Now, heads of departments of ministries/departments will be able to approve medical claims up to ₹10 lakh without consulting the Integrated Finance Division (IFD). Previously, this limit was ₹5 lakh. This decision was announced through an Office Memorandum (OM) issued on February 16, 2026.
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There’s news of great relief for central government employees and pensioners. The Ministry of Health and Family Welfare (MoHFW) has increased the maximum limit for medical reimbursement. Heads of departments of ministries/departments will now be able to approve medical claims up to ₹10 lakh without consulting the Integrated Finance Division (IFD). Previously, this limit was ₹5 lakh. This decision was announced through an Office Memorandum (OM) issued on February 16, 2026.
What are the details?
The Ministry has made another important change. In cases where no relaxations are granted and the entire payment is made according to the prescribed CGHS rates, the settlement limit has been increased from ₹2 lakh to ₹5 lakh. This means that if the claim is fully compliant and the rates are in accordance with the Ministry of Health and Family Welfare (CGHS), it will now be easier to pay higher amounts. This is expected to provide relief to employees from long waits and file delays.
However, two clear conditions have been added to the new ₹10 lakh limit. First, there will be no relaxation of CGHS or CS(MA) rules in the claim. Second, the reimbursement amount will be strictly in accordance with the CGHS/CS(MA) rates. The implication is clear: if the hospital bill exceeds the prescribed rates and requires a relaxation, the matter will still be processed at a higher level, as before. The ministry also referred to its earlier order of November 23, 2016, in which the limit for cases without exemption from rules was increased from Rs 2 lakh to Rs 5 lakh.
Where to Apply
The CGHS medical claim process has also been simplified. Pensioners must submit an application to the CMO of their wellness center within six months of treatment or discharge. They must also submit a medical reimbursement claim form, a checklist, a copy of the discharge summary, a referral/permission slip, an emergency certificate (if applicable), original hospital bills and receipts, a copy of a valid CGHS card, and a cancelled check or mandate form for bank details. Complete and accurate documentation expedites the process.
As for ambulance expenses, they are also reimbursable, but with a condition: Ambulance expenses within the city are reimbursable only if the treating doctor certifies that transportation by any other means would have endangered the patient’s life or worsened their condition. Overall, this government decision will expedite medical claim approvals and provide relief to employees and pensioners even in cases involving large sums of money.
