Medical Oncologist
CION Cancer Clinics
CGHS, EHS and ESI cover for cancer surgery | CION Cancer Clinics
Yes, CGHS, EHS and ESI all cover cancer surgery. CGHS is for central government staff and pensioners, EHS for Telangana state employees and pensioners, and ESI for insured workers. Each pays for the operation at a hospital on its own list, usually cashless once the referral or permission is in place. This page explains which scheme is yours, how the route works and what may still be paid by the family. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MM
Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Do CGHS, EHS and ESI cover cancer surgery?
- Which scheme is yours, and how do you get in?
- How does a planned operation actually get approved?
- What the scheme pays and what may still be yours
- Words you will meet at the scheme desk, in plain language
- Four things employees and pensioners tell us, and what is true
- What this page cannot tell you
- Common questions about CGHS, EHS and ESI cover for surgery
The short answer
Do CGHS, EHS and ESI cover cancer surgery?
Yes, all three do. CGHS covers central government employees and pensioners, EHS covers Telangana state government employees and pensioners, and ESI covers insured workers in the organised sector. Each pays for cancer surgery at hospitals on its own list, and in most cases the treatment is cashless once the paperwork is in place.
What the three have in common
Each scheme has a list of empanelled hospitals, a list of approved procedures with a fixed rate, and a step where the treatment has to be permitted or referred before a planned operation. Get those three things right and the operation itself is usually paid in full. Get one of them wrong and the family can end up paying the hospital's private rate.
Who they do not help
A person is covered only through their own or a family member's entitlement. A private-sector employee who is not under ESI, a self-employed person, or a dependant who was never registered on the card is outside all three. For them the routes are Aarogyasri, Ayushman Bharat, private insurance or the relief funds.
If the patient is a dependant, check that their name is on the card before anything else. Adding a dependant later takes time that a surgery date may not have.One by one
Which scheme is yours, and how do you get in?
CGHS
For serving and retired central government staff and their registered dependants. Planned treatment at an empanelled private hospital normally starts with a referral from the CGHS wellness centre. Pensioners usually get credit facility, which means cashless care; serving employees may pay and claim through their department.
What to carry
- The CGHS card of the patient
- The wellness centre referral
- All diagnosis reports
EHS (Telangana)
For Telangana state government employees, pensioners and their dependants. It is run by the same trust that runs Aarogyasri, so the scheme desk at a network hospital raises the case and the trust pre-authorises the package. Treatment is cashless at network hospitals.
What to carry
- The EHS card or employee ID
- Aadhaar of the patient
- All diagnosis reports
ESI
For insured workers below the wage ceiling and their dependants. Care starts at the ESI dispensary or hospital, which refers cancer cases to a tie-up hospital when it cannot treat them itself. Without that referral the tie-up hospital cannot bill ESI.
What to carry
- The ESI e-Pehchan card
- The referral from the ESI hospital
- All diagnosis reports
Step by step
How does a planned operation actually get approved?
Get the referral or permission
For CGHS this is the wellness centre, for ESI the ESI hospital, and for EHS the network hospital's scheme desk. Ask each one how long the referral stays valid, because a surgery date can slip past it.
The hospital raises the case
The surgeon's plan, the biopsy report (the tissue test that confirms cancer) and the scans go to the scheme with a request for a named procedure at the scheme's rate.
Approval comes back
The scheme confirms the procedure, the rate and the ward entitlement. A query at this stage usually means a report is missing. Nothing planned happens in theatre until this is done.
Admission, operation, discharge
Everything inside the approved procedure is billed to the scheme. At discharge you sign the scheme papers and should be handed a summary that shows what was paid and what, if anything, is yours.
Leave a number, we will call you
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Side by side
What the scheme pays and what may still be yours
Usually paid by the scheme
Often still the family's
The operation at the scheme's approved rate
The gap if the hospital charges above the rate and the scheme does not cover it
The ward the card entitles you to
The difference for a higher room category you choose
Implants and consumables on the scheme's list
Items not on the list, or above the ceiling for that item
Tests and medicines during the admission
Attendant food, lodging, travel and most medicines after discharge
On the papers
Words you will meet at the scheme desk, in plain language
- Empanelled
- A hospital that has agreed the scheme's rates and can bill it. Empanelment is by hospital and often by speciality.
- Scheme rate
- The fixed amount the scheme pays for a named procedure. It is often lower than the hospital's private price, which is where a gap can appear.
- Ward entitlement
- The room category your pay grade or pension carries. Choosing a higher category is usually allowed, at your own cost for the difference.
- Credit facility
- The hospital bills the scheme directly, so you do not pay first. This is what "cashless" means on these schemes.
- Reimbursement
- You pay the hospital and claim the scheme rate back. Slower, and the gap between rate and bill stays with you.
- Referral validity
- How long a referral or permission stays live. If the operation is delayed past it, a fresh one is needed before admission.
Commonly believed
Four things employees and pensioners tell us, and what is true
"The card means the bill will be zero."
The scheme pays its rate for the listed procedure and the entitled ward. A room upgrade, an item outside the list or a charge above the rate can still be yours. Ask the desk for the expected gap in writing before admission.
"We can go straight to any big hospital."
Only to one empanelled with your scheme, and for a planned operation only with the referral or permission in hand. A walk-in to a hospital that is not on the list is a private admission, whatever card you hold.
"ESI does not do cancer."
It does. Cancer care that the ESI hospital cannot give itself is referred to a tie-up hospital. The condition is that the route starts at ESI, not at the private hospital's front desk.
"My father retired, so his CGHS cover has ended."
Pensioners keep CGHS on a pensioner card, and in practice they are the group that gets cashless credit most easily. What ends is the department route. Check the card is current and the dependants on it are correct.
Being straight with you
What this page cannot tell you
This page cannot tell you the scheme rate for your operation, the ward your card entitles you to, or whether a specific hospital is empanelled with your scheme for cancer surgery this year. Rate lists and hospital lists are revised, and the scheme desk sees the current version.
It cannot tell you whether to have the operation
Whether surgery is the right step is a question for the treating team, weighed against the type of cancer, its stage (how far it has spread) and the patient's general health. The scheme's approval is about payment. It is not a medical opinion either way.
What to do next
Find the card and confirm the patient's name is on it. Then ask the hospital's scheme desk three questions: are you empanelled with this scheme for surgical oncology, what referral do you need from us, and what is likely to fall outside the scheme rate. Get the third answer in writing.
If the referral has expired, or the dependant was never added, say so at the desk early. Both are fixable, and both take longer than a surgery date allows if left to the last day.Questions we are asked
Common questions about CGHS, EHS and ESI cover for surgery
Do I need a referral from the CGHS wellness centre for cancer surgery?
For a planned operation at a private empanelled hospital, usually yes, though the rules for cancer patients have been relaxed at times. Ask the wellness centre what is required this year, and ask the hospital's scheme desk the same question. If the answers differ, get the wellness centre's version in writing.
Is EHS the same as Aarogyasri?
They are run by the same Telangana trust and use the same network and desks, but EHS is for state employees and pensioners while Aarogyasri is for card-holding families. The ward entitlement and some procedure lists differ. Tell the desk which one you hold so the case is raised under the right scheme.
My mother is a dependant on my ESI card. Is she covered?
Only if she is registered as your dependant on the ESI record. Parents can be added within the scheme's income rules for dependants. If she is not on the record yet, start that at the ESI office now. The tie-up hospital cannot bill ESI for someone who is not listed.
Will we have to pay anything at all?
Often nothing for the operation itself if the hospital accepts the scheme rate and you stay in the entitled ward. Costs that commonly land on the family are a room upgrade, an item outside the scheme list, attendant expenses and medicines after discharge. Ask for the likely gap before admission.
Can we combine the scheme with private insurance?
Sometimes. A private policy can pick up costs the scheme does not, such as a higher room category, but insurers have their own rules about being second payer. Tell the scheme desk and the insurer that you hold both, before admission.
What happens in an emergency, before any referral?
All three schemes have an emergency route that allows admission first and paperwork after, within a set window. Tell the hospital at the door which scheme the patient is on, hand over the card, and ask the scheme desk to open the emergency case that day.
Are implants and staplers covered?
Items on the scheme's list are covered up to the scheme's ceiling for that item. Anything outside the list, or the amount above the ceiling, may be billed to you. Ask the surgeon what will be used, and the desk which of those items the scheme pays for.
Does CION accept these schemes?
CGHS, ECHS, EHS, Aarogyasri, Ayushman Bharat and cashless insurance are accepted. Whether a particular operation can be billed depends on the scheme's list and the referral, so call the helpline with the card and the reports first.
What moves the figure
What affects the cost
Four things change the total more than anything else.
The technique used
A shaped or image-guided delivery costs more than a conventional one, and is chosen on clinical grounds rather than preference.
How many sessions
The total is driven by the number of sittings or cycles, not by a single per-visit figure.
Supporting tests
Scans, blood work and pathology done alongside treatment are billed separately.
Your cover
Aarogyasri, CGHS, ECHS, EHS or cashless insurance usually change the out-of-pocket figure substantially.
Paying for it
Insurance, schemes and payment
What you actually pay usually differs a great deal from the sticker figure.
AarogyasriEmpanelled. Bring the card and a referral where you have one.
CGHS / ECHS / EHSAccepted at CION centres for eligible treatment.
Cashless insuranceMost major insurers are empanelled. Pre-authorisation is handled by our desk.
Self-payItemised estimate given before treatment starts. No EMI scheme exists.
Accreditation and empanelment
- NABH
- NABL
- ISO 9001:2015
- ArogyaSri empanelled
- CGHS accepted
- ECHS accepted
- EHS accepted
- Major cashless insurers
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A surgical consultation can be booked at any of these centres through one helpline, and your team will tell you where the operation itself takes place.
Warangal
Vizag
Sources
- National Cancer Institute — Surgery to treat cancer
- American Cancer Society — Financial and insurance matters
- Cancer.Net — Financial considerations
- Tata Memorial Centre — Tata Memorial Centre
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Is Cancer Surgery Covered by Health Insurance?If you hold a private policy alongside the schemeRoom Rent Limits and Proportionate DeductionWhy a room upgrade costs more than the roomImplants, Staplers and Consumables: The Hidden Line ItemsThe items most often outside a scheme listCancer Surgery Under AarogyasriThe route if no employee scheme appliesCost, Insurance and Schemes for Cancer SurgeryEvery page on paying for an operation
Talk to us
Not sure what your card entitles you to?
Call the helpline with the card and the reports. We will check the route and the likely gap before you come in. One helpline serves every CION centre.