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Separate Health Insurance for people covered by DGEHS

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23 Mar, 2022 by  vikas rawat

Hi All,

My wife is Delhi government teacher and hence we both are covered by DGEHS(Delhi Government Employees Health Scheme).

We have no child yet and parents are also covered by the organization dad retired from.


My question is:

Do we need to get extra health insurance other than what DGEHS provides? Specially if we met with an accident and/or have a huge bill, as DGEHS has specific rates for its hospitals and not sure how much it will pay if we are not in the list of hospitals.(see below points)


Below are what I have found till now:

  1. DGEHS hospital list is only of Delhi and few NCR hospitals.
  2. For emergency, Treatment in private hospitals not recognized/not empanelled under the scheme in medically emergent conditions will also be admissible when treatment is necessitated in such hospitals being situated near the place of illness / trauma and when no other recognized facility is available nearby or due to circumstances beyond the control of the beneficiary. However, reimbursement in such cases shall be made by the concerned department within the ceiling of DGEHS rates.
  3. I am thinking of 5 lakh base + 5 lakh super top up floater, with option to get plan which refills the amount even if one person has already used in a year. We are both fit so cover should get to 20 lakh if not used for couple of years.
  4. But would we need it? I can think of only scenario where we have for say 20 lakh bill from private and DGEHS based on their rates would only approve 5 lakh. Or if we want a private room but based on my wife's grade, we can only get general ward.
  5. Family wise we can afford it as I am also an Engineer. Don't want to rely on employee's basic group health insurance plan as well.


DGEHS site: http://health.delhigovt.nic.in/wps/wcm/connect/doit_health/Health/Home/Directorate+General+of+Health+Services/DGEHS/

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23 Mar, 2022
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You should consider a health insurance which is fuss free with fewer sub limits.

Because at the time of admission, generally we don't want to compromise on health checkups.


You can take a 5 lakh base cover with 45 lakhs super top up (premiums are reasonable).

You can get in touch with me for further details, will be happy to help.

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23 Mar, 2022
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Dear Vikas,


A DGEHS is like a staff bus. It will be helpful in most cases however if you are looking for a personalised experience and better facilities then a personal car (in this case health insurance) will be helpful. Also there have been instances in past where hospitals have denied hospitalisation to DGEHS or CGHS patients for the reason of large outstanding bills with the respective Govt.

In my opinion ideally you should look to have a conversation with an advisor of your choice. A detailed conversation helps in suggesting a product mix.


Regards

Rohit Dhingra



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