CGHS Facilities for Dependent Sons/Brothers with Critical & Terminal Illness: New OM Dated 26 October 2026
CGHS Facilities for Dependent Sons/Brothers with Critical & Terminal Illness: New OM Dated 26 October 2026
The Ministry of Health & Family Welfare has clarified how CGHS cards can be extended to dependent sons and brothers suffering from critical or terminal illnesses, beyond the normal age limit, through the decentralised Special Technical Committee (STC) mechanism.
Families of Central Government employees and pensioners who look after a son or brother with a serious long-term illness have often struggled once the dependent crosses the permissible age limit under the CGHS rules. A fresh Office Memorandum issued by the Ministry of Health & Family Welfare on 26 October 2026 explains how such cases will now be handled at the Additional Director (AD) level instead of at the Directorate.
This article explains the OM in simple language, including the process, the role of the Local Technical Committee, the card validity, the full list of 42 critical and terminal illnesses and the administrative provisions that apply.
1. OM at a Glance
| Particulars | Details |
|---|---|
| Issued by | Ministry of Health & Family Welfare (EHS Section), Government of India |
| File number | S.11030/54/2023-EHS(8248513)/I/3909989/2026 |
| Date | 26 October 2026 |
| Subject | Extension of CGHS facilities to dependent sons/brothers suffering from critical/terminal illnesses under the decentralised STC mechanism |
| Earlier MoHFW OM | S.11030/54/2023-EHS dated 01.09.2026 (relaxation in age and marital status criteria) |
| Directorate of CGHS OM | No. 56-1/2026-27/CGHS/MSD dated 01.09.2026 (decentralised STC mechanism) |
| Governing rules | CGHS/CS(MA) Rules, 1944 |
| Signed by | Ashish Kumar Yadav, Under Secretary to the Government of India |
2. What Does the New OM Say?
The Ministry referred to its earlier OM dated 1 September 2026, which relaxed the age limit and marital status criteria for dependent sons and brothers suffering from critical or terminal illnesses under the CGHS/CS(MA) Rules, 1944. The latest OM clarifies the following points.
- Decentralised STC mechanism: Cases for extension of CGHS facilities to such dependents, even beyond the permissible age limit, may also be considered under the decentralised STC mechanism prescribed by the Directorate of CGHS vide OM dated 01.09.2026.
- No standing Medical Board in CGHS: Since CGHS has no standing Medical Board, the advice and prescription of a Government Specialist of the concerned specialty will be taken as the medical recommendation.
- Examination by LTC: That recommendation will be examined by the Local Technical Committee (LTC) constituted at the office of the Additional Director (AD), CGHS.
- Card issue: After consideration and recommendation by the LTC at the AD level, the CGHS beneficiary card shall be issued or extended.
- Annual basis: The card under this relaxation is issued initially on an annual basis.
- Annexure-A: An indicative list of eligible critical and terminal illnesses is attached to the OM.
- Compliance: The Directorate of CGHS has been asked to issue necessary instructions to all concerned for strict compliance.
3. Who Can Benefit from This Relaxation?
The relaxation applies to dependent sons and brothers of CGHS beneficiaries who suffer from a critical or terminal illness and who would otherwise be outside the permissible age limit. Annexure-A states that the list is for consideration of relaxation in the age criteria for unmarried dependent sons/brothers under the CGHS/CS(MA) Rules, 1944.
| Condition | Requirement |
|---|---|
| Relationship | Dependent son or brother of the CGHS beneficiary |
| Marital status | Unmarried (as per Annexure-A heading) |
| Age | Beyond the normal permissible age limit, under the relaxation of OM dated 01.09.2026 |
| Medical condition | Critical or terminal illness, as indicated in Annexure-A |
| Medical advice | Recommendation from a Government Specialist of the concerned specialty |
4. Role of the Local Technical Committee (LTC)
Under the administrative provisions annexed to the Directorate's OM, a three-member Local Technical Committee, headed by the Additional Director, examines the cases placed before it. It includes two GDMOs, preferably with qualifications or experience in Medicine and/or Surgery.
| Feature | Provision |
|---|---|
| Name | Local Technical Committee (LTC) |
| Location | Office of the Additional Director, CGHS |
| Members | Three: the Additional Director (head) and two GDMOs |
| GDMO background | Preferably qualified or experienced in Medicine and/or Surgery |
| Basis of examination | Medical recommendation of a Government Specialist of the concerned specialty |
5. CGHS Card Validity and Extension
The card issued under this relaxation will be valid initially for one year. Extension beyond one year is not automatic. It will be considered only when the beneficiary produces fresh medical or treatment records showing the ongoing nature of the illness.
- Initial issue: annual basis.
- Further extension: on production of fresh medical/treatment records.
- Purpose of the records: to demonstrate that the illness is continuing.
Families should therefore keep the latest prescriptions, investigation reports and specialist notes updated well before the card's expiry date.
6. Step-by-Step Process to Seek CGHS Card Extension
The OM and its annexure do not prescribe a detailed application format, since standard formats and operational guidelines will be issued separately by the Directorate. The sequence below follows the process described in the orders.
- Get the medical recommendation. Obtain advice and prescription from a Government Specialist of the concerned specialty.
- Submit the case. Place the case with complete medical, administrative and financial records, as applicable, before the CGHS office concerned.
- Deficiency check. Deficiencies in documents are ordinarily communicated within 3 working days. Reasonable efforts are made to obtain missing documents or clarifications.
- LTC examination. The three-member LTC at the Additional Director's office examines the case.
- Decision. A complete case is ordinarily decided within 15 working days from the date of receipt of complete documents.
- Card issue. On the LTC's recommendation, the CGHS beneficiary card is issued or extended, initially for one year.
7. Annexure-A: List of 42 Critical and Terminal Diseases
The OM attaches an indicative list of 42 critical and terminal diseases for consideration of age relaxation for unmarried dependent sons and brothers under the CGHS/CS(MA) Rules, 1944. The conditions are reproduced below as given in Annexure-A.
| Sl. No. | Name of disease / condition |
|---|---|
| 1 | All patients requiring Major Organ Transplant/Bone Marrow Transplant OR patients who are post-organ transplant/bone marrow transplant. |
| 2 | All Malignant tumors including both solid tumors and hematological malignancies. |
| 3 | Congenital Heart Disease. |
| 4 | Eisenmenger Syndrome. |
| 5 | Post Cardiovascular Implantable Electronic Devices (PCD/CRT-D) with heart failure (EF <35%). |
| 6 | Symptomatic, hemodynamically significant Valvular Heart Disease. |
| 7 | Severe Left Ventricular Dysfunction with EF <35%. |
| 8 | Cardiomyopathy. |
| 9 | Primary Pulmonary Artery Hypertension. |
| 10 | Aortic Aneurysm/Dissections (Treated/Untreated) (repeated). |
| 11 | Demyelinating disease. |
| 12 | Degenerative/progressive nervous system disorders. |
| 13 | Wilson's Disease (congenital metabolic and storage disorders). |
| 14 | Refractory Epilepsy Syndromes. |
| 15 | Myasthenia gravis. |
| 16 | Autoimmune disorders. |
| 17 | Immunodeficiency syndromes. |
| 18 | Chronic Liver Disease. |
| 19 | Chronic Pancreatitis. |
| 20 | Chronic Bleeding Disorders. |
| 21 | Congenital hemolytic anemias. |
| 22 | Thrombotic microangiopathy – Hemolytic Uremic Syndrome. |
| 23 | Budd Chiari Syndrome. |
| 24 | Adrenal cancer/functioning adrenal tumors. |
| 25 | Diabetes Mellitus type 1. |
| 26 | Endogenous Cushing's syndrome. |
| 27 | Panhypopituitarism. |
| 28 | Chronic primary adrenal insufficiency. |
| 29 | Chronic respiratory failure. |
| 30 | Obstructive sleep apnea syndrome requiring treatment with CPAP. |
| 31 | Severe Bronchial asthma. |
| 32 | Chronic Kidney Disease. |
| 33 | Autosomal Dominant Polycystic Kidney Disease. |
| 34 | Congenital/hereditary progressive kidney disorders. |
| 35 | Congenital/acquired Bladder dysfunction requiring continued intervention. |
| 36 | Major congenital genitourinary abnormality with residual functional defects requiring continued management/intervention. |
| 37 | Anatomic Disorders of sexual dysfunction. |
| 38 | Moderate to Severe Psoriasis of PASI >10. |
| 39 | Severe Atopic Dermatitis. |
| 40 | Severe Pemphigus Vulgaris. |
| 41 | Severe Chronic Urticaria. |
| 42 | Vitiligo >10 to <50% BSA. |
Broad groups covered by the list
- Transplant and cancer: major organ or bone marrow transplant, and all malignant tumours (items 1–2).
- Heart and blood vessels: items 3–10.
- Nervous system: items 11–15.
- Immune, liver, blood and related conditions: items 16–23.
- Endocrine disorders: items 24–28.
- Respiratory conditions: items 29–31.
- Kidney and urinary system: items 32–37.
- Skin disorders: items 38–42.
8. General Administrative Provisions (Annexure I)
The Directorate of CGHS OM No. 56-1/2026-27/CGHS/MSD dated 01.09.2026 contains an Annexure I titled "General Administrative Provisions" that governs the decentralised mechanism. Its main provisions are summarised below.
| Provision | Summary |
|---|---|
| Referral to Directorate/STC | Cases not covered under the categories in the OM, or exceeding the delegated financial powers of the Additional Director, are referred to the Directorate. |
| Technical Committee | A three-member LTC headed by the Additional Director, with two GDMOs preferably having qualifications or experience in Medicine and/or Surgery, examines the cases. |
| Documents | Complete medical, administrative and financial records, as applicable, are placed before the Committee. |
| Deficiencies | The concerned office and the Committee make reasonable efforts to obtain deficient documents or clarifications. Deficiencies are ordinarily communicated within 3 working days. |
| Decision timeline | A complete case is ordinarily decided within 15 working days from receipt of complete documents. |
| Post-facto approval | May be considered in specified circumstances (see next section). |
| Further guidelines | Detailed operational guidelines, monitoring and reporting requirements, digital functionality and standard formats will be issued separately by the Directorate. |
9. Post-Facto Approval
Post-facto approval may be considered in an emergency, in unavoidable circumstances, or where prior approval could not be obtained for reasons beyond the control of the beneficiary. It is subject to supporting records and recorded reasons.
10. Documents to Keep Ready
The orders say that complete medical, administrative and financial records, as applicable, should be placed before the Committee. Since formats will be issued separately, beneficiaries are advised to keep the following ready and confirm the exact list with their CGHS wellness centre.
- Recommendation and prescription from a Government Specialist of the concerned specialty.
- Diagnosis and investigation reports showing the illness.
- Records of ongoing treatment, for card extension after the first year.
- Proof of relationship and dependency of the son or brother.
- Details of the CGHS beneficiary (employee or pensioner) and existing card.
- Any financial records or estimates, where treatment cost is involved.
11. Frequently Asked Questions
Q1. What is the subject of the CGHS OM dated 26 October 2026?
It deals with the extension of CGHS facilities to dependent sons and brothers suffering from critical or terminal illnesses under the decentralised STC mechanism.
Q2. Who decides these cases now?
The Local Technical Committee constituted at the office of the Additional Director, CGHS examines the case. On its recommendation, the CGHS beneficiary card is issued or extended.
Q3. Is a Medical Board required?
No. Since there is no standing Medical Board in CGHS, the advice and prescription of a Government Specialist of the concerned specialty is taken as the medical recommendation.
Q4. For how long is the card issued?
Initially on an annual basis, that is, for one year.
Q5. Can the card be extended beyond one year?
Yes, but only on production of fresh medical or treatment records showing the ongoing nature of the illness.
Q6. How many diseases are listed in Annexure-A?
Annexure-A is an indicative list of 42 critical and terminal diseases, including transplant cases, malignant tumours, heart, neurological, kidney, endocrine and certain skin conditions.
Q7. How long will the LTC take to decide?
A complete case shall ordinarily be decided within 15 working days from the date of receipt of complete documents. Deficiencies are ordinarily communicated within 3 working days.
Q8. Who is on the Local Technical Committee?
It has three members: the Additional Director as head, and two GDMOs preferably having qualifications or experience in Medicine and/or Surgery.
Q9. Can approval be taken after treatment in an emergency?
Post-facto approval may be considered in an emergency, in unavoidable circumstances, or where prior approval could not be obtained for reasons beyond the beneficiary's control. It needs supporting records and recorded reasons, and is not an automatic entitlement.
Q10. Where will the application formats be available?
Detailed operational guidelines, digital functionality and standard formats will be issued separately by the Directorate of CGHS.
12. Reference Orders
| Order | Date | Subject |
|---|---|---|
| MoHFW OM No. S.11030/54/2023-EHS(8248513)/I/3909989/2026 | 26 October 2026 | Extension of CGHS facilities to dependent sons/brothers with critical/terminal illnesses under decentralised STC mechanism |
| MoHFW OM No. S.11030/54/2023-EHS | 01 September 2026 | Relaxation in age and marital status criteria for dependent sons/brothers with critical/terminal illnesses |
| Dte. of CGHS OM No. 56-1/2026-27/CGHS/MSD | 01 September 2026 | Decentralised STC mechanism and General Administrative Provisions (Annexure I) |
Conclusion
The OM dated 26 October 2026 brings relief to families caring for a son or brother with a serious long-term illness. By allowing cases to be examined by the Local Technical Committee at the Additional Director's office, on the advice of a Government Specialist, the process becomes local, time-bound and easier to follow. The card is issued for one year and can be extended with fresh medical records, while the 42-disease Annexure-A gives a clear indication of the conditions that can be considered.
Beneficiaries should read the OM of 01.09.2026 for the detailed age and marital-status criteria, keep their medical records current and contact their local CGHS office for the formats and guidelines the Directorate will issue.
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