OM dated 11.02.2026.pdf

Medical · الجمعة، 16 أكتوبر 2026
Medical
13 Feb 2026

No. G-14017/5/2026-Ins. Il

Government of India

Ministry of Finance

Department of Financial Services

OFFICE MEMORANDUM

2nd Floor, Jeevan Deep, Parliament Street, New Delhi Dated: 11.02.2026

Subject: Paripoorna Mediclaim Ayush Bima for CGHS beneficiaries-reg.

The undersigned is directed to refer to the subject cited above and to say that the Paripoorna Mediclaim Ayush Bima product has been launched by The New India Assurance Company Limited (NIACL) on 14.01.2026 for CGHS beneficiaries, offering cashless facilities, modern treatments and access to a wide network of hospitals. The product is available to customers through offices of NIACL and also through its website.

2. It is noted that the policy is exclusively available to CGHS beneficiaries with a maximum of six members under one policy, including spouse, children, parents and parents-in-law. It provides indemnity-based in-patient hospitalization coverage within India, with sum insured options of 10 Lakh or 20 Lakh. The product will have a co- payment component allowing beneficiaries to choose between 70:30 or 50:50 co- sharing between insurance company and the subscribers. As compared to regular policy of NIACL, it will be available at a discount of 28% and 42% for 70:30 and 50:50 co-sharing model respectively. The key features of the product are enclosed as Annexure.

3.

This optional health insurance plan is available as a retail product for all CGHS beneficiaries, with no GST to ensure maximum affordability. Designed to complement existing benefits, this enhanced policy will provide seamless experience, with greater flexibility and expanded access to quality healthcare services across India, thus leading to additional financial security with ease and confidence for all CGHS beneficiaries.

4.

In view of the above and for ensuring wider awareness about this product, it is requested that this information may be disseminated among all CGHS benefit availing officers and staff, including those in attached and subordinate offices under respective Ministry/Departments. In this regard, an e-banner has also been developed (enclosed) which may be displayed on the official website, e-office dashboard, HRM portal of your Ministry/Department, along with a hyperlink to DFS webpage https://financialservices.gov.in/beta/en/page/paripoorna-mediclaim-ayush-bima,

wider awareness among employees.

at

for

5.

This issues with the approval of Competent Authority.

Encl. As above

11.02.2026 (Satish Kumar Singh)

Under Secretary to the Govt. of India Tel. No. 011-23748715

To,

The Secretary of all Ministries/Departments of Government of India (as per list attached)

1. Ministry of Agriculture and Farmers Welfare, Department of Agricultural

Research and Education (DARE)

2. Ministry of Agriculture and Farmers Welfare, Department of Agriculture and

Farmers Welfare

3. Ministry of Ayush

4. Ministry of Chemicals and Fertilizers, Department of Chemicals and

Petrochemicals

5. Ministry of Chemicals and Fertilizers, Department of Fertilizers

6. Ministry of Chemicals and Fertilizers, Department of Pharmaceuticals

7. Ministry of Civil Aviation

8. Ministry of Coal

9. Ministry of Commerce and Industry, Department of Commerce

10. Ministry of Commerce and Industry, Department for Promotion of Industry and

Internal Trade

11. Ministry of Communications, Department of Posts

12. Ministry of Communications, Department of Telecommunications (DOT)

13. Ministry of Consumer Affairs, Food and Public Distribution, Department of

Consumer Affairs

14. Ministry of Consumer Affairs, Food and Public Distribution, Department of

Food and Public Distribution

15. Ministry of Cooperation

16. Ministry of Corporate Affairs

17. Ministry of Culture

18. Ministry of Defence, Department of Defence

19. Ministry of Defence, Department of Defence production

20. Ministry of Defence, Department of Defence Research and Development

21. Ministry of Defence, Department of Ex-servicemen Welfare

22. Ministry of Defence, Department of Military Affairs

23. Ministry of Development of North Eastern Region

24. Ministry of Earth Sciences

25. Ministry of Education, Department of Higher Education

26. Ministry of Education, Department of School and Education and Literacy

27. Ministry of Electronics and Information Technology

28. Ministry of Environment, Forest and Climate Change

29. Ministry of External Affairs

30. Ministry of Finance, Department of Economic Affairs

31. Ministry of Finance, Department of Expenditure

32. Ministry of Finance, Department of Investment and Public Asset Management

33. Ministry of Finance, Department of Revenue

34. Ministry of Finance, Department of Public Enterprises

35. Ministry of Fisheries, Animal Husbandry and Dairying, Department of Animal

Husbandry and Dairying

36. Ministry of Fisheries, Animal Husbandry and Dairying, Department of

Fisheries

37. Ministry of Food Processing Industries

38. Ministry of Health and Family Welfare, Department of Health and Family

Welfare

39. Ministry of Health and Family Welfare, Department of Health Research 40. Ministry of Heavy Industries

41. Ministry of Home Affairs, Department of Border Management

42. Ministry of Home Affairs, Department of Home

43. Ministry of Home Affairs, Department of Official Language

44. Ministry of Home Affairs, Department of Internal Security

45. Ministry of Home Affairs, Department of States

46. Ministry of Home Affairs, Department of Jammu Kashmir and Ladakh Affairs

47. Ministry of Housing and Urban Affairs

48. Ministry of Information and Broadcasting

49. Ministry of Jal Shakti, Department of Drinking Water and Sanitation

50. Ministry of Jal Shakti, Department of Water Resources, River Development

and Ganga Rejuvenation

51. Ministry of Labour and Employment

52. Ministry of Law and Justice, Department of Justice

53. Ministry of Law and Justice, Department of Legal Affairs

54. Ministry of Law and Justice, Legislative Department

55. Ministry of Micro, Small and Medium Enterprises

56. Ministry of Mines

57. Ministry of Minority Affairs

58. Ministry of New and Renewable Energy

59. Ministry of Panchayati Raj

60. Ministry of Parliamentary Affairs

61. Ministry of Personnel, Public Grievances and Pensions, Department of

Administrative Reforms and Public Grievances (DARPG)

62. Ministry of Personnel, Public Grievances and Pensions, Department of

Pension & Pensioners' Welfare

63. Ministry of Personnel, Public Grievances and Pensions, Department of

Personnel and Training

64. Ministry of Petroleum and Natural Gas

65. Ministry of Planning

66. Ministry of Ports, Shipping and Waterways

67. Ministry of Power

68. Ministry of Railways

69. Ministry of Road Transport and Highways

70. Ministry of Rural Development, Department of Land Resources (DLR) 71. Ministry of Rural Development, Department of Rural Development (DRD) 72. Ministry of Science and Technology, Department of Bio-Technology

73. Ministry of Science and Technology, Department of Science and Technology

(DST)

74. Ministry of Science and Technology, Department of Scientific and Industrial

Research (DSR)

75. Ministry of Skill Development and Entrepreneurship

76. Ministry of Social Justice and Empowerment, Department of Empowerment of

Persons with Disabilities

77. Ministry of Social Justice and Empowerment, Department of Social Justice

and Empowerment

78. Ministry of Statistics and Programme Implementation

79. Ministry of Steel

80. Ministry of Textiles

81. Ministry of Tourism

82. Ministry of Tribal Affairs

83. Ministry of Women and Child Development

84. Ministry of Youth Affairs and Sports, Department of Sports

85. Ministry of Youth Affairs and Sports, Department of Youth Affairs

86. Department of Atomic Energy

87. Department of Space

88. NTII Aayog

89. President's Secretariat

orb no obs

Annexure

Eligibility Criteria

In-Service CGHS Beneficiaries-

o Exclusively available to CGHS beneficiaries with up to six members under one policy. Dependents of primary CGHS card holders who are not covered under A900 CGHS, can be added under the policy. Tax paying family members like non- dependent parents, in-laws and proposer's financially dependent brother/sister can also be covered.

Retired CGHS Beneficiaries-

o Exclusively available to Retired CGHS beneficiaries with up to six members under one policy. Dependents covered under the policy must also be CGHS Cardholders.

The key features of Paripoorna Mediclaim Ayush Bima are as under: -

Cashless Hospitalization

Available at ~20,800 Third Party Administrator

network hospitals and ~5050 insurer

network

hospitals

nenin (https://www.newindia.co.in/hospitals-list).

Beneficiaries have the option to claim first either under CGHS or under the insurance policy.

o Comprehensive hospitalization cover - Covers room rent, ICU, doctor's fees,

medicines, diagnostics, surgeries, dialysis, chemotherapy, etc.

o Modern Treatment Cover - 25% of SI (inbuilt)

o Modern Treatment Rider - Optional cover up to 100% of SI with additional 15%

premium.

o Major procedures like Hip replacement, sciatica pain and specialized surgeries like lung transplant are covered. Robotic surgeries and other modern surgeries like Intravitreal injections, Stereotactic radio surgeries, Deep Brain stimulation, Uterine Artery Embolization and HIFU (High intensity focused ultrasound), Balloon Sinuplasty, Bronchial Thermoplasty, etc. are covered up to 25% of Sum Insured, which can be enhanced up to 100% of Sum Insured by opting for the Modern Treatment Rider.

o No doctor's endorsement is needed. No need to approach dispensaries,

wellness centres, pharmacies etc. prior to hospitalization.

o Room Rent and ICU Limits - Room Rent up to 1% of Sum Insured per day; ICU up to 2% of Sum Insured per day irrespective of ward entitlements under CGHS rules. No differential category based on pay scale.

o Pre-Hospitalization Expenses - Up to 30 days prior to hospitalization.

o Post-Hospitalization Expenses - Up to 60 days from date of discharge.

。 100% AYUSH Coverage

-

Covers Ayurveda, Yoga, Naturopathy, Unani,

Siddha & Homeopathy up to 100% of SI (in-patient only).

Annexure is a part of DFS OM No. G-14017/5/2026-Ins.Il dated 11.02.2026

o The Insurer endeavours to decide on the request for cashless authorization at the earliest and within one hour of receipt of the request, and to grant final authorization within three hours of receipt of the discharge authorization request from the hospital.

o Family Discount - 5% (2 members), 10% (3 members), 15% (more than 3

members).

o Cumulative Bonus - 10% of SI for every claim-free year up to maximum 100%. o Lifetime Renewability - No age limit for renewal.

o Waiting Periods - First 30 days; 90 days for Diabetes & Hypertension; 24 months for specified illnesses. Waiver of Pre-Existing Disease (PED) - May be considered on submission of Good Health Certificate from CGHS/Employer/ existing insurer certifying no hospitalization in the past 24 months. 360 Explanation of Co-payment component - In 70:30 model, 70% of admissible claim amount will be borne by insurance company and remaining 30% to be borne by policyholder. In 50:50 model, 50% of admissible claim amount will be borne by insurance company and remaining 50% to be borne by policyholder. However, in both the cases, the policy premium is to be borne by policyholder 10 itself.

This policy is offered by New India Assurance Company Limited, which is a leading public sector general insurance company in India. It is a dominant force in the Indian non-life insurance market, known for its extensive network with 1600+ offices across the country. In the fiscal year 2024-25, New India Assurance maintained its position as the largest general insurer in India, with an all-time high gross written premium (GWP) of over 43,618 crores and a market share of 12.57%. During FY 2024-25, the company settled a total of 1.28 Cr claims with a claim settlement ratio of 96% (non-suit). The hospitals are paid their dues promptly ensuring seamless service.

Annexure is a part of DFS OM No. G-14017/5/2026-Ins. Il dated 11.02.2026

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