CGHS New Rule 2026: Geographical Restrictions Removed for Central Government Employees

In a significant policy shift, the Ministry of Health & Family Welfare has expanded healthcare access for serving central government employees. According to an Office Memorandum (OM) dated September 17, 2026, the government has completely removed the geographical restrictions that previously determined whether an employee could enroll in the Central Government Health Scheme (CGHS).

What has changed in the CGHS eligibility rules?

Previously, CGHS coverage for serving beneficiaries was generally restricted to those residing or working within a 5-km radius of a CGHS Wellness Centre. Employees living beyond this radius were typically governed by the Central Services (Medical Attendance) Rules, 1944, known as CS(MA) Rules.

The CGHS new rule 2026 eliminates this 5-km criterion. Serving central government employees who are posted or reside outside CGHS-covered areas—including cities not covered by the scheme—can now opt to become CGHS beneficiaries, provided they meet other eligibility conditions and pay the required contributions.

CGHS vs. CS(MA) Rules: Key Differences

The primary motivation for employees to switch to CGHS is the nature of medical facility access. While both systems provide healthcare, they differ fundamentally in how payments are handled:

Feature	CS(MA) Rules, 1944	CGHS (Central Government Health Scheme)
Payment Mode	Reimbursement of medical expenses	Cashless medical facilities
Eligibility	Default for those outside CGHS areas	Now optional for those outside covered areas
Coverage	Based on residence/posting	Wellness centres, polyclinics, and empanelled hospitals

Critical Conditions for Opting-In

While the expansion offers more flexibility, the government has imposed strict conditions to prevent the misuse of benefits:

• One-Time Irreversible Option: The choice to shift from CS(MA) coverage to CGHS is a one-time option. Once exercised, the decision is "final and binding" [1].
• Mandatory Enrollment: Employees who already reside or are posted within a CGHS-covered area (defined as the limits of the district headquarters where a Wellness Centre is situated) must remain under CGHS; they cannot opt out in favor of CS(MA) Rules.
• Family Unity: The choice made by the principal beneficiary applies to all eligible dependents. Entitlements cannot be split between the two systems within a single family.
• No Dual Benefits: Beneficiaries cannot claim medical facilities under both CGHS and CS(MA) Rules simultaneously.

Compliance and Penalties

Employees opting for the scheme must furnish an undertaking confirming they will not claim benefits under both systems. The government has warned that providing "false, incorrect, suppressed or misleading information" [2] to obtain benefits will lead to disciplinary action under the Central Civil Services (Conduct) Rules, 1964, and the recovery of any inadmissible benefits.

Additionally, it is important to note that no travelling allowance or daily allowance (TA/DA) will be payable for treatment or the procurement of medicines under the CGHS Rules.