RGHS is a beneficial health insurance plan for
beneficiary category including Ministers, MLAs, ex-MLAs, All
India Services, Serving and Retired employees of State
Government and of State Autonomous Bodies. All RGHS
beneficiary will have access to the cashless medical facility
based on the Central Government Health Scheme (CGHS) package
rates as per the applicable medical rules for the respective
RGHS category . Some of the features and benefits of the
scheme are outlined as given below:
Cashless Hospitalization: The
beneficiaries of RGHS can avail cashless hospitalization in all
Government and duly empanelled private hospitals of the State.
The complete list is available on RGHS web-portal:
www.rghs.rajasthan.gov inand as the name suggests, a cashless
treatment means that the beneficiary does not have to bear the
cost of a medical treatment. The costs will be borne by the
government. Cashless facility shall be offered only at
empanelled Health care Network providers (HCNP) including all
Government and Private hospitals, Diagnostic / Imaging centers
under RGHS at the prescribed CGHS rates.
Cashless OPD Medicines: The
beneficiaries of RGHS can avail OPD cashless medicines from
Government owned CONFED stores as well as from Private
empanelled Pharma Stores. The complete list is available on RGHS
web-portal:www.rghs.rajasthan.gov.in. RGHS beneficiary will also
be able to upload the OPD prescription with the given facility
on their registered SSO login ID along with a “VIEW PHARMACY”
option to see the list of Pharma stores as per the District and
Enhanced Medical Facility
A large number of Empanelled
Hospitals and Pharma stores: To provide maximum benefits to
all the beneficiaries a large number of private hospitals and
Pharma stores are empanelled under the scheme across the State.
This will help to cater the patients at the time of medical
Empanelment of Diagnostic
Centre/ Imaging centre: All RGHS Beneficiaries can also avail
the services of especially diagnostic centres/ Imaging centres
for investigations and tests for easy and hassle free diagnosis
of the disease as an added feature in medical facilities along
with novel e – pharma facility. This will bring all the health
coverage facilities under one umbrella for imparting holistic
treatment facilties. City location.
Wide Coverage of Medical Facility
Wide Coverage of Medical
facilities: RGHS offers a comprehensive package of treatment
offering coverage that pays for the entire cycle of medical
emergency as well as for OPD/IPD/Day Care, maternity and Child
care facility. All the packages and rates will be as per the
CGHS guidelines and therefore Beneficiary does not have to pay
the hospital private designed rates.
RGHS Card Tracker System: All
RGHS beneficiary have an accessibility of RGHS card Tracker
facility on their registered SSO login ID which will have a
feature of OPD and IPD card limit display as per their
facility for Pensioner’s: RGHS
beneficiary falling under the Pensioner category (under RCS
(Pension) Rules 1996) can also avail the facility of online OPD
enhancement, an easy and hassle free system developed to provide
maximum benefit so that they can have a real time provision of
the availability of the funds for the required medicines.
Facility For SAB (serving and
Retired employees): For RGHS beneficiaries, especially SAB
serving and Retired employees a sum insurance of Rs 5 lakhs (Rs.
20,000 OPD inclusive) will be admissible per family per year
with an extra sum of Rs 5 lakhs coverage per family per year for
any catastrophic illness as specified within the scheme.
Automated IT enabled Process
Automated IT enabled facility:
Enhancing e-governance in the State, RGHS includes a completely
automated IT enabling facility for Seamless Registration,
Healthcare Network Provider (HCNP) empanelment, Beneficiary
Identification Selection (BIS), RGHS Package selection for
treatment, Transaction Management and Claim settlement and
Grievance redressal mechanism making it a complete paperless
system. This will have minimum documentation at each level and
will provide a hassle free admission, treatment and discharge to
the RGHS beneficiary for any medical treatment at a hospital.
Online processing of HCNP
Empanelment: The entire Private Health care network Providers
(HCNP) can use the online empanelment module for applying for
empanelment under RGHS through the RGHS web portal. The
selection process for approval/rejection of the HCNP application
by the Health benefit Empowered Committee(HBEC) will also work
on online and automated module in a time bound manner. The
Empanelment of private Pharma Store is also an online
Services outside Rajasthan
Besides private hospital
empanelment in the State of Rajasthan, few selected
multi-specialty / Specialty private hospitals are also
registered under the scheme outside the State enabling the
beneficiaries to opt for the medical facilities in case of dire
need whenever required outside Rajasthan.
Provision of Electronic Medical Record(EMR)
RGHS beneficiary will have its
own electronic medical record for easy access to the medical
history and to avail the best medical facilities in selected
State Government and empanelled private Hospitals.
Self Managed RGHS e-card system for beneficiary
Self Printing of RGHS e-card:
Since RGHS is an automated IT enabled module, beneficiaries can
print their own RGHS e-card on RGHS web-portal:
www.rghs.rajasthan.gov.in to avail the medical facility.
Single RGHS Card Number All
the Eligible dependent Family members of RGHS card holder will
have a single unique ID number printed on the RGHS card.
There are certain hospital /
medical treatments and non payable items which are not included
within the scheme and are not covered in the claims. These
conditions and features are as per enlisted in CGHS guidelines.