CGHS guidelines revised! THESE pensioners can’t avail fixed medical allowance facility

In a major update for Central Government Health Scheme (CGHS) beneficiaries, the Ministry of Health & Family Welfare has revised its guidelines for availing fixed medical allowance (FMA) facility by central government pensioners and their dependents living in areas which have the health scheme facility running.

This update has come through a notice stating that the government has extended the CGHS benefits to pensioners and family pensioners of the Union Territory of Puducherry.

This follows the health ministry’s order dated 13.11.2023 and related communications from the Directorate of Accounts and Treasuries, Government of Puducherry.

It is, however, unclear whether this direction on unavailability of FMA in CGHS-covered areas in the UT will lead to similar instructions for other states and UTs as well or not.

Also read: New guidelines for CGHS beneficiaries! Here’s all central govt employees, pensioners need to know

In an Office Memorandum, the health ministry said, “…CGHS facility has been extended to the Pensioners /Family Pensioners of Union Territory of Puducherry.”

“…Fixed Medical Allowance (FMA) hitherto paid to all the Pensioners/Family Pensioners of UT of Puducherry, who are residing in the areas covered under CGHS, shall be discontinued from February 2025 onwards.”

For those living in areas not covered by CGHS (such as Karaikal, Mahe, and Yanam), they have the following options:

They can continue receiving FMA along with CGHS inpatient (IP) benefits only. They can also opt out of FMA and avail both outpatient (OPD) and inpatient (IP) benefits under CGHS.

“Pensioners/Family Pensioners of UT Puducherry who are residing in areas not covered under CGHS may have the option to avail both FMA and CGHS facilities for IP only or they can forego FMA and avail both OPD & IP facilities e.g. Pensioners/Family Pensioners who are residing in Karaikal, Mahe and Yanam regions of UT of Puducherry, which are non-CGHs covered areas are entitled for payment of Fixed Medical Allowance (FMA) except in the cases of those who have opted to migrate to CGHS,” the OM said.

Banks responsible for pension disbursement must implement these changes accordingly, the ministry directed.

Also read: CGHS facilities extended for THESE central govt employees – Check fresh guidelines

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