If you are a central government employee or pensioner, getting reimbursed for high medical bills is about to become much easier.
On February 16, 2026, the Ministry of Health issued an Office Memorandum (OM) raising the approval limit for medical claims.
Now, Heads of Departments (HODs) in ministries and departments can directly approve medical reimbursement claims up to ₹10 lakh.
Earlier, this limit was only ₹5 lakh. Any claim above ₹5 lakh had to be sent to higher authorities, which caused long delays.
With the new rule, claims up to ₹10 lakh will be settled at the department level itself, helping employees and pensioners receive payments faster without long waiting periods.
Conditions for the ₹10 Lakh Approval Limit
The government has set two clear conditions for approving claims up to ₹10 lakh:
The claim must not request any relaxation under CGHS or CS(MA) rules.
The reimbursement amount must strictly follow CGHS/CS(MA) prescribed rates.
This means if your hospital bill is higher than government-approved rates and you seek extra reimbursement or relaxation, the case will still go through the old higher-level approval process. But if your bill matches CGHS rates, the claim can be processed quickly at the local level.
Settlement Limit Also Increased to ₹5 Lakh
The Ministry has also increased another important settlement limit. In cases where no relaxation is requested and payment is fully as per CGHS rates, the settlement limit has been raised from ₹2 lakh to ₹5 lakh.
This change aims to reduce delays in settling large medical bills and speed up reimbursements.
How and Where to Apply for Reimbursement
The claim process has been simplified. Pensioners should note that they must submit their application to the CMO of their CGHS wellness centre within six months of treatment or hospital discharge.
Required documents include:
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 and cancelled cheque (bank details)
Rules for Ambulance Expense Reimbursement
Ambulance charges can also be reimbursed, but there is a condition.
For travel within the same city, reimbursement is allowed only if a doctor certifies that transporting the patient by any other vehicle could have been life-threatening or worsened their condition.
Relief for Employees and Pensioners
This government decision will bring major relief to millions of employees and elderly pensioners.
After costly medical treatment, they will no longer have to wait months to get their reimbursement, as claims will now be processed and settled much faster.
