Centre allows employees to get full claim from insurers/CGHS

NEW DELHI: In a move that would boost the business of health insurers, the Centre has done away with the limits imposed on the amount its employees could claim as reimbursement for their medical expenses from the government and insurance firms.

A recent office memorandum by the Health and Family Welfare Ministry has done away with the monetary caps imposed by the Central Government Health Scheme (CGHS) for different treatments.

"Beneficiaries who have subscribed to medical insurance policies in addition to availing CGHS facilities ... may be allowed to claim reimbursement from both the sources subject to the condition that the reimbursement ... should not exceed the total expenditure incurred," the government said in a circular.

Earlier, the reimbursement of employees who have subscribed to mediclaim policy from an insurance company and comes under the Central Government Health Scheme (CGHS) were not allowed to exceed the package rates prescribed under the CGHS for the particular treatment.

The government was requested by employees to remove the monetary cap as the beneficiaries had no incentive to subscribe to the mediclaim policy. In any case, they would get the amount without subscribing to mediclaim policy.