Delhi Government Employees Health Scheme (DGEHS) was launched in April 1997 with a view to provide medical facilities to Delhi Government employees and pensioners on the pattern of Central Government Health Scheme on the basis of monthly contribution.
For this purpose, the Directorate of
Health Services is providing Health cards to all the Delhi Government
Departments/Offices on receiving their requirement. The cards are issued
to the employees by the respective offices, which entitles them to free
treatment in dispensary/hospital of Govt. of
In case of pensioners, they can
avail of the benefit if they agree to have the rates of subscription deducted
from their monthly pension or make a lump sum payment which is equivalent to
their subscription for five years i.e. 60 months. Pensioners who have
settled outside
The scheme has been modified vide
O.M. No. F.342/81/2003/H&FW/3264 Dated
1.
INSTITUTIONS FOR MEDICAL ATTENDANCE/TREATMENT:
2.
REFERRING AUTHORITY/AUTHORIZED MEDICAL
ATTENDANT:
4. PERMISSION FROM COMPETENT AUTHORITY
No
prior permission is required to undergo medical treatment health
facilities/institutions under Delhi Government, its autonomous bodies and those
under local bodies (viz. MCD, NDMC and Delhi Cantonment Board) as per CS(MA) rules.
In
non-emergent/routine cases for getting treatment/diagnostic facility from the
empanelled private hospitals/diagnostic centres,
prior permission of the competent authority (usually Head of the Department) on
the advise of Authorised Medical Attendant (AMA) is
required. However, during emergency the patient can directly approach the
empanelled hospitals.
Permission
is needed to take treatment in Central Government hospitals.
4.
MEMBERSHIP OF THE SCHEME
The
membership of scheme will be compulsory for all employees in due course.
However, for the time being, the membership of the scheme will be continued to
be OPTIONAL, for both serving Government employees as well as pensioners, till
further orders. The rate of monthly contribution Delhi Government
Employees/ Pensioners Health Scheme have been revised according to Pay range/Pension/Family
pension and the corresponding contribution required for DGEHS beneficiaries is
as under: -
|
|
Penson/Family Pension |
Rate
of monthly contribution |
|
Upto Rs. 3000 |
Upto Rs. 1500 |
15 |
|
Rs.
3001-6000 |
Rs.
1501-3000 |
30 |
|
Rs.
6001-10000 |
Rs.
3001-5000 |
50 |
|
Rs.10001-15000 |
Rs.
5001-7500 |
75 |
|
Rs.15001&
above |
Rs.
7501 & above |
100 |
The
above rates of contribution will be effective with effect from 1.9.03 (The date
of approval by the Cabinet). A lump sum payment of 120 months (10 years)
membership contribution by the pensioners (as per eligible category) will
enable them to avail such medical facilities for life long with prospective
effect.
For
employees, the subscription is deducted from their salaries by the concerned
office.
In
case of pensioners, the subscription can be deposited by the pensioners on
yearly basis. There is also a provision
to deposit the same as lumpsum equal to 120 month
subscription to avail life long benefits under the scheme for the pensioners.
4. FIXED MEDICAL
ALLOWANCES
1. Fixed medical allowances will be
granted as per CGHS rule, (at present being Rs. 100/-pm) to the retired
persons/pensioners, residing in areas not covered by the scheme.
2. Fixed
medical allowance will also be granted to retired persons only, residing
in the areas covered by the scheme, but who do not opt to become member of the
scheme.
5. AVAILABILITY/SUPPLY
OF MEDICINES EQUIPMENTS/APPLIANCES AND MEDICAL REIMBURSEMENT
1.
All
required medicines will be supplied from the dispensary/hospitals of Government
of Delhi.
2.
In
case of non-availability of prescribed medicine, in these institutions the
CMO/MO I/C of the dispensaries/hospitals will purchase them from identified and
approved local chemists, with prior approval of concerned CDMO/MS of the
Hospitals. Accordingly, one chemist shop will be selected and earmarked
and linked with each dispensary/hospital. All our efforts will be made to
ensure codal formalties and
foolproof measure for appropriate selection of chemist shops.
3.
The
purchase of medicines from private source/markets will be separately reimbursed
as per entitlement on the basis of cash memo and appropriate essentiality
certificate, duly signed by the AMA, as per CS(MA)
Rules.
4. All Private recognized hospitals and
diagnostic centers will ensure provision/supply of required
medicines/equipments/appliances/consumable etc. required for the serving
Government employees/pensioners of Government of Delhi, attending the
institutions for treatment on emergency basis and thereafter the Private
Institutions will be reimbursed the said amount from the concerned department
directly (from where the Serving Government employees draw salary & retired
Government servant had last retired and avails pensionary
benefits). In certain unavoidable circumstances or if the employees/pensioners
is forced to purchase the medicines/consumables etc. from market, the same will
be reimbursed later on by the concerned department.
5.
In
case of treatment in Private/Recognized Hospitals, the medical reimbursement
will be up to the maximum ceiling of package amounts/as per entitlement, based
either on approved package rates of CGHS or the CS(MA)
Rules, as the case may be.
GUIDELINE FOR OFFICES FOR ISSUING THE HEALTH CARD
1. Blank health cards (Index Cards(3 copies) and Medical Facility Card(1) for each
beneficiary) are being supplied by Directorate of Health Services to respective
departments for issue to their employees/pensioners who have opted for the
health scheme. In case of pensioners, the issuing authority will be concerned
department from the pensioner has retired.
2. After being filled up, the first
copy of the of the index slip is to be retained by
issuing authority and kept in the services book/personal file of the employee.
The second copy of the card is to be sent to the Medical Officer Incharge of
the dispensary, to which the employee want to be attached. The third copy is
sent to State Program Officer (DGEHS), Directorate of Health Services (HQ) F17,
Karkardooma,
3. The medical facility Card is to be
issued to the employees after being duly filled in. This card shall be used by
the employee for availing medical facilities.
4. The dispensary to which the
beneficiary wants to be attached should be clearly mentioned on the index card as well as medical
facility card.
5. An account of blank index cards and
medical facilities cards received from Directorate of Health Services and
details of cards issued to employees/pensioners have to be maintained in every
office
·
In
case of Education department, the cards are now issued by Directorate of Health
Services to DDEs/RDEs only, from where
concerned/subordinate schools can indent their requirement of DGEHS Cards.
·
In
case of PWD, the individual subordinate office he cards are issued to the Chief
Engineers Offices, Engineer in Chief Office, from where subordinate offices may
get their requirement of DGEHS Cards.
FREQUENTLY ASKED QUESTIONS
1. What
is this ‘
Delhi
Government Health Scheme is a welfare scheme of Delhi Government to provide
medical facilities to Delhi Government employees and pensioners on the pattern
of Central Government Health Scheme on the basis of monthly contribution by the
beneficiaries.
2. Who
can become the member and How?
The
membership of scheme will be compulsory for all employees in due course.
However, for the time being, the membership of the scheme will be continued to
be optional, for both serving Government employees as well as pensioners, till
further orders. The membership of the scheme is prospective in nature
i.e. from the date of becoming the member.
By
contributing the stipulated contribution/subscription one can become the member
of the scheme.
For this
one can approach the office from where the employee is working or has retired
from. On becoming the member, the beneficiary will be issued a medical facility
card, that will entitle the beneficiary the benefit s
of scheme at empanelled hospitals.
The
pensioners who do not opt for the scheme are to get fixed medical allowance at
Rs. 100/- per month.
3. What
is the subscription of the scheme ?
Subscription of the scheme is as per para 3 of
Upto
Rs. 3000 Upto Rs. 1500 15
Rs. 3001-6000 Rs.
1501-3000 30
Rs. 6001-10000 Rs.
3001-5000 50
Rs.10001-15000 Rs.
5001-7500 75
Rs.15001& above Rs. 7501 & above 100
In case of
employees, this contribution
is deducted from the salary on monthly basis.
In case of
pensioners, this subscription can be deposited ON YEARLY BASIS OR AS A LUMPSUM equal
to 120 month subscription to avail life long benefits under the scheme for the
pensioners.
4. I am a pensioner, whether I can become Life
member for the scheme?
There is a
provision for becoming a life member for pensioners only. A lump sum payment of
120 months (10 years) membership contribution by the pensioners (as per
eligible category) will enable them to avail such medical facilities for life
long with prospective effect.
5. I have deposited a lumpsum
of 60 months contribution in 1997 before the modified scheme was notified in
2003. Will I be getting the medical benefits?
For those
pensioners who have deposited 60 months contribution as per scheme orders in
1997, the
medical facilities will be provided to such pensioners under the scheme on life
long basis.
6.
From where the Medical Facility card will be
issued to me?
The
medical facility card will be issued from the office where the employee is
working or from the office from where retired in case of pensioners.
The
concerned office should indent such Medical Facility Card/Index Cards from
State Programme Officer (DGEHS), Directorate of Health Services (HQ), F17,
Karkardooma,
7.
What are the hospitals recognized empanelled under the scheme ?
All health facilities/institutions under Delhi
Government, its autonomous bodies and those under local bodies (viz. MCD, NDMC
and Delhi Cantonment Board) as per CS(MA) rules are
recognized under the scheme.
As on
These hospitals will be providing
treatment/diagnostic facilities at CGHS rates to the beneficiaries of the
scheme. During emergency conditions the hospitals will be providing credit facilities to the
beneficiaries of the scheme.
8.
Do I need a referral to avail treatment facilities in these hospitals?
All
beneficiaries are supposed to get attachment to one of the Delhi Government
Dispensary/Hospital, the Medical Officer Incharge/Medical Superintendent will be the Authorised Medical
Attendant for the respective beneficiaries. In non-emergent/routine cases for
getting treatment/diagnostic facility from the recognized private
hospitals/diagnostic centres, prior permission from
competent on medical advise from Authorised Medical
Attendant (AMA) is required. However, during emergency the patient can directly
approach the private hospitals.
No
permission is needed for getting treatment from health facilities/institutions
under Delhi Government, its autonomous bodies and those under local bodies
(viz. MCD, NDMC and Delhi Cantonment Board) as per CS(MA) rules
9.
Are there any credit facilities for the beneficiary under the scheme?
Currently
credit/cashless facilities are available at 46 notified hospitals/diagnostic centres during emergency treatment for all pensioners. In
this regard, Agreements with these hospitals have been signed. In such cases,
the bill will be sent by the empanelled hospital to concerned offices from
where the health card to the beneficiary has been issued/ or to the office from
where retired in case of pensioners.
In case of
pensioners, the credit/cashless facility is available
during nonemergent conditions also. For this an
authorization/permission from competent authority will be required to the
concerned hospital.
10. Where should I deposit my medical
reimbursement bills?
The
medical reimbursement bills along with essentiality certificate are to be
deposited for reimbursement to the concerned office from where the Medical
Facility card have been issued.
11. My spouse is also in service, whether
he/she can also avail the benefits?
If both
husband and wife are in service, only one of them will contribute to the scheme
and both of them will be getting the benefits under the scheme, the spouse
being dependent on the contributing member for medical reimbursement purpose,
in accordance to CS(MA) rules & the spouse shall not avail medical
reimbursement from his/her office.
12. Whether the scheme is applicable to the
employee where medical allowance is being given?
No, this
scheme is not applicable to the employees who are entitled for any other
allowance /medical facility.
14. Is the scheme benefits available to
pensioners residing outside
Vide
13. Who is a competent authority to sanction
advance?
Under the
scheme, now the financial power to sanction advance for medical treatment to
the tune of 90% of expected expenditure treatment has been decentralized and
delegated to head of the departments vide OM dated 21.2.2005.
LIST OF RECOGNISED HOSPITALS/DIAGNOSTIC CENTRES
UNDER DGEHS
Hospital/Diagnostic Centre, Address, Purpose recognised
for
|
No |
Hospital/Diagnostic Centre |
District |
Purpose Recognised for |
|
1.
|
Arya Vaidya
Sala Kottakkal, |
East District |
Indian System of Medicine |
|
2.
|
|
South District |
Cardiac Procedures like CAG, PTCA, CABG, EP
Study, Cardio Vascular procedure, MRI, CT, Imaging, Chemotherapy & Cancer
Radiation Therapy |
|
3.
|
CD Diagnostic CT Scan
Centre, |
North West District |
CT |
|
4.
|
Centre for Sight, A-23, |
South District |
Specialized purpose-Ophthalmology |
|
5.
|
Diwan Chand
Satyapal Aggarwal Imaging
Research Centre, 10B, Kasturba Gandhi Marg, |
|
All Radiological Investigations and Nuclear
Medicine |
|
6.
|
Dr Anand’s
imaging and Neurological Research Centre, G14, Preet
Vihar, |
East District |
Conventional Radiology, CT and MRI |
|
7.
|
Dr Lal
Path Labs Pvt. Ltd, 54, |
|
Lab |
|
8.
|
Dr Savita
Jain’s Arun Imaging Centre, D-29, Vivek Vihar, |
East District |
Conventional Radiology, USG and Mammography |
|
9.
|
GMR Institute of Imaging
and Research (MRI Scans Pvt Ltd), A-13, |
South District |
MRI |
|
10. |
Mahajan Nuclear Medicine and Bone Densitometry Centre, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi –110060 |
Central District |
Nuclear Medicine and Bone Densitometry |
|
11. |
C-1 Block, Janakpuri, New Delhi-110058 |
West District |
General purpose, specialised
purpose and Dialysis, Non invasive Cardiac Procedures, Diagnostic except
cardiac surgery |
|
12. |
Millenium Bone Densitometry and
Osteoporosis Research Centre, |
Central District |
Bone Densitometry |
|
13. |
Mohan Eye Institute, |
Central District |
Specialized purpose- Ophthalmology |
|
14. |
New Delhi Scan Institute, |
Central District |
CT |
|
15. |
North MR Scan Research Institute, |
Central District |
MRI |
|
16. |
Premadhar Research Institute and
Hospitals in Ayurveda- Naturopathy, Yoga Sciences,
Deep Vihar, Prahladpur
Road, Pooth Kalan (opp. Sec 24 Rohini), Delhi 110042 |
North West District |
Indian System of Medicine |
|
17. |
RG Stone Urological Research Institute, East of Kailash , |
South District |
Lithotripsy |
|
18. |
|
North District |
General and
specialised purpose, Diagnostic except
cardiac surgery |
|
19. |
St |
North District |
General and Specialised
purpose treatment and diagnostic procedures |
|
20. |
Sunder Lal Jain
Charitable Hospital, Ashok Vihar
Phase III, |
North West District |
General and Specialized purpose except cardiac
surgery, Diagnostic procedures |
|
21. |
The Heart Centre, 2, Ring Road, Lajpat NagarIV, |
South District |
Non-invasive cardiac Procedures |
|
22. |
Patparganj, |
East District |
Indian System of Medicine |
|
23. |
|
South District |
All Radiological Investigations & Nuclear
Medicines, Laproscopic Surgery, Dialysis, Urology,
Organ Transplant (Renal, Liver), Lithotripsy, Joint Replacement, Radiation
Therapy, Cardiology, Cardiac Surgery, Cardio Thoracic, Vascular Surgery |
|
24. |
|
West District |
General & specialized purpose, Dialysis,
Laparoscopic Surgeries, Non-Invasive Cardiac Procedure etc., diagnostic
(except Cardiac Surgery) |
|
25. |
Rajiv Gandhi Cancer Institute
& Research Centre, Sector 5, Rohini, |
North West District |
Specialized purpose – Cancer diagnosis, Cancer
Chemotherapy and Radiotherapy |
|
26. |
Tirath Ram Shah Charitable
Hospital, |
North District |
General purpose & Diagnostic |
|
27. |
Escorts Heart Institute and Research
Centre, Okhla,
|
South District |
Cardiovascular Surgery, Invasive and Noninvasive
Cardiology and Pediatric Cardiology |
|
28. |
1st Dwarka
Lab, 185, Sector 6, Pocket1, MIG
Flats, Dwarka, |
Swest District |
All Laboratory investigations except
Histopathology |
|
29. |
Dev Diagnostics Labs.
C9/13, Yamuna Vihar |
Northeast District |
All Laboratory investigations except
Histopathology |
|
30. |
Dr Chopra Bone
Densitometry Centre & Lab, 2, Rajouri Palace,
J1/162, Rajouri Garden, New Delhi 110027 |
West District |
Bone Densitometry |
|
31. |
Dr Garg
Labs (P) Ltd., A73, Laxmi Nagar,
Vikas Marg, |
East District |
All Laboratory investigations except
Histopathology |
|
32. |
Dr SS Doda’s
Ultrasound Centre, 23 B, |
Central District |
All Radiological Investigations, CT,
Mammography, Ultrasound, Colour Doppler,
Echocardiography, TMT & EEG |
|
33. |
Dr Suri
Labs Pvt. Ltd., 23 B, |
Central District |
All Laboratory investigations |
|
34. |
Mahajan Imaging Centre, K18, Hauz Khas Enclave, |
South District |
All Radiological Investigations, MRI, CT, Bone
Densitometry, Mammography, Ultrasound, Colour
Doppler, Echocardiography and TMT |
|
35. |
National MRI , CT Scan
& Diagnostic Centre MRI Centre
: 17, NWA, Punjabi Bagh, |
West District |
All Radiological Investigations, MRI, CT,
Ultrasound, Colour Doppler, Echocardiography, TMT,
ECG, Laboratory Investigations except histopathology |
|
36. |
NMC Imaging and
Diagnostic Centre VIMHANS, 1, Instt. Area, Nehru Nagar, |
South District |
Conventional Radiology, CT, MRI, Ultrasound, Colour Doppler, Laboratory investigations |
|
37. |
Saral Advanced Diagnostic Pvt Ltd. 2, Shakti Vihar, Delhi 110034, MRI Centre & Nuclear Med Lab;
E-1073, Saraswati
Vihar, Delhi-110034. |
North West District |
All Laboratory Investigations, Neurological Lab
Investigations, Nuclear Medicine Laboratory Investigations, All Radiological
Investigations, MRI, CT, Ultrasound, Colour
Doppler, Echocardiography, TMT and EEG, |
|
38. |
YK Diagnostics (Sun
Imaging Centre ) 15, Hargovind
Enclave, Main Vikas Marg,
|
East District |
Bone Densitometry |
|
39. |
3MM ll,
|
Central District |
Specialized purpose :Cardiology, Cardiothoracic
Surgery and Respiratory Medicine and allied Diagnostic Services |
|
40. |
Jeevan Nursing Home &
Hospital, 2B, |
Central District |
General Purpose and specialized purpose :
Laparoscopic Surgery |
|
41. |
Kukreja Nursing Home & Heart
Centre, C1, Vishal
Enclave, |
West District |
General and Specialized purpose :Laparoscopic
Surgery, Endoscopic Surgery, Nephrology, Dialysis,
Cardiology (Interventional and Noninterventional)
excluding cardiothoracic surgery |
|
42. |
|
Central District |
General and Specialised
purpose |
|
43. |
Instt.Area, Madhuban
Chowk, Rohini, |
North West District |
General and Specialised
purpose including Cardiothoracic Surgery |
|
44. |
|
North West District |
General and Specialised
purpose excluding Cardiothoracic Surgery |
|
45. |
|
East District |
Cancer Diagnosis, Chemotherapy, Radiation,
Palliative Care, Rehabilitation and General Diagnostic Purpose |
|
46. |
Sri Balaji
Action Medical Institute, FC-34, A-4, Paschim Vihar Delhi-110063 |
West District |
General purpose and Specialized purpose:Cardiology inclusive Cardiothoracic &
Vascular Surgery, Neurosurgery, Urology, Joint replacement, Laparoscopic
Surgery, Gastroenterology, Dialysis |
|
47. |
67/1 and 66 A/2, New |
Central District |
General and specialized purpose: Laparoscopic
Surgery, Dialysis, Lithotripsy, Nephrology, Neurology, Neurosurgery, Non interventional Cardiology, except
Cardiac Angiography/ Cardiac Surgery |
|
48. |
A5-6, Kirti
Nagar, |
West District |
General and Specialized purpose: Nephrology,
Dialysis, lithotripsy, laparoscopic
surgery, interventional cardiology excluding cardiothoracic surgery |
|
49. |
Delhi Institute of
Functional imaging, K16, South Extension, |
South District |
Nuclear Medicine, SPECT Scan |
|
50. |
Focus Imaging &
Research Centre, CT Scan / Diagnostic
Centre: C-10, MRI Centre : 47/1-2, Yusuf Sarai Mkt. Aurobindo Marg , |
South District |
All Radiological Investigations, MRI, CT, Bone
Densitometry, Mammography, Ultrasound, Echocardiography, Colour
Doppler, ECG, EEG. |
|
51. |
|
South District |
Indian System of Medicine. |
|
52. |
12,
Chowkhandi, |
West District |
General Purpose including Laparoscopic Surgery. |
|
53. |
|
South District |
General and Specialized Purpose: Orthopedic
Joint Replacement, Nephrology, Dialysis, Urology, Gastroenterology,
Laparoscopic Surgery, Cancer Diagnosis and treatment (Cancer Chemotherapy,
Cancer Surgery) except Radiotherapy. |
|
54. |
|
East District |
General Purpose including Laparoscopic Surgery
& Lithotripsy. |
|
55. |
Sun Imaging Centre, (YK
Diagnostics) 15, Hargovind
Enclave, Vikas Marg, |
East District |
All Radiological Investigations, CT, MRI, USG,
Echocardiography, Colour Doppler and Bone
Densitometry’. |
IMPORTANT CIRCULARS
For
suggestions/corrections to this page please contact/write or email to:
Dr PARVEEN KUMAR
SPO(DGEHS)
DGEHS Cell
Directorate
of Health Services
DHS(HQ), F17,
Karkardooma,
Email: dirdhs@nic.in
Notice: Click
here for application format for empanelment under DGEHS (AppFormatDGEHS2k6.pdf)