If you are a central government employee or pensioner, getting your medical bills reimbursed is now going to be much easier.
The Ministry of Health issued an Office Memorandum (OM) on February 16, 2026, increasing the approval limit for medical claims.
Earlier, Heads of Departments (HODs) could approve medical claims only up to ₹5 lakh. Any amount above ₹5 lakh had to be sent to higher authorities, which caused long delays.
Now, HODs can directly approve claims up to ₹10 lakh without sending the file to the Integrated Finance Division (IFD). This means claims up to ₹10 lakh will now be settled at the local level, saving employees from long waiting periods.
Conditions for the New ₹10 Lakh Limit
The government has set two clear conditions for this increased limit:
The claim must not ask for any relaxation in CGHS or CS(MA) rules.
The reimbursement amount must strictly follow the rates prescribed under CGHS/CS(MA).
In simple terms, if your hospital bill is within the government-approved rates, your claim will be processed quickly. However, if your bill exceeds the approved rates
and you request relaxation or a higher reimbursement, the claim will still go through the higher-level approval process as before.
Increase in Settlement Limit
The Ministry has also raised another important limit. In cases where no relaxation is requested and payment is made fully as per CGHS rates, the settlement limit has been increased from ₹2 lakh to ₹5 lakh. This step has been taken to reduce delays in paying large medical bills.
How and Where to Apply
The claim process has been simplified. Pensioners must submit their application to the Chief Medical Officer (CMO) of their CGHS wellness center within six months of treatment or discharge.
Documents Required
Medical Reimbursement Claim Form and Checklist
Copy of discharge summary and referral/permission slip
Emergency Certificate (if applicable)
Original hospital bills and receipts
Copy of valid CGHS card
Cancelled cheque for bank details
Rules for Ambulance Expenses
Ambulance expenses can also be reimbursed, but there is a condition. For ambulance use within the city, reimbursement is allowed only if the doctor certifies that transporting the patient in any other vehicle could have been life-threatening or worsened the patient’s condition.
This decision by the government will provide major relief to millions of employees and elderly pensioners. They will no longer have to wait for months to get their money back after undergoing expensive medical treatment.
