In a major relief for government employees and pensioners, the Centre has introduced a new optional health insurance plan for CGHS members. The policy, named Paripoorna Mediclaim Ayush Bima, is designed to provide additional medical coverage beyond regular CGHS benefits.
The best part? CGHS services will continue as usual, while this new insurance can be added for extra financial protection and wider hospital access.
What Is Paripoorna Mediclaim Ayush Bima?
Paripoorna Mediclaim Ayush Bima is an optional retail health insurance product launched for existing CGHS beneficiaries. It aims to strengthen medical coverage by offering features like:
- Cashless treatment options
- Wider hospital network coverage
- Coverage for modern treatments
- Better flexibility during hospitalization
This plan is being offered as an added layer of support for those who want extra security in case of high medical expenses.
Key Benefits of the New CGHS Optional Insurance Plan
Here are the major highlights CGHS beneficiaries should know:
✅ 1) It Works Alongside CGHS Benefits
This mediclaim policy does not replace CGHS, it complements it. You can keep using CGHS services while also having extra insurance backup.
✅ 2) Cashless Facility + Wider Hospital Network
The plan offers access to a broad hospital network across India, helping beneficiaries get treatment more smoothly with cashless benefits (as per policy conditions).
✅ 3) Coverage for Up to 6 Family Members
One policy can cover a maximum of 6 members, which makes it useful for families who want combined coverage under a single plan.
✅ 4) Pre and Post Hospitalization Coverage
The plan includes:
- Pre-hospitalization expenses: up to 30 days
- Post-hospitalization expenses: up to 60 days
This helps cover tests, medicines, and follow-ups related to treatment.
✅ 5) Room Rent Limits Defined
Room rent is capped based on the sum insured:
- Normal room: 1% of sum insured per day
- ICU room: 2% of sum insured per day
This keeps room charges within a fixed limit.
Sum Insured Options: Up to Rs 20 Lakh
The policy offers two coverage choices:
- Rs 10 lakh
- Rs 20 lakh
It is an indemnity-based plan covering in-patient hospitalization expenses within India.
Co-Payment Choices: 70:30 or 50:50
Beneficiaries can choose a co-payment model:
- 70:30 → Insurance company pays 70%, subscriber pays 30%
- 50:50 → Insurance company pays 50%, subscriber pays 50%
This flexibility allows people to balance premium affordability with out-of-pocket costs.
AYUSH and Modern Treatment Coverage
The policy has special benefits for alternative and advanced treatment needs:
✅ AYUSH Treatments
AYUSH in-patient hospitalization is covered up to 100% of the sum insured.
✅ Modern Treatments
Modern treatments are covered up to 25% of the sum insured, with an option to add a rider to extend coverage further.
Claim-Free Bonus: Extra Benefit Every Year
To reward policyholders, the plan offers:
- 10% cumulative bonus per claim-free year
- Bonus can go up to 100% of the sum insured
That means long-term policyholders could increase their effective coverage significantly over time.
Premium Discounts + No GST Advantage
The policy is designed to be affordable for CGHS members:
- Premium discount of 28% for the 70:30 co-payment option
- Premium discount of 42% for the 50:50 co-payment option
- No GST is charged (to keep costs low)
This makes it cheaper compared to regular retail health policies.
How to Buy Paripoorna Mediclaim Ayush Bima?
CGHS beneficiaries can purchase the policy through New India Assurance Company Limited:
✅ Via their official offices
✅ Through the online platform (expected to be available shortly)
Since it’s a retail product, beneficiaries can subscribe directly without changing their CGHS membership.
Final Words
The launch of Paripoorna Mediclaim Ayush Bima is an important update for central government employees, pensioners, and families covered under CGHS. With up to Rs 20 lakh coverage, cashless access, AYUSH support, modern treatment benefits, and discounted premiums, it can be a strong add-on for anyone looking to reduce healthcare financial stress.
✅ Useful for extra protection
✅ Helps cover high medical bills
✅ Keeps CGHS benefits intact
