CGHS vs PSU Medical Schemes 2026: Which Healthcare Model is Better?
New Delhi: Healthcare has always been a major concern for government employees in India. In 2026, the comparison between the Central Government Health Scheme (CGHS) and PSU-specific medical schemes—such as those offered by NTPC, ONGC, and IOCL—has become even more relevant. While CGHS has been upgraded with digital transformations and revised rates, Maharatna PSUs continue to provide their employees with premium “corporate-style” healthcare.
1. CGHS 2.0: New Changes in 2026
CGHS is no longer the same scheme it was years ago. The October 2025 Tariff Revision, the first in 15 years, has made the scheme more attractive to private hospitals.
Revised Rates:
Treatment costs in critical specialties like Cardiology, Oncology, and Orthopaedics have increased by 5%–30%, enabling beneficiaries to access better facilities at top hospitals like Max Healthcare and Apollo Hospitals.
Comprehensive Mediclaim and AYUSH Cover:
In January 2026, the government introduced an optional insurance plan for CGHS beneficiaries, offering additional coverage of ₹10–20 lakh for hospitalization and specialized treatments.
8th Pay Commission Factor:
With the establishment of the 8th Central Pay Commission (CPC), discussions have intensified around modernizing CGHS into a new insurance-based model (CGEPHIS) to further improve coverage and efficiency.
Also Read: EPS-95 Higher Pension 2026: New Breakthrough for PSU Retirees & Supreme Court Finality
2. PSU Schemes: Premium and Customized (NTPC & ONGC)
The medical schemes of Maharatna PSUs like NTPC and ONGC are significantly different from CGHS and are often described as more generous and tailored.
No Upper Ceiling:
In PSUs such as ONGC, there is no upper limit on treatment costs. Even procedures costing ₹50 lakh or more are fully covered by the company.
Dedicated Hospital Network:
PSUs maintain their own hospitals while also partnering with top-tier corporate hospitals. Treatments are often processed fast through Third Party Administrators (TPAs).
Retiree Benefits:
PSU retirees continue to receive post-retirement medical benefits, which are more personalized than CGHS coverage but can be limited by geographical constraints, depending on the location of company hospitals or panel hospitals.
3. Major Differences at a Glance
| Feature | CGHS (2026 Update) | PSU Schemes (NTPC/ONGC) |
|---|---|---|
| Authority | Ministry of Health & Family Welfare | Individual PSU HR Policies |
| Tariff Rates | Standardized (recently revised) | Variable, often higher or no cap |
| AYUSH Support | Fully covered (new optional policy) | Limited, PSU rules apply |
| Accessibility | 80+ cities (expanding) | Corporate hubs and operational areas |
| Insurance Option | Optional AYUSH Mediclaim | Primarily self-funded or group insurance |
4. Key Challenges in 2026
While both schemes look robust on paper, certain challenges persist:
CGHS Payment Delays:
Some private hospitals report 150–180 days for bill clearance, slowing access to reimbursements.
PSU Reach Limitations:
PSU schemes can become difficult for retirees living in cities without a company office or panel hospital, limiting access despite generous coverage.
Conclusion
In 2026, both CGHS and PSU medical schemes have evolved to meet the growing healthcare demands of employees and retirees. CGHS offers standardized, nationwide access and new insurance options, while PSU schemes provide customized, high-end healthcare with generous coverage for employees and retirees in operational areas.
The choice between the two depends on employment type, location, and healthcare needs, making it essential for beneficiaries to understand each scheme’s scope, coverage, and limitations to make informed decisions.