Finance Ministry Launches Paripoorna Mediclaim Ayush Bima for CGHS Beneficiaries

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The Ministry of Finance has rolled out Paripoorna Mediclaim Ayush Bima, a voluntary health insurance policy exclusively for CGHS beneficiaries, with coverage options of Rs 10 lakh and Rs 20 lakh. Announced on 14 January 2026, the scheme is intended to strengthen financial protection for central government employees and pensioners amid escalating medical expenses.

Nature and Scope of the Scheme

This policy functions as a supplementary health insurance to CGHS and provides indemnity-based in-patient hospitalisation cover across India. It is designed to address situations where CGHS coverage may be insufficient, particularly for expensive treatments in private healthcare facilities.

Premium Flexibility and Co-Payment Structure

A key feature of the scheme is its customisable co-payment mechanism. Beneficiaries may choose:

• a 70:30 cost-sharing ratio, or

• a 50:50 cost-sharing ratio between the insurer and the insured.

Higher co-payment choices result in reduced premium costs, with discounts ranging from 28% to 42% compared to conventional health insurance plans. This allows beneficiaries to tailor coverage according to affordability.

Insurance Provider and Benefits

The policy is offered by New India Assurance, a public sector insurer. Notable provisions include:

• Room rent limits fixed at 1% of the insured amount for standard rooms and 2% for ICU care

• A no-claim incentive of 10% increase in sum insured per year, capped at 100%

• Coverage of pre-hospitalisation expenses for 30 days and post-hospitalisation expenses for 60 days

Supporting Financial Initiatives

Simultaneously, the Department of Financial Services has introduced a Composite Salary Account Framework in collaboration with public sector banks. This initiative integrates salary accounts, banking facilities, and insurance benefits under a single platform for central government employees.

Importance for CGHS Beneficiaries

Paripoorna Mediclaim Ayush Bima fills a critical gap in public healthcare provisioning by offering voluntary, cost-effective, and flexible insurance protection. It enhances healthcare access, reduces out-of-pocket expenditure, and contributes to broader objectives of social security and financial inclusion.

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