Haryana Medical Reimbursement: Rules, Rs 9,000 Dependent Limit and Package Rates

Who can claim, which family members count, how a claim moves and how the bill is worked out at package rates. Built from the Health Department letters of 14 July 2020 and 13 July 2026 and the Medical Reimbursement Policy.

Read this first. Most of the figures below come from the Health Department letter of 14 July 2020 and the older Medical Reimbursement Policy. The newest paper is the letter of 13 July 2026 that raised the dependent income ceiling. If a later order has changed a figure, the official order wins. Ask your DDO or the Health Department before you rely on a number for a big bill.

Who can claim medical reimbursement in Haryana?

If you are a regular Haryana Government employee or a pensioner, the State pays back what you spend on treatment, for yourself and for family members who depend on you. It is not insurance and it is not a card you swipe. You get treated, collect the bills and papers, and your office sanctions the claim.

• Regular employees of the Haryana Government.
• Pensioners. The policy says all pensioners of the Haryana Government are eligible for treatment in the same way as employees.
• Family members who fit the definition of "family" in the Health Department letter of 8 January 2008, explained in the section on dependents below.

Adhoc and contractual staff are not allowed any kind of medical advance under the policy, and the summary policy does not give them a separate reimbursement scheme. If you are on contract or deployed through HKRN, read your engagement terms first and see the contractual and HKRN guide.

The Rs 9,000 dependent income ceiling (13 July 2026)

This is the newest change in the scheme. Letter No. 2/144/07-1HBIII, dated 13 July 2026, from the Additional Chief Secretary, Health Department, goes to all Heads of Department, Divisional Commissioners, Deputy Commissioners and the Registrar of the Punjab and Haryana High Court. Its operative line says it has been decided to increase the income ceiling of the dependents of State Government employees and pensioners from the existing Rs 3,500 to Rs 9,000 per month for the purpose of medical reimbursement.

The letter points back to the 2007 letter No. 2/144/2007-1HBIII dated 14.12.2007, where the old limit was set. It was issued with the concurrence of the Finance Department, conveyed by U.O. No. 12/4/2025-IFDII/16207 dated 26.06.2026. A copy went to the Accountant General, Haryana.

What was the old rule?

The policy note said, "The income of dependants should not exceed Rs 3,500 per month." Many printed copies and office notes still carry this line. After the letter, read it as Rs 9,000.

Who benefits?

The dependent has to earn within the limit, so the people who gain are family members who earn a little: a parent with a small pension, a sister who does part-time work, a child on a low stipend. News reports name dependent parents, children, legally adopted children, widowed daughters and dependent sisters, and speak of about 4.5 lakh employees and pensioners. The letter itself lists no beneficiaries and gives no numbers.

Is it a flat Rs 9,000?

The letter says "Rs. 9000/- per month". It does not mention any dearness relief on top. Central Government rules use a Rs 9,000 limit with dearness relief added, but nothing in the Haryana letter says so. Until the department says otherwise, read it as a flat Rs 9,000 a month.

What about the Rs 3,000 old-age pension?

Reports say the Punjab and Haryana High Court held that an employee cannot be refused reimbursement for dependent parents only because a parent gets an old-age pension of Rs 3,000 a month, and that a Director General Health Services clarification of 3 February 2025 said such a pension should not count as income. This is reported, not part of the 13 July 2026 letter. Ask your DDO for the court order or the clarification before you rely on it. With the new Rs 9,000 limit, a Rs 3,000 pension no longer crosses the line anyway.

I lost a claim earlier because the income was above Rs 3,500. What now?

The letter does not say whether it applies to treatment taken before 13 July 2026, and it says nothing about reopening old claims. If a claim was rejected only on the income ground, write to your head of office with a copy of the letter and ask for it to be reconsidered or sent to the Health Department. Nothing in the letter promises a yes.

Who is a dependent for medical reimbursement?

Reimbursement is for you and your "family" as defined in letter No. 2/354/07-1HBIII dated 8 January 2008.

For dependants other than a spouse and children, two things apply. First, income: the limit is now Rs 9,000 a month. Second, real dependence: for parents, mother-in-law and father-in-law the policy says physical and financial dependence "is a must". Living in your house and relying on you for money and care is what the office looks for.

Can a woman employee claim for in-laws?

Yes. A woman employee can opt for either her own parents or her mother-in-law and father-in-law. She has to inform the authorities in time, so decide and put it in writing. It should not change from one claim to the next.

What is the joint affidavit?

If husband and wife are both State Government employees, they can give a joint affidavit so that the bill is claimed from one of the two offices. This stops the same bill being claimed twice. In this case the policy says the income limit does not apply.

Check a dependent

How to apply and what to attach

A clean claim is half the battle. This is the process the policy sets out.

1. Keep the treatment papers. Collect the prescription, discharge summary, every bill and receipt, and investigation reports. For package treatment in an empanelled hospital the bill should show the package and implant details, with stickers or batch numbers of implants, stents and valves pasted on or noted.
2. Fill the bill on the proper proforma. It must be duly filled in and signed by the claimant. The bill may also be countersigned by the Civil Surgeon or Medical Superintendent.
3. Submit within 12 months after the treatment is completed. If the patient or claimant has died, the Health Department can extend the limit. After 12 months the case goes to the Health Department for ex-post facto sanction, so attach a short letter explaining why you were late.
4. Show identity. Employees and pensioners produce the identity card of the department at the hospital. Pensioners are issued the card by the Head of Office.

Pensioners: where do I submit?

Before retirement an affidavit is given stating the permanent place of settlement (it can be changed later). The pensioner submits medical claims to the head of office at the place of permanent settlement.

What does the office look at?

• Is the person covered: employee, pensioner or dependent family member?
• Is the hospital government, a government medical college, an empanelled private hospital or an emergency case?
• Is the bill worked out at the correct package rates?
• Are all items reimbursable?
• Is the amount within the sanctioning powers of the office?

A warning on false bills. The policy says in plain terms that false drawal of medical reimbursement bills is tantamount to dismissal of the claimant. Do not pad a bill.

Checklist: claim form on the proforma, original bills, prescriptions and discharge summary, investigation reports, implant stickers or batch details, emergency certificate where the hospital is not on the approved list, a dependency declaration for a dependent patient, and a copy of the identity card.

Government hospitals, empanelled hospitals and emergencies

Government hospitals and medical colleges

Charges are reimbursed in full in all government hospitals, and in all government medical colleges in the country. For a medical college you need a certificate from the Medical Superintendent or Civil Surgeon that the college is run by the State (Government). Many colleges are private or run by trusts and charge package rates, so ask for a short certificate on the letterhead and pin it to the bill. Even in a government hospital the office checks that the patient is a dependent, that the items are reimbursable (admission fee and consultation charges are not), and the 12-month limit.

Empanelled private hospitals

Private hospitals can treat you under this scheme only if the State Government has approved them. The letter calls it a private hospital approved by the State Government, and it includes private medical colleges recognised by the Medical Council of India in Haryana and empanelled by the State. The list changes from time to time, so check the current list before taking treatment. Expenditure on treatment taken in the branches of approved hospitals is not reimbursable.

Package rates differ by accreditation. A hospital with Entry-level NABH uses the Entry-level column. A Full NABH or JCI hospital uses the higher column. The hospital has to provide a valid accreditation certificate, otherwise it is treated as non-NABH/non-JCI when charging lump-sum rates, which is the safe reading to keep.

Emergency treatment in an unapproved hospital

You do not choose the hospital when someone collapses. The policy allows full reimbursement for emergency treatment in unapproved hospitals equal to PGI Chandigarh rates, with the approval of the Administrative Department. The Head of the Department, in consultation with the concerned Civil Surgeon, is competent to certify an emergency. The policy quotes the line from Shakuntala vs State of Haryana: emergency knows no law and no precedents when human life is at stake.

A planned visit to a reputed or specialised hospital that is not on the list is different. Finance Department U.O. No. 5/7/2005-1B&C dated 20 December 2012 says such claims are disposed of at the Administrative Department, subject to prior permission before the expenditure is incurred, adequate budget provision, and an Emergency Certificate from the Civil Surgeon or Chief Medical Officer. No further approval from the Health Department is needed.

A short plan if it happens

1. Take the patient to the nearest hospital that can treat them. Do not wait to find an approved one.
2. Ask the hospital for a detailed bill, discharge summary and admission note.
3. Ask the Civil Surgeon or CMO for an emergency certificate and put the request to your Head of Department.
4. Send the claim with the certificate, noting that the Administrative Department's approval is needed.
5. Expect the amount to be worked out at PGI Chandigarh rates. Any excess is your own expense.

Package rates explained (14 July 2020 letter)

On 14 July 2020 the Health Department replaced its 2015 letter and fixed lump-sum rates for 1,340 packages, including the 152 notified earlier. The rates were worked out with specialists in government hospitals and compared with the tariff of leading private empanelled hospitals, CGHS (Delhi NCR) rates and package rates of insurance companies. The Finance Department agreed on 15 September 2019. Each package has two rates: one for Entry-level NABH hospitals and a higher one for Full NABH or JCI hospitals. The complete 1,340-package finder will be added with the full site.

What a package includes

• Admission charges, visit and consultation fee, patient's diet
• Monitoring charges, pre-operative and other investigations
• Operation, anaesthesia and OT charges, surgeon's and anaesthetist's fee
• Surgical disposables, consumables, gas charges and OT assistant charges
• Medicines used during the stay, physiotherapy and nursing care
• Routine post-operative stay in ICU
• Blood transfusion (grouping, cross matching, blood or component, transfusion)
• Medicines for 7 days after discharge

What is extra

Room rent as per your entitlement; implants where the table shows a separate implant cost; and a few items marked "cost of drug extra" or "fully reimbursable", such as the dialyzer for dialysis and medicines for chemotherapy. ICU, CCU and ventilator charges are not charged extra when the package already includes the routine post-operative stay.

Day care means a stay in hospital of less than 24 hours, certified by the hospital. The day figure in the table (1, 2, 3, 4, 5, 7, 10 or 14 days) is the usual stay without complications, and room rent is paid for those days.

Two or more packages in one operation

Room rent is charged once only.

Procedures with no package

• Room rent as per entitlement.
• Lab and diagnostics at the Annexure-I rates.
• Medicines and consumables at Rs 1,750 per day, excluding high-cost injections such as Anti-D, Anti-Haemophilic Factors, thrombolytic treatment, anti-cancer drugs and antibiotics costing more than Rs 2,000 a day after taking 30% off MRP. The hospital must give an undertaking that no cheaper brand of the same composition is in stock.

For diseases not in the limited cashless list, reimbursement is at the package rates, and for non-package procedures at PGIMER Chandigarh rates plus 75% of the balance amount. Where no package rate exists at all, the policy says to look at PGI Chandigarh rates, then PGI Rohtak, then AIIMS Delhi, and then refer to the Director General Health Services.

A few popular packages (Entry-level NABH / Full NABH or JCI, 2020)

Delivery is treated as a disease for reimbursement, and prenatal and postnatal treatment is reimbursable (letter of 16.03.1964). For the maternity leave side, see the Maternity Benefit Act guide.

Room rent entitlement by pay

Package rates for a procedure are the same whichever room you choose, but room rent is charged separately and depends on your pay. The slab is worked out on your revised pay under the 7th Pay Commission, that is (basic pay + grade pay) × 2.57, and the rent is per day.

As printed, the slabs leave small gaps (between Rs 50,192 and Rs 50,217, and between Rs 64,532 and Rs 64,588). The letter does not say which slab a pay in a gap belongs to, so ask your office if your pay falls there.

• Private ward: one patient, attached bath, furnishing, a bed for the attendant, and air-conditioned.
• Semi-private ward: two to three patients in a room with attached toilet facilities.
• Room rent covers the bed, patient's diet, water and electricity, linen, nursing, heater or A.C. charges and routine housekeeping.
• Day care: room rent up to Rs 750.
• No separate room rent in ICU, CCU and HDU. A higher category than your entitlement is paid by you.

Find your room rent

ICU, CCU and over-stay

These rules apply when a patient is in intensive care for a medical condition, not as part of a surgery already covered by a package. No extra room rent is charged in ICU or CCU. HDU is charged at the same rate as room rent.

ICU with invasive ventilation includes the ventilator, nursing, diet, procedural charges such as lines, catheters, chest tube, infusion pump and tracheostomy, physiotherapy, drugs, consumables, all lab investigations, dietician and specialist visits, and nothing is excluded. When treatment is under a fixed package and the post-operative protocol needs CCU, ICU or HDU, no extra charge is taken.

If the patient stays longer than the package

In an exceptional case, supported by medical records and certified by the hospital, extra reimbursement may be allowed for accommodation as per entitlement, investigations at approved rates and the cost of medicines. The hospital issues a separate bill for the over-stay. Nothing extra is allowed if the longer stay is because of infection, a consequence of the surgical procedure or a faulty investigation procedure. Ask the hospital to write the reason in the discharge summary and keep the day-wise ICU chart.

Implant ceilings (Annexure-II, 14 July 2020)

Package rates usually do not include the implant. For items with a fixed implant cost, you get the ceiling or the actual cost, whichever is less. Rates fixed by the Government of India for stents and knee implants apply when lower. Check the current NPPA price before you pay.

Cochlear implant: reimbursement is 100% for children aged 1 to 5, 80% for ages 5 to 10 and 50% for ages 10 to 16, and 50% of the wearable components can be allowed for replacement every 3 years on the advice of two ENT surgeons. If you choose an implant above these rates, the hospital must explain and take your written undertaking, and you bear the difference.

Medical advance and sanctioning powers

If a planned treatment is expensive, you can ask for a medical advance before admission. Powers (w.e.f. 19 September 2016):

The same figures apply to medical advance, and to sanctioning a claim. Late claims go to the Health Department, emergency treatment in an unapproved hospital needs the Administrative Department, and package-rate doubts can go to the Director General Health Services.

How much is advanced?

• Government hospital: 90% of the hospital's estimate.
• Approved (empanelled) hospital: 75% of the estimate on non-packaged rates, worked on PGI Chandigarh rates plus 75% of the balance amount. A second line in the policy gives 50%, and a third refers to rates notified by the State; these last lines are not fully clear in the scanned copy, so ask your office which percentage applies.

Conditions

1. Only for approved hospitals. For unapproved hospitals the case may be sent to the Finance Department.
2. Only after an estimate of cost, signed by the doctor or medical officer and countersigned by the Medical Superintendent.
3. Only to regular employees. Adhoc and contractual employees are not allowed any kind of advance.
4. Pensioners and temporary employees get it only with sureties of two permanent employees or one regular employee, plus an affidavit.
5. A utilisation certificate within three months of sanction, failing which penal interest is charged.

Chronic diseases and outdoor treatment

For long-running illnesses the policy lets you claim outdoor treatment as well as indoor, if the disease is on the list notified by letter No. 2/640/2005-1HBIII dated 8 June 2005:

1. CAD (coronary artery disease)
2. Chronic heart disease
3. Chronic respiratory disease, COPD, ILD, cystic fibrosis
4. Chronic renal failure
5. Rheumatoid arthritis, osteoarthritis
6. Brain tumour and malignancy of different organs
7. Paraplegia, quadriplegia, hemiplegia
8. Epilepsy
9. Multiple sclerosis, myasthenia gravis
10. Ulcerative colitis, Crohn's disease, coeliac disease
11. Cirrhosis of liver, chronic hepatitis B and C
12. Thalassemia
13. Psoriasis
14. AIDS
15. Diabetes mellitus, scleroderma
16. Organ transplant
17. Glaucoma
18. Connective tissue disorders, Wegener's granulomatosis, SLE and polyarteritis nodosa

Since 28.05.2003, indoor and outdoor expenditure is reimbursable for the chronic disease, including outdoor follow-up of indoor treatment. The disease is reviewed after two years by a Medical Board, and you can change your option at any time after getting a chronic disease certificate from the Civil Surgeon. Under the fixed medical allowance arrangement, Rs 1,500 a year is reimbursable for outdoor treatment of other-than-chronic diseases of dependants. The letter number for this in the scanned policy looks like 2/157/2022-1HBIII dated 21/04/2008, so check the number on your own copy.

What you can and cannot claim

The scanned policy page also lists room heater charges and attendant room rent and diet charges beside these items, and the page begins in the middle of a list. They appear to be items not allowed, but check the line on your own copy of the policy before you decide. Consultation is "not reimbursable" as a separate item, but in a package the fee is already inside the lump sum, so you do not lose it.

Denture, knee, lens and hearing aid

TA, pensioners, cashless and other rules

• TA for referral. TA is admissible only once if the patient is referred outside the state by the Civil Surgeon for special treatment, with an attendant. There is no TA for repeated OPD follow-ups. Get the referral in writing before you travel.
• Delivery is treated as a disease. Letter No. 237-4HBW-64/8589 dated 16 March 1964 makes prenatal and postnatal treatment reimbursable.
• IAS officers are entitled to reimbursement of their outdoor medical claims also.
• Limited cashless facility. The 2020 letter refers to a limited cashless facility for six conditions notified on 20.11.2017 but does not list them, and the 2017 letter is not in the papers used for this guide. Ask your DDO for the current list. A general cashless card is a union demand, not an order.
• Follow-up. Ask the hospital to write the follow-up plan in the discharge summary, because that record decides what is covered.

Where the papers are silent

• Whether the Rs 9,000 limit applies to treatment before 13 July 2026.
• Whether any dearness relief is added to Rs 9,000.
• The list of six cashless conditions and the present hospital list.
• Any revision of the 2020 package rates after 14 July 2020.

Related pages: Maternity Benefit Act (leave and benefits around delivery) and contractual and HKRN policy (staff who are not covered by the regular scheme).

Frequently asked questions

Last reviewed 24 October 2026. An independent guide, not an official Government of Haryana website. Always rely on the latest official notification.