The central government has removed the geographical restriction that earlier determined whether serving central government employees could avail themselves of healthcare facilities under the Central Government Health Scheme (CGHS). Such employees can now exercise a one-time option to be a CGHS beneficiary, as per an office memorandum (OM) dated September 17, 2026, issued by the Employees’ Health Scheme (EHS) section of the Ministry of Health & Family Welfare. The revised provisions will come into force with immediate effect.

The decision is aimed at addressing difficulties faced by serving central government employees residing/posted either outside the above prescribed geographical coverage of CGHS or in a city not covered by the CGHS.

The Ministry of Health and Family Welfare had earlier specified that CGHS coverage for serving beneficiaries was generally within a five kilometre radius of a CGHS Wellness Centre. Where such demarcations were not specified, an additional director, CGHS, of the concerned city will notify such areas covered under CGHS Wellness Centres. Employee living within the limits of the Municipal Corporation concerned but beyond 5 km radius of a CGHS Wellness Centre and is otherwise a Central Services (Medical Attendance)- CS(MA)- beneficiary, has the option to avail CGHS facility, the Ministry had suggested.

The government has now reviewed these provisions and decided to completely remove the existing geographical criterion for determining the eligibility of serving central government employees for CGHS facilities.

Serving Central Government employees who live outside the prescribed CGHS geographical area and are currently covered under the CS(MA) Rules, 1944 only because of their residence or posting outside the CGHS coverage area can now exercise a one-time option to become CGHS beneficiaries, says the OM.

However, they will have to meet all other applicable eligibility conditions and pay the prescribed CGHS contribution or subscription.

This means that an employee who was earlier required to remain under the CS(MA) Rules because their place of residence or posting fell outside the CGHS coverage area can now choose CGHS, subject to the applicable conditions.

Under CS(MA) Rules, such employees can reimburse their medical expenses such as treatment and medicine, but they can’t avail cashless facilities. However, under the CGHS, they can avail cashless medical facilities.

The rules are different for serving central government employees who live or are posted within the CGHS-covered area.

Employees residing or posted within the CGHS-covered area, which includes the limits of the district headquarters where a CGHS Wellness Centre is situated, will mandatorily come under CGHS, as per the OM

Such employees will not have the option to opt out of the CGHS in favour of medical facilities under the CS(MA) Rules, 1944.

The option to shift from CS(MA) coverage to the CGHS will be available once.

Once an employee exercises the option, the decision will be final and binding, subject to the applicable eligibility conditions.

The government has also clarified that the choice made by the principal beneficiary will apply to all eligible dependents. The entitlement will not be split between the two systems within a family.

An employee or family covered under the CGHS cannot simultaneously avail of or claim medical facilities under the CS(MA) Rules, 1944 and vice versa.

The government order also makes it clear that no travelling allowance or daily allowance (TA/DA) will be payable for treatment or procurement of medicines under CGHS Rules.

Employees opting for the CGHS will have to furnish an undertaking confirming that neither they nor any eligible family member will avail benefits under both the CGHS and CS(MA) Rules.

If any inadmissible benefit is claimed or received under both systems, the amount will be liable to recovery under the applicable rules.

Employees who do not exercise the option to come under the CGHS, will continue to be governed by the CS(MA) Rules, 1944, as applicable.