8th Pay Commission Update: New Insurance Scheme Likely to Replace CGHS

Central Government Health Scheme (CGHS) has been an important healthcare provider for central government employees and pensioners. Over the last ten years, especially during the 7th Pay Commission period, CGHS has seen many changes and updates. With the 8th Pay Commission coming up, many are curious about possible changes, including the chance of replacing CGHS with a new insurance-based scheme. This article looks at the major reforms, recent digital updates, and what to expect in the future for CGHS.

Major Changes in CGHS During the 7th Pay Commission

Between 2016 and 2025, CGHS kept improving to make healthcare easier to get and better for its users.

• Ward Allocation: Eligibility for general, semi-private, and private wards in private hospitals was linked to employees’ basic salary, making access fair based on pay scale.
• Linking to ABHA ID: Work started to connect CGHS cards with the Ayushman Bharat Health Account (ABHA), though mandatory linking was delayed.
• Easy Card Issuance: CGHS cards are now automatically given to employees whose salary includes CGHS contributions, making the process simpler.
• Simplified Referral Process: Treatment without referral in government hospitals was allowed, consultation with up to three specialists on a single referral in private hospitals was permitted, and the age limit for CGHS benefits was lowered to 70 years.

These changes made healthcare more accessible and convenient for central government employees and pensioners.

Digital Updates and New Rules in 2025

The year 2025 brought a big digital upgrade for CGHS, making services faster and clearer.

• Online Application and Equipment Approval: Digital approvals for medical devices like CPAP, BiPAP, and oxygen concentrators were introduced, speeding up the process.
• Better Payment System: The old payment system was replaced by a new Health Management Information System (HMIS) portal, making sure all payments are handled efficiently online.
• Launch of MyCGHS App: The mobile app lets you transfer cards, add dependents, and use other services, making CGHS easier to use.
• Relaxed Photo Rules: Photos are now only needed at admission and discharge for admitted patients, with simpler procedures for critical illnesses and elderly patients.
• Expanded Physiotherapy Services: Physiotherapy is now available at patients’ homes, improving convenience and care quality.
• Time-bound Approvals and Alerts: Medical equipment approvals are promised within five days, with status updates sent via SMS and email.

These digital updates have made CGHS more accessible and efficient for all users.

Expected Changes Under the 8th Pay Commission

With the 8th Pay Commission announced but formal notifications and appointments still pending, employees and pensioners are eagerly waiting.

Possible Replacement with Insurance-Based Scheme

There is ongoing talk about replacing CGHS with a new insurance-based scheme called CGEPHIS. This change aims to offer more complete and modern health services to central government employees and pensioners.

Employee Requests and Future Health Service Improvements

• Adding More Hospitals: Employees want CS(MA) and ECHS hospitals included under CGHS to make treatment easier to access.
• Proportional Improvement in Facilities: With expected salary and pension increases, employees want health facilities and contributions to improve accordingly.

These requests show the desire for better healthcare benefits along with financial improvements under the new pay commission.

In short, CGHS has changed a lot over the last ten years, especially during the 7th Pay Commission, with digital updates in 2025 making it easier to use. As the 8th Pay Commission approaches, central government employees and pensioners are looking forward to more improvements in health services and benefits.