Question : REIMBURSEMENT OF MEDICAL EXPENSES TO PENSIONERS

(a) whether the Government are aware that retired Government employees CGHS card holders are facing a lot of difficulties to get reimbursement of medical expenses from the CGHS Wing of Health Ministry;

(b) if so, the reasons therefor;

(c) whether the Government propose to change the system and allow reimbursement of medical expenses to the retired employees through the Department from where the Government employee retired; and

(d) if so, the details thereof and the time by which such instructions are likely to be issued to all the Government Departments in this regard?

THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI A. RAJA)

(a)&(b): The Government is aware of the difficulties being faced by the pensioner beneficiaries of CGHS in getting reimbursement of medical expenses.

In this connection, the Govt. has taken various measures like issue of advertisement in the major newspapers of CGHS covered cities calling pensioner beneficiaries of CGHS to express their grievances, if any, relating to reimbursement of medical expenses through the CGHS. The grievances received from the pensioners are forwarded to the Heads of the CGHS organisation in the concerned CGHS covered cities for taking immediate necessary action for redressal of the same.

All the Additional Directors/Joint Directors functioning as the Head of CGHS covered cities have been delegated the powers to settle medical claims of CGHS pensioner beneficiaries in accordance with the rules and subject to a fixed financial limit. In a few cases, medical claims of pensioner beneficiaries of the CGHS are referred to the CGHS(HQ) in New Delhi for being considered under relaxation of rules, etc.

Grievances of CGHS beneficiaries and their redressal by the Governemnt is a continuous process and the Government is constantly making its endeavour to reduce the same.

(c): There is no such proposal at present under consideration of the Govt. for changing the present system of reimbursement in respect of CGHS pensioner beneficiaries.

(d): In view of (c) above, the question does not arise.