Who may need reimbursement
Reimbursement can arise where an eligible beneficiary has paid medical expenses that are claimable under CGHS rules. The route can differ for serving employees and pensioners.
Use the correct claim form
An official CGHS Medical Reimbursement Claim Form for serving employees asks for principal-cardholder details, beneficiary ID, patient relationship, hospital details, empanelment status, treatment type, emergency status, prior permission, insurance details, medical advance, amount claimed and bank details.
Core documents
Keep the completed claim form, CGHS card details, prescriptions/referrals/permissions as applicable, hospital bills and receipts, discharge summary, investigation reports, payment evidence and bank details. Additional documents can be required for particular treatments or beneficiary categories.
Emergency claim
If treatment was taken in emergency, make sure the hospital record and claim clearly state that fact. The official claim form itself asks whether treatment was taken in emergency.
Empanelled or non-empanelled hospital
The claim form asks whether the hospital/diagnostic centre was empanelled. This matters because admissibility and reimbursement can depend on hospital status, treatment circumstances and CGHS rates.
Insurance or medical advance
The official form asks whether the beneficiary subscribes to medical insurance and the amount claimed/received, and whether a medical advance was taken. Declare these accurately to avoid adjustment problems.
Bank details
Check account number, IFSC and beneficiary details carefully. Payment can be delayed or returned if banking information is wrong.
Submit through the correct authority
Serving employees normally follow their department/office reimbursement channel; pensioner claims follow the CGHS process applicable to them. Use the latest local/online instructions rather than sending documents to an address copied from an old form.
Track deficiencies
If the claim is returned, note the exact missing document or objection. Resubmit against that deficiency and keep the acknowledgement/reference.
Settlement timeline
Older Government material has referred to target timelines for medical-claim settlement, but this guide does not promise one universal current disposal period for every beneficiary and claim type. Use the timeline shown by the current CGHS/departmental system handling the claim.
Related CGHS guides
CGHS Hub · Referral · Emergency Treatment · Medicines · Medical Reimbursement
Official sources
- Official CGHS medical reimbursement claim form (serving employee)
- VMMC & Safdarjung Hospital official Forms and Formats page
- MoHFW Annual Report 2025–26
Source review: 10 September 2026.