Monthly Archives: August 2013

Central Government will soon be launching a new health insurance scheme named as CGEPHIS (Central Government Employees & Pensioners Health Insurance Scheme).

               The Government has proposed the Central Government Employees and Pensioners Health Insurance Scheme (CGEPHIS. There is an option for serving employees and current pensioners if they are interested in joining the new scheme. Serving employees and pensioners will have one more option to continue in both, the new scheme and the CGHS.

             Designed specifically for central government employees and pensioners, this scheme is expected to cover about 7 lakh pensioners and 17 lakh serving employees. Offering  maximal coverage for a minimal premium , it’s one of the best health insurance plans to ever been introduced in India and would definitely bring a change in the features of the private health insurance plans as well, especially senior citizen health insurance.

       This scheme is largely being perceived as an upgraded alternative to the current CGHS scheme which works well for those residing in CGHS covered areas, but fails to address the needs of those residing in Non-CGHS areas.  Apparently, this scheme is going to bring the latter immense benefits.

 

Who are covered?

 

This health insurance scheme will benefit newly recruited, serving and retired central government employees. Serving employees and pensioners will have the voluntary option to switch from their CGHS scheme to CGEPHIS. However, it will be mandatory for newly recruited and newly retired.

 

What does it cover?

 

It is a family floater plan that will get the insured a coverage for self, spouse and dependents. At a nominal premium, the plan will feature an annual coverage of 5 lakh and will cover all the specified family members.  The government is trying to get it implemented on cashless basis via smart card (Cashless Access Service).

The coverage will include pre-existing diseases, pre-hospitalization, post-hospitalization, maternity benefit and domiciliary hospitalization.

 

What makes it click?

  • CGEPHIS will provide coverage for all diseases starting from day one. Most of the health insurance plans have a specific waiting period before a disease starts to get covered in the plan.
CGEPHIS Other Plans
No initial waiting period 30 days waiting period
No waiting period for the pre-existing diseases 4 years waiting period
No waiting period for specific diseases like cataract, hernia, etc. 2 years waiting period
  • There’s no limited term for the insurance. The insured will get the coverage till his/her survival.
  • CGEPHIS is purported to be the best health insurance plan around. A utopian version of senior citizen health insurance, it surely is a lucrative scheme especially considering the bitter fact that with age it gets harder to get a decent coverage under most health insurance plans.

When you compare health insurance plans from private insurers to CGEPHIS, the former seems to lose its sheen. 

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