Reliable sources within the health ministry suggest that the 8th CPC is seriously considering a long-standing recommendation to transition from the dispensary-based CGHS model to a Comprehensive Health Insurance Scheme. This move aims to provide truly “cashless” and “borderless” treatment across all private hospitals in India, moving away from the limited network of empanelled facilities.

Fixed Medical Allowance (FMA): The ₹3,000 Demand

For lakhs of pensioners living in “Non-CGHS” areas (districts where a government dispensary isn’t within reach), the current Fixed Medical Allowance (FMA) of ₹1,000 per month has become a point of frustration. With the cost of basic medicines and diagnostics nearly doubling over the last decade, the JCM and various Pensioner Associations have officially moved a proposal to triple this amount.

CGHS Rate Revision: Why Your Local Hospital is Hesitating

You may have noticed that many top private hospitals are refusing to accept CGHS patients or delaying treatments. The reason? CGHS package rates were last majorly revised in 2014. The 8th Pay Commission is expected to benchmark CGHS rates to the Consumer Price Index (CPI) to ensure that hospitals get paid fair market value, reducing the “rejection” rates for government patients.

The ‘Health Arrears’ Opportunity

If the 8th Pay Commission implements a retrospective hike in medical allowances, pensioners could see a significant lump-sum payment. A jump from ₹1,000 to ₹3,000 would result in arrears of ₹24,000 per year for those residing in non-CGHS areas. This remains a priority item for the next cabinet meeting.