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A Guide to Delhi Government Employees Health Scheme (DGEHS)

If you're a Delhi Government employee, pensioner, or a dependent family member, the Delhi Government Health Scheme for Employees (DGEHS) is designed to make quality healthcare accessible and affordable. Launched in 1997 and modeled closely on the Central Government Health Scheme (CGHS), it covers over4 lakh beneficiaries (including serving employees, pensioners, and their families) with cashless treatment options at government facilities and select private hospitals.

This guide draws directly from the official DGEHS portal (dgehs.delhi.gov.in) and recent office memorandums to give you accurate, up-to-date information as of December 2025.

What is DGEHS?

DGEHS full form: Delhi Government Employees Health Scheme

Introduced by the Government of NCT of Delhi, DGEHS ensures seamless medical care through government hospitals, dispensaries, autonomous bodies, and private empanelled hospitals.

It offers:

• OPD & IPD treatment
• Emergency care
• Diagnostics
• Cashless services
• Medical reimbursement under defined reimbursement rules

Who Can Benefit from DGEHS Scheme?

• Serving employees of the Government of NCT of Delhi (including autonomous bodies).
• Pensioners and family pensioners.
• Dependent family members: spouse, children (up to 25 years or marriage), dependent parents/parents-in-law (income not exceeding ₹9,000 per month + DA, as per latest guidelines).
• All Delhi Government hospitals, dispensaries, and polyclinics are automatically recognized, along with central institutions like AIIMS Delhi.

Dependent Family Members with Disabilities

As per prevailing CGHS/DGEHS dependency norms, a child or sibling with a permanent disability can be included as a dependent regardless of age, provided:

• They are financially dependent on the primary DGEHS beneficiary (income ≤ ₹9,000 + DA per month).
  
  
• They possess a valid disability certificate issued by a competent medical authority.
  
  
• The disability falls under categories recognised under the Persons with Disabilities (PwD) Act, such as intellectual disability, locomotor disability, autism, multiple disabilities, etc.

What is a Permanent Disability?

A permanent disability refers to a long-term physical, mental, neurological or sensory impairment that significantly restricts a person’s daily activities and is certified as 40% or above disability by a government-authorised medical board.

Key Benefits for Disabled Dependents:

• No age restriction (unlike the usual limit of 25 years for dependent children).
• Entitled to the same medical facilities as the primary beneficiary.
• Coverage extends to assistive devices, rehabilitation care, therapy-based consultations, and other medically necessary services as per CGHS/DGEHS rules.

Tip: Keep the disability certificate updated in departmental records to avoid interruptions or delays in claim processing.

Who is Not Entitled?

• Individuals opting for FMA
• Relatives outside dependency criteria
• Children with income above eligibility
• Patients seeking treatment outside Delhi/NCR without referral

DGEHS Contribution Rates (Monthly Subscription Charges)

Your contribution keeps the scheme running and is deducted automatically from salary (for serving employees) or paid as a one-time/lump-sum amount (for pensioners).

These rates are based on 7th CPC pay matrix levels and have remained unchanged since the OM dated 09-01-2017 (automatically aligned with CGHS revisions). Pensioners can also opt for monthly deduction from pension if preferred.

Your DGEHS Card – The Key to Cashless Treatment

Your plastic DGEHS beneficiary card (with photo and unique ID) is essential for availing cashless facilities.

• Serving employees: Apply through your department's drawing & disbursing officer.
• Pensioners: Apply online or via the DGEHS cell after retirement.
• Renewal: Automatic for serving employees; pensioners need to submit life certificates annually.

Lost your card? Re-issue requests are processed quickly through the official portal.

How to Register for DGEHS?

• Serving Employees: Automatically enrolled – your department deducts monthly contribution from salary and issues the plastic DGEHS card through the DDO (Drawing & Disbursing Officer). Submit the application form to your department.
• Pensioners: Apply online or offline at the DGEHS Cell (Directroom F-17, Karkardooma) after retirement. Submit form with PPO copy and life certificate for annual renewal.
• Card Status: You can check the DGEHS card status of your application with the Application Reference ID and Email or Contact number.  
• Card delivery: Usually within 15–30 days. Lost card? Apply for duplicate with FIR copy.

Documents Required for DGEHS Online Registration

Common documents (serving + pensioners):

• DGEHS application form (download from website)
• Two passport-size photos (beneficiary + dependents)
• Attested copy of Aadhaar/PAN
• Proof of residence
• For pensioners: Pension Payment Order (PPO), bank details, and last pay certificate
• Dependent details: Income certificate (below ₹9,000 + DR per month), age proof for children Submit everything to your department (serving) or DGEHS Cell (pensioners).

DGEHS Wellness Facilities & Polyclinics

Delhi Government runs more than 150 wellness centres/polyclinics/dispensaries across the city where you get free OPD consultation, medicines, and basic investigations.

• All are cashless with your DGEHS card.
• Services: General OPD, dental, physiotherapy, Ayurvedic/Homeopathic units in many centres, dressing & injections.
• Locate your nearest centre: Download the official directory PDF from dgehs.delhi.gov.in - "Wellness Centres" section (updated list as of 2025).

Annual Health Check-up Facilities

DGEHS provides one free comprehensive annual health check-up (for beneficiaries aged 40 years and above) at empanelled private diagnostic centres/hospitals.

• Package includes blood tests, lipid profile, liver/kidney function, ECG, X-ray chest, ultrasound abdomen, eye check-up, etc.
• No referral required — just show your DGEHS card at any empanelled lab (e.g., Dr Lal PathLabs, City X-ray, Ganesh Diagnostic).
• Adopted from latest CGHS guidelines (2024–2025 package rates apply).

Latest List of DGEHS Empanelled Hospitals 2025

As per the Office Memorandum dated January 1, 2025, the current empanelment of private hospitals and diagnostic centres is valid until December 31, 2025 (with possible extensions via subsequent OMs).

The official list includes approximately ~350 private healthcare organisations as per the latest official OM dated 01-01-2025 (hospitals, exclusive eye centres, cancer centres, dialysis units, and diagnostic labs) across Delhi and select NCR areas (Gurgaon, Noida, Ghaziabad, Faridabad). Most are NABH/NABL accredited where applicable, ensuring quality standards.

DGEHS Panel Hospitals List by Area 

For a hospital near you or specific specialities (e.g., cancer treatment), you can download the DGEHS private hospital list PDF from the link provided below. 

Latest DGEHS Empanelled Hospitals (01-01-2025)

This pdf is the single source of truth – always cross-check it before visiting a facility, as occasional suspensions or additions occur (e.g., a June 2025 OM updated the list with minor changes).

Find Network Hospitals Under DGEHS

The easiest way is to visit the official DGEHS website (dgehs.delhi.gov.in) and download the consolidated latest list of DGEHS empanelled hospitals and diagnostic centres.

• Current list: Check the "Important Office Memorandums" section or direct PDF links shared in recent OMs (e.g., updated June 2025).
• The PDF includes hospital name, address, contact, approved specialities, and NABH status.
• All Delhi Govt hospitals, polyclinics, and institutions like AIIMS and central institutions are recognized for treatment under existing referral norms – no separate list needed.
  Quick tip: Search the PDF by area (South Delhi, Gurgaon, etc.) or speciality (cardiology, oncology).

How to Check Empanelled, De-Empanelled or Suspended Hospitals?

• Empanelled: Always refer to the latest official PDF (current extension valid till 31/12/2025).
• Suspended/De-empanelled: These are announced separately through Office Memorandums on the website. Recent examples include de-empanelment of certain labs (e.g., Dr. Lal Chandani Labs in 2024).

Best practice: Before visiting any private hospital, confirm its status by checking the most recent OM list on the portal or calling the DGEHS helpline. Outdated lists can cause cashless denial.

Treatments & Diseases Covered Under DGEHS

A wide range of treatments is included:

• OPD & IPD services
• Surgeries
• Cardiac procedures
• Kidney transplant
• Cancer care
• Orthopaedic procedures
• Maternity care
• Lab & radiology tests
• Critical care
• Emergency services

Costs are regulated under the official DGEHS panel rate list.

What DGEHS Does NOT Cover

While DGEHS provides broad medical coverage, certain services, items, and procedures remain non-admissible:

Non-Medical / Cosmetic Exclusions

• Cosmetic procedures (rhinoplasty, liposuction, hair transplant, facelift, etc.)
• Non-essential dental procedures (veneers, cosmetic aligners)
• Weight-loss surgeries done for cosmetic purposes (without medical indication)
• IVF and assisted reproductive treatments (unless covered under specific government orders)

Non-Admissible Hospital Charges

• Admission kit, toiletries, food for attendants
• Deluxe/Executive room charges beyond entitlement
• Telephone, television, internet charges
• Registration/administration fees over prescribed limits

Medicines & Consumables Not Covered

• Non-essential vitamins, supplements
• Disposable items not included in CGHS package rates
• Unapproved implants or high-cost materials above CGHS ceiling

Benefits of DGEHS for Beneficiaries

Beneficiaries enjoy multiple healthcare advantages under the scheme:

1. Cashless Treatment

Cashless care in DGEHS empanelled hospitals, including emergency services and full cashless access for pensioners.

2. Wide Network

A strong network of government hospitals plus a large list of empanelled hospitals under DGEHS, you can check before treatment.

3. Structured Reimbursement

Medical bills can be claimed using the DGEHS medical reimbursement form, complying with reimbursement rules.

4. Standardised Package Rates

All major hospitals follow the approved DGEHS rate list for treatments.

What Are DGEHS/CGHS Package Rates?

DGEHS adopts standard CGHS package rates, which are fixed, all-inclusive costs for common medical procedures. A "package" includes:

• Consultation fees
• Pre-operative investigations
• Surgeon + anaesthetist charges
• Operation theatre expenses
• Medicines & consumables during stay
• Room rent (as per entitlement)
• Nursing charges

Why This Matters:

Beneficiaries do not face unexpected costs—hospitals must adhere to these fixed rates for cashless treatment. If a hospital charges more, reimbursement is still limited to the approved CGHS rate.

DGEHS Rates List for Treatments

DGEHS automatically adopts the latest CGHS package rates without separate notification. This means:

• Cashless indoor treatment at empanelled private hospitals.
• Fixed rates for consultations, investigations, surgeries, and room entitlements (based on your pay level/basic pension).
• No need to pay upfront in emergencies at empanelled centres.

Ward Entitlement Under DGEHS

Your room entitlement in empanelled hospitals follows your pay level or pension (same as CGHS rules, revised OM dated 07-03-2023):

Higher entitlements apply for pensioners drawing equivalent pension. Cashless treatment is as per this entitlement only.

Cashless vs Reimbursement Under DGEHS

Tip: In true emergencies, most empanelled hospitals provide cashless even without prior intimation – just show your card. For reimbursement, claims are usually settled in 30–60 days. Always keep your DGEHS card valid!

When Treatment Isn’t Available at an Empanelled Hospital – Medical Reimbursement

In genuine emergencies or when specialised treatment isn’t available under DGEHS, you can get treated at any hospital and claim reimbursement (up to CGHS/AIIMS rates or actual cost – whichever is lower).

DGEHS Reimbursement Rules and Eligibility

• Valid DGEHS card at the time of treatment.
• Emergency certification by the treating doctor.
• Prior permission required for planned non-emergency treatment outside the scheme (except in relaxed categories like cancer, kidney failure, or heart disease).

DGEHS Claim Process Step-by-Step

To process your claim through DGEHS network hospitals, follow the steps below:

1. Download the forms (official links):
• Revised DGEHS Medical Reimbursement Claim Form
• Modified Checklist for Reimbursement Claims
• Essentiality Certificate (from treating hospital) All available at: https://dgehs.delhi.gov.in/dghs/downloadable-forms
2. Attach required documents: Original bills, prescriptions, discharge summary, emergency certificate, break-up of package charges, bank details, and copy of DGEHS card.
3. Submit:
• Serving employees - Your department’s accounts section.
• Pensioners - DGEHS Cell, Directorate of Health Services.
4. Processing time: Usually 30–60 days. Up to 90% advance is available for prolonged/major treatments.
5. Track your claim: Contact your department or the DGEHS helpline (check the portal for current numbers).

Common Reasons Why DGEHS Claims Get Rejected

Understanding frequent rejection causes helps beneficiaries avoid delays:

• Missing Essentiality Certificate
  The most common reason; mandatory for all reimbursement cases.
• Invalid or expired DGEHS card at time of treatment
• Treatment taken at non-empanelled hospital without emergency proof or prior permission
• Mismatch in dates between admission, discharge, and bills
• Submission of photocopies instead of original bills
• Inadequate justification for high-cost medicines or implants
• Claim submitted after the deadline (usually 6 months from date of discharge unless condoned)
• Charges beyond CGHS/DGEHS rates without supporting documents

Tip: Always keep copies of discharge summary, daily treatment chart, and itemised billing to strengthen your claim.

Common Reimbursement Tips from Beneficiaries

• Always get an “Essentiality Certificate” from the hospital – claims are rejected without it.
• Use generic medicines where possible (mandatory for full reimbursement).
• Double claims allowed if you have private insurance (total cannot exceed actual expense).

DGEHS for Pensioners vs Serving Employees

Pensioners enjoy more flexibility because they no longer have departmental bottlenecks.

Referral System

For planned treatment at empanelled private hospitals, serving employees generally need a referral/permission letter from a government DGEHS wellness centre (polyclinic) or AMO (Authorised Medical Officer).

• Visit your nearest polyclinic -> Doctor examines -> Issues referral to the specific empanelled hospital/speciality. This ensures treatment is necessary and follows approved rates. In emergencies, show your DGEHS card directly — no prior referral needed.

Where Referral May Not Be Required

Thanks to continuous relaxations (latest adopted from CGHS OM dated 2024–2025), referral is waived in these common situations:

• All pensioners and their dependents (direct cashless access).
• Emergencies (life-threatening conditions) for everyone.
• Follow-up treatment within the same hospital for the same ailment.
• 14 listed chronic/specialised diseases (e.g., cancer, heart disease, kidney failure, stroke, major organ transplants, brain haemorrhage — full list in CGHS guidelines adopted by DGEHS).
• Direct OPD consultation at empanelled hospitals (no referral needed since 2018 relaxation). These relaxations make day-to-day care much smoother for beneficiaries.

DGEHS NOC for Treatment Outside Delhi/NCR

If required treatment is not available in Delhi/NCR empanelled hospitals:

• Obtain prior permission/NOC from Directorate of Health Services (DGEHS Cell).
• Submit application with recommendation from Delhi Govt specialist + two quotations from hospitals outside NCR.
• Approved cases are reimbursed at CGHS rates of the station where treated (or actual, whichever lower).
• Emergencies outside Delhi: No prior permission needed — submit claim later with emergency certificate. Form available under "Downloadable Forms" → "Permission for treatment outside Delhi". Processing usually takes 15–30 days for planned cases.

DGEHS Online Services

While full online claim submission is still being rolled out, the following are available 24×7 on dgehs.delhi.gov.in:

• Download the latest DGEHS hospital list, forms, OMs, and rate lists.
• Locate wellness centres and check empanelment status.
• View important circulars and updates.
• Pensioners can download card application forms and life-certificate formats. A dedicated beneficiary login portal is under development (as mentioned in recent OMs).

Grievance Redressal Mechanism

If you face issues (delayed claims, hospital denial, etc.):

1. First level: Contact the Nodal Officer of your department or the empanelled hospital.
2. Second level: Lodge online on Centralized Public Grievance Redress and Monitoring System (cpgrams.gov.in) - select “Government of NCT of Delhi - Health & Family Welfare”.
3. Third level: DGEHS Grievance Cell, Room No. F-17, DGHS Headquarters, Karkardooma, Delhi-110032 (Phone numbers listed on website). Most grievances are resolved within 30–60 days as per Citizen’s Charter.

DGEHS vs CGHS: Common Differences

In practice, DGEHS beneficiaries enjoy almost identical benefits and hospital network as CGHS.

DGEHS Latest Orders 2025

Here are key updates from the latest orders of DGEHS released on the official website. 

Read Full list of official Updates here: https://dgehs.delhi.gov.in/doit-content/important-office-memorandums-and-office-orders

Need Help?

• Official website: https://dgehs.delhi.gov.in
• Helpline/email: Listed on the homepage (frequently updated).
• Locate a government dispensary/polyclinic near you via the portal’s directory.

This scheme has been a lifeline for thousands of Delhi Government families, offering peace of mind during medical needs. Always refer to the official DGEHS portal for the most current documents – policies evolve to serve you better.

Have a specific query about a hospital or claim? Feel free to ask! Stay healthy.