राजस्थान में अशोक गहलोत सरकार ने केंद्र सरकार की सेंट्रल गवर्नमेंट हेल्थ स्कीम की तर्ज पर प्रदेश के सरकारी कर्मचारियों के लिए राजस्थान गर्वनमेंट हेल्थ स्कीम लागू की है। आम लोगों के लिए चिरंजीवी स्वास्थ्य बीमा योजना है। उसी तरह सरकारी कर्मचारियों के लिए यह स्कीम लागू की गई है।
State Government has identified medical care as one of the key sectors from the perspective of overall health care and development of the State. Hon’ble Chief Minister vide point no. 244 of Budget Speech for financial year 2021 has announced new Rajasthan Government Health Scheme (RGHS). The ambitious plan of State medical facilities necessitates the infusion of all medical schemes under one roof and thereby restructuring it as Rajasthan Government Health Scheme.
Government of Rajasthan has been providing medical facilities to Hon’ble MLAs, Ex-MLAs and its State Government employees and pensioners through provisions under various Rules, Scheme and Medical Insurance Policies. State Autonomous bodies / Boards / Corporations are providing medical facilities through their own regulations. The main rules / schemes are as under:
- The Rajasthan Legislative Assembly Members (Medical Facilities) Rules, 1964
- Rajasthan Legislative Assembly Ex-Members and Family Pensioners (Medical Facilities) Rules, 2010
- Rajasthan Civil Services (Medical Attendance) Rules, 2013
- Rajasthan State Pensioners’ Medical Concession Scheme, 2014
- Raj Mediclaim Policy
In addition to above, Ministers, Judicial Officers, All India Service Officers are also getting medical facilities under following rules:
- The Rajasthan Ministers (Medical Attendance) Rules, 1961
- Rajasthan Judicial Officers (Medical Facilities) Rules, 2008
- All India Services (Medical Attendance) Rules, 1954
About the Scheme
All hospitals run by State Government, approved Hospitals and Public Private Partnership Hospitals will be eligible for providing medical facilities under this scheme as per norms and terms & conditions. In case of grave emergency, treatment will be allowed in Referral Hospitals after due reference from competent authority.
The Scheme is based on CGHS rates and provisions if otherwise not amended under this Scheme for the treatment taken in empaneled hospitals.
This Scheme will provide:
- OPD Treatment
- Cashless Facility for IPD/day care services.
- Investigations at Government and Empaneled Diagnostic centers
- Family Welfare, Maternity and Child Health Services.
Beneficiaries and Scheme Coverage
|Sub-Category||Beneficiary Category||Rules / Scheme presently applicable||RGHS Coverage|
|RGHS-1||Ministers||Medical facilities as per The Rajasthan Ministers (Medical Attendance) Rules, 1961||Coverage as per Rules Applicable|
|RGHS-2||Members of Rajasthan Legislative Assembly||Medical facilities as per The Rajasthan Legislative Assembly Members (Medical Facilities) Rules, 1964||Coverage as per Rules Applicable|
|RGHS-3||Ex-Members of Rajasthan Legislative Assembly||Medical facilities as per Rajasthan Legislative Assembly Ex-Members and Family Pensioners (Medical Facilities)Rules, 2010||Coverage as per Rules Applicable|
|RGHS-4||Serving and Retired Judicial Officers||Medical facilities as per Rajasthan Judicial Officers (Medical Facilities) Rules, 2008||Coverage as per Rules Applicable|
|RGHS-5||Serving AIS Officers||Medical facilities as per All India Services (Medical Attendance) Rules, 1954 and also various orders issued by DOP in this regard.||Coverage as per Rules Applicable|
|RGHS-6||Retired AIS||Coverage as per Rules Applicable|
|RGHS-7||Serving State Government employees appointed prior to 01-01-2004||Medical facilities as per RCS(MA) Rules, 2013||Coverage as per Rules Applicable|
|RGHS-8||Pensioners and family pensioners under RCS (Pension) Rules, 1996||Medical facility as per Rajasthan State Pensioners Medical Concession Scheme, 2014||Coverage as per Rules Applicable|
|RGHS-9||Serving State Government employees appointed on or after 01-01-2004||Medical facilities up to the extent of Raj Mediclaim Policy (i.e. up to the limit of Rs 3.00 lacs only for indoor patients.)||
|RGHS-10||Pensioners of State Government covered under NPS||No medical facility available at present||
|RGHS-11||Serving employees of State Autonomous Bodies (SAB) including Boards, Corporation etc. who were appointed prior to 01.01.2004||As per applicable Scheme of concerned Board / corporation etc.||
|RGHS-12||Serving employees of State Autonomous Bodies (SAB) including Boards, Corporation etc. who were appointed on or after 01.01.2004||Presently under Raj Mediclaim Scheme.||
|RGHS-13||Pensioners of State Autonomous Bodies (SAB) including Boards, Corporation etc. who were appointed prior to 01.01.2004||As per applicable Scheme of concerned Board / corporation etc.||
|RGHS-14||Pensioners of State Autonomous Bodies (SAB) including Boards, Corporation etc. who were appointed on or after 01.01.2004||No medical facilities.||
RGHS Coverage in case of Grave Illness
Cases of Coronary Artery Surgery, Vascular Surgery, Hodgkin’s Disease, Acute Retention of urine more than 24 hrs., Acute Myocardial infarction, Acute Pneumonitis, Acute Respiratory Distress, Cancer, renal failure i.e. failure of both the kidney, Stroke,, Multiple Sclerosis, Meningitis, Major organ Transplants like Kidney ,Lungs, Pancreas, Heart, Liver or Bone Marrow, Accidents, Delivery, Tubal Pregnancy and related complication, swine flu, dengue fever, burst Appendicitis, Pancreatitis etc. can be covered under as cases of grave emergency.
Any Query Helpdesk contact mail below and Toll Free Number
please write to us email@example.com
RGHS: Fully Online and Automated system
- Identified database for beneficiary status of family (Jan Aadhar)
- Hospital Empanelment by HBEC (Apply and approve system) on RGHS web-portal: Online and transparent procedure
- Pre-authorization at hospital level only
- Online Payment System to Hospitals
Claim Settlement under RGHS
The claim settlement procedure will be on IT Platform of RGHS through the RGHS portal and the electronic medical record (EMR) of each beneficiary will be kept in RGHS card holder’s e-Wallet.
Any dispute between the parties namely SIPF and beneficiary, SIPF & empaneled hospitals and beneficiary and empaneled hospital during the scheme period or thereafter in connection with the validity, interpretation, implementation or alleged breach of any provision of the scheme will be settled by District Level Grievance Redressal Committee(DGRC), State Level Grievance Redressal Committee(SLGRC) and Appellate authority.