Beruflich Dokumente
Kultur Dokumente
FACILITIES
INTRODUCTION
1. The following categories are eligible for availing the medical facilities:-
2. FACILITIES:
c) Without Family Health Identity Card/Photo Identity Card, employees are not advised
to be admitted except in case of extreme emergency/road accident. In such cases,
serving/retired employee or their dependentent will submit the copy of the Family
Health Identity Card/Photo Identity Card. In case of non-production of valid Family
Health Identity Card/Photo Identity Card, the responsibility of payment will be of the
patient/beneficiary or their dependents as the case may be.
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3) If the accommodation of the appropriate class becomes available and it is
considered that the patient cannot be shifted under medical advice, the
certificate should be obtained with reference to the point of time at which
the accommodation of appropriate class becomes available.
1) Original FAR (First Admission Report) form completed filled by the Hospital.
2) Photocopy of medical identity Card
3) Summary of the case, including outcome of treatment.
4) All the supporting documents such as investigation report, first admission
report/pre authorization letter, copy of authorization letter, original cash memos
and discharge summary report be submitted by the hospital to the AGM (Bills) of
the concerned FCI office within the stipulated period of time within 3 months
from the date of completion of treatment and necessary bill will be authenticated
by the patient /escort’s signature.
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4. PROCEDURE OF AVAILING INDOOR FACILITY:(where authorization letter is
not issued)
The serving/retired employee can take treatment in any hospital without having
Authorization Letter issued by the FCI office but in that case at the time of relieving
the hospital, the employee/ patient is required to get the hospital bill and receipts,
vouchers, Essentiality Certificate etc., duly signed or countersigned by the Authorized
Medical Attendant or the medical officer in-charge of the patient in the hospital, as
the case may be, for the purpose for claiming refund of expenses incurred.
Employee has to prefer his/her claim in the relevant application form, giving full
particulars called for therein and also attaching Certificate ‘B’ along with the medical
claim form required to be produced under the rules.
1. The Hospital/ Dental/ Diagnostic Centre shall provide the agreed upon services to
cases referred on a Referral slip duly authenticated and stamped. The Hospital/ Dental or
Diagnostic centre would not refuse admission/treatment or investigations to referred cases on
flimsy grounds.
2. The Hospital/ Dental or Diagnostic centre shall raise bills in the prescribed format to
the FCI offices’ on completion of treatment/ discharge of the patient. The rates for tests and
treatment would be charged as per mutually agreed rate list and approved by FCI. Under no
conditions will rates exceed the rates laid down by the CGHS for the particular zone. FCI
will make payments only as per approved/ CGHS rates. Expenditure in excess of approved /
package deal rates would be borne by the beneficiaries.
3. During In-patient treatment of the FCI beneficiaries, the Hospital shall not ask the
members to purchase separately the medicines from outside but bear the cost on its own, as
the package deal rate fixed that includes the cost of drugs, surgical instruments and other
medicines etc.
4. All other conditions listed in the MOA will be complied with by both parties, that is,
the Empanelled facility and FCI.
1. Medical reimbursement for OPD treatment is not admissible to those who are in
receipt of Fixed Medical Allowance.
2. Consultation / injection fee for the treatment taken at the OPD of the Government
Hospital not admissible.
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4. Where ever an employee wants to claim reimbursement of medical charges for more
than 10 days say for one month in that case the employee has to produce a Prolonged
Treatment Certificate which is valid for one year. On that basis an employee can
claim reimbursement for 30 days instead of 10 days at a time.
6. Here, retired employees are eligible only for prolonged specified diseases only for a
maximum limit of Rs.12000/- p.a. and they will also have to submit the same
documents as submitted by the serving employees only here limit / disease is
restricted. (Annexure – I)
7. Instructions:
a) Cash memos for purchase of medicines must be countersigned by the doctor
prescribing the medicines.
8. Time limit for medical claims: Bills to be preferred within 3 months for
reimbursement by the central Government servants in respect of a particular spell of
illness should ordinarily be preferred within 3 months from the date of completion of
treatment.
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ANNEXURE – I
The list of specified prolonged diseases for OPD treatment shall include 13 prolonged
diseases is given as under:
v. Kidney disorders
ix. Tuberculosis
xi. Osteoporosis
xii. Thalassemia