it, and the spouse-transfer rule is the mechanism that carries the cover from the pensioner to the family pensioner.

A pensioner who bought a whole-life card before the 2017 contribution revision is not asked to pay the difference for the higher current slab. The card bought under the earlier, lower rates remains valid, and only fresh cards and top-ups are charged on the current slabs, so an early buyer is not penalised by a later revision.

Ward entitlement for a pensioner

A pensioner’s ward entitlement in an empanelled hospital, general, semi-private or private, is fixed by the basic pay at retirement against the basic-pay thresholds set out in the contribution and ward entitlement article. Unlike a serving employee’s entitlement, which rises with each increment, a pensioner’s is frozen at retirement, because there are no further increments to lift the basic pay.

There is an important qualification for those who retired before the 7th Central Pay Commission. The government has said that a pensioner who retired before the 7th CPC is not brought under the revised 2022 ward thresholds, so such a pensioner keeps the entitlement fixed by the rules in force at their retirement, rather than being tested against the current basic-pay figures. A pensioner who retired under the 7th CPC is entitled by their last basic pay against the current thresholds. Either way, the pensioner’s ward is settled at retirement and does not change afterwards.

The pensioner in a non-CGHS area

Not every pensioner settles in a CGHS city, and the scheme has a clear answer for one who does not. A pensioner residing in a place with no CGHS Wellness Centre cannot use the scheme’s outpatient care there, so for day-to-day outpatient expenses they draw the Fixed Medical Allowance of Rs. 1,000 a month instead. That covers the routine outpatient care that a Wellness Centre would otherwise give.

For hospitalisation, a pensioner in a non-CGHS area may still hold a CGHS card and use the empanelled hospitals of the nearest CGHS city, subject to the current rules, so that major treatment is met at CGHS rates even though the day-to-day outpatient care is on the Fixed Medical Allowance. The exact combination permitted depends on the prevailing orders, because the allowance and the card cannot both cover outpatient care, so a pensioner in this position should confirm the current arrangement. The core rule is that the Fixed Medical Allowance and CGHS outpatient care are alternatives, while hospitalisation cover through a CGHS card is a separate question.

Applying: timing, documents and avoiding a gap

The timing of the application matters, because the serving-employee card lapses on the last day of service and the pensioner card has to be in place to carry the cover forward without a break. The best practice is to apply for the pensioner card as retirement approaches, so the card is ready on retirement. A retiring employee can apply in the months before the date of retirement, using the details of the pay level and basic pay that fix the slab and the ward entitlement, and pay the contribution through Bharatkosh so the pensioner card issues around the date of retirement.

The application needs the pension papers and the identity documents: the pension payment order or the intimation of it, the last pay certificate that establishes the pay level and basic pay at retirement, recent photographs of the beneficiary and the dependants, and the identity proof the scheme requires. A pensioner who applies late, after the serving card has already lapsed, can still join, but there may be a gap during which neither card is in force, which is why applying ahead of retirement is the safe course. Because the whole-life card issues against a single Bharatkosh payment, a pensioner who plans the application to coincide with retirement moves from the serving card to the pensioner card without an interval in which the family is uncovered.

Dependants on a pensioner card

The pensioner card covers the pensioner and the dependants who satisfy the scheme’s dependant test, in the same way as the serving-employee card did, so the family’s cover continues into retirement. The spouse is covered, as are dependent children within the age and earning conditions and dependent parents who meet the income and residence test, and a dependant with a disability is covered without an age bar. The test is whether the family member is wholly dependent on the pensioner, against the income ceiling the scheme fixes and revises from time to time.

A pensioner adds or removes a dependant through the CGHS authorities in the same way as a serving employee: a dependant is added on marriage, a birth, or a parent coming to satisfy the test, and removed when a child starts earning or a daughter marries, with a card carrying a beneficiary identification number issued for each covered member. Because the dependant conditions and the income ceiling are revised, a pensioner adding a dependant should confirm the current limit. The continuation of the cover for the spouse after the pensioner’s death, through the spouse transfer of a whole-life card, is the most important of these rules for a family, because it carries the medical cover to the family pensioner along with the family pension .

What the card is worth to a pensioner

The value of the pensioner card is easiest to see with a concrete case. A pensioner who retired from a lower pay level pays Rs. 30,000 once for a whole-life card, and one from a middle level Rs. 78,000, for cover that runs for the whole of a retirement. Against that one-time payment stands the cost the pensioner would otherwise carry: the outpatient medicines for a chronic condition such as diabetes or hypertension, which recur every month for life and which no ordinary health-insurance policy meets, and the hospitalisations of later life at private-hospital rates.

For a chronic condition alone, the free medicines from the Wellness Centre commonly add up, over a few years, to more than the one-time whole-life payment, so the card repays itself early and then continues at no further cost. Add a single major hospitalisation at CGHS package rates, well below the open-market price, and the card’s value over a retirement runs to many times the payment. This is why converting to a pensioner CGHS card is one of the most consequential financial decisions a retiring employee in a CGHS city makes, and why, for a pensioner who expects to stay in a CGHS city, the whole-life card is almost always the better choice over the annual one.

The annual card has its place. A pensioner who is unsure whether they will remain in a CGHS city, perhaps because they may move to live with family in a place with no Wellness Centre, may prefer to take the annual card and convert to the whole-life card later, using the top-up facility to pay only the balance of the 120 months once they are settled. For a pensioner who is settled in a CGHS city, though, the whole-life card is the straightforward choice.

The 8th CPC outlook

The pensioner contribution slabs follow the serving-employee slabs, so they will change only when the 8th Central Pay Commission revises the contribution and the Ministry of Health and Family Welfare issues a fresh order. The commission was constituted by gazette notification on 3 November 2025 but has not yet reported, and no revised slab or whole-life amount can be stated as fact until it does. Until then a pensioner joins on the slabs of the 9 January 2017 order: Rs. 250, Rs. 450, Rs. 650 or Rs. 1,000 a month by the last pay level, and 120 times that for a whole-life card.

Related Articles

• Central Government Health Scheme (CGHS)
• CGHS contribution and ward entitlement
• Reimbursement of medical expenses
• Fixed Medical Allowance
• CS(MA) Rules 1944
• Ex-Servicemen Contributory Health Scheme (ECHS)
• Central government pension
• Family pension
• Old Pension Scheme
• National Pension System
• Unified Pension Scheme
• PPO and life certificate
• Income tax for pensioners
• Section 80D deduction
• Pension calculation
• Dearness relief
• Central government employees in India

External references

• Central Government Health Scheme (CGHS)
• Ministry of Health and Family Welfare
• Department of Pension and Pensioners’ Welfare
• Bharatkosh payment portal

References

1. Ministry of Health and Family Welfare, Office Memorandum No. S.11012/1/2024-EHS dated 27 June 2024: guidelines for issue of CGHS cards to serving employees and pensioners, including the whole-life card, Bharatkosh payment, top-up and spouse transfer.
2. Ministry of Health and Family Welfare, Office Memorandum No. S.11011/11/2016-CGHS(P)/EHS dated 9 January 2017: CGHS contribution slabs on the 7th CPC recommendations, effective 1 February 2017.
3. Department of Pension and Pensioners’ Welfare, Office Memorandum No. 4/34/2017-P&PW(D) dated 19 July 2017: Fixed Medical Allowance of Rs. 1,000 a month for pensioners in non-CGHS areas.
4. Department of Pension and Pensioners’ Welfare, Office Memorandum dated 23 March 2022: one-time change permitted between the Fixed Medical Allowance and CGHS outpatient care.