Retired Government Employee Benefits From Both CGHS Card and Ayushman Bharat Scheme.
Can Retired Government Employee Above 70 Years Old Avail Benefits From Both CGHS Card and Ayushman Bharat Scheme?
Retired Government Employee Benefits From Both CGHS Card and Ayushman Bharat Scheme
A common question among retired government employees is whether they can avail of benefits from both the Central Government Health Scheme (CGHS) and the Ayushman Bharat Scheme, especially if they are above 70 years old.
This is a concern for many seniors who are looking for affordable healthcare options.
The answer to this question depends on several factors, including the eligibility criteria for both schemes and the specific rules set by the government.
What is the CGHS Card?
The Central Government Health Scheme (CGHS) is a health insurance scheme for central government employees, pensioners, and their dependents. It provides medical treatment and reimbursement for health-related expenses at government hospitals and CGHS empanelled private hospitals.
Retired government employees who are eligible for CGHS can apply for a CGHS card. This card allows them access to healthcare services under the scheme. CGHS benefits include free medical treatment, medicines, diagnostic tests, and surgeries at CGHS dispensaries or empanelled hospitals.
What is Ayushman Bharat Scheme?
Ayushman Bharat, also known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), is a health insurance scheme launched by the Indian government in 2018.
The scheme aims to provide free healthcare coverage of up to Rs 5 lakh per family annually to over 10 crore low-income families.
The primary goal of Ayushman Bharat is to offer affordable medical treatment to economically weaker sections of society.
Ayushman Bharat provides cashless treatment at government hospitals and empanelled private hospitals. It covers a wide range of medical services, including hospitalization, surgeries, and diagnostics, for individuals whose families fall under the scheme’s eligibility criteria.
Can Retired Government Employees Over 70 Avail Both Schemes?
The question of whether retired government employees, especially those over 70 years of age, can avail benefits from both CGHS and Ayushman Bharat is not straightforward. The government has specific guidelines that help clarify this matter.
- CGHS Benefits for Retired Employees:
Retired government employees who were covered under CGHS during their service are eligible to continue receiving these benefits after retirement. The eligibility is not based on age alone, but rather on whether the person was a government employee and whether they opted for CGHS after retirement. This scheme offers lifetime health benefits, so individuals can avail of medical treatment through CGHS even after they turn 70, as long as they have an active CGHS card. - Ayushman Bharat Eligibility:
Ayushman Bharat primarily targets low-income families, and its benefits are meant for those who do not have any health insurance coverage or whose medical expenses are beyond their means. Retired government employees who have CGHS coverage are generally not eligible for Ayushman Bharat benefits. This is because CGHS is considered a comprehensive health coverage scheme and is already offering medical benefits to its cardholders. However, if a retired government employee is not enrolled in CGHS and belongs to an eligible family as defined by the Ayushman Bharat scheme, they could avail of Ayushman Bharat benefits. This is possible in cases where the retired employee belongs to a family that qualifies as economically weaker or does not have access to comprehensive healthcare coverage. - Can They Avail Both?
Generally, retired government employees who have CGHS coverage cannot avail of benefits from Ayushman Bharat at the same time. The reason is that both schemes provide similar healthcare benefits, and the government does not allow a person to avail of dual coverage under these two schemes simultaneously. However, there can be exceptions in certain circumstances. For example, if a retired government employee’s family members (who may not be covered under CGHS) are eligible for Ayushman Bharat, they can still receive benefits under this scheme. In such cases, the retired government employee would benefit from CGHS, while their family members might use Ayushman Bharat for healthcare services.
What Should Retired Employees Over 70 Do?
If you are a retired government employee over 70 years old, here are some steps you can take to ensure that you are making the most of the available health schemes:
- Check CGHS Eligibility: First, confirm that you are enrolled in the CGHS scheme and have an active CGHS card. You can visit the nearest CGHS dispensary or check the official CGHS website for any updates.
- Explore Ayushman Bharat: If you are not enrolled in CGHS or if your family is eligible, you may consider applying for the Ayushman Bharat scheme. Visit the official Ayushman Bharat website or your local Common Service Center (CSC) to check if your family qualifies.
- Consult Healthcare Providers: If you need medical treatment, consult healthcare providers to understand which scheme is best for your needs. CGHS offers better coverage for retirees, especially for those with chronic illnesses or long-term medical conditions, while Ayushman Bharat is more suitable for families with financial constraints.
- Understand Benefits for Family Members: Even if you cannot avail of Ayushman Bharat benefits directly, your family members may still be eligible for this scheme. This could be especially useful for senior citizens who need additional support for healthcare expenses.
Retired Government Employee Benefits From Both CGHS Card and Ayushman Bharat Scheme
Retired government employees above 70 years old can continue to avail benefits from CGHS as long as they are enrolled in the scheme.
However, they generally cannot use both CGHS and Ayushman Bharat simultaneously, as the two schemes overlap in terms of the benefits they offer.
Ayushman Bharat is mainly for low-income families who do not have access to other health insurance schemes like CGHS.
Retired government employees should focus on making full use of CGHS benefits, while also checking whether their family members are eligible for Ayushman Bharat. It is important to stay informed about both schemes and ensure that healthcare needs are met through the available options.