Employees Health Scheme guidelines: ₹3 lakh per episode, no episode cap, cashless above the line.

The Employees Health Scheme now has published guidelines. The ₹3 lakh line is per episode, not a lifetime freeze.

The state government has rolled out a comprehensive Employees Health Scheme for employees, pensioners and eligible dependents. Guidelines framed by the Employees Healthcare Trust came into force from 17 August 2026. The public desk lock for the detailed package is dated 23 August. In force from 17 August is the operative date. This desk will not invent a hospital-wise enrolment headcount.

Coverage is ₹3 lakh per episode of illness, with no limit on the number of episodes. Network hospitals are directed not to deny cashless treatment where costs exceed ₹3 lakh. The ₹3 lakh cap will not apply where predetermined package rates are already above ₹3 lakh. Per episode and no episode cap are the two sentences that matter for a serving employee or a pensioner reading this page.

Claims above ₹3 lakh and up to ₹10 lakh per episode go to a sub-committee of the technical committee plus three to four Employees Healthcare Trust board or trust members. Claims exceeding ₹10 lakh go to the board or trust quorum in an emergency physical or digital meeting. Sub-committee and board quorum are process steps. They are not automatic sanction slips already signed.

Payments follow CGHS package rates notified in October 2025. Ceiling or control prices for implants, stents, devices, drugs or consumables are to be applied. Processing is first-in, first-out after medical and financial scrutiny. Finance on the card is monthly beneficiary contributions from serving employees, service pensioners and family pensioners, with an equal matching State contribution, plus additional budgetary support as provided. Expert and executive committees are to be constituted. To be constituted is not already named. This desk will not invent committee members.

This is a notified scheme circular. It is not a hospital-wise enrolment count. No headcount of beneficiaries sits on the opened card. None will be invented. ₹3 lakh, ₹10 lakh and the October 2025 CGHS rates are the money and rate locks this desk will print.

Hyderabad is the place line for the statewide scheme desk. Employees Healthcare Trust is the framing body.

What is not here is an enrolment census, named committee members, or a hospital that has already refused cashless under the new line. What is here is guidelines in force from 17 August 2026, ₹3 lakh per episode with no episode cap, cashless direction above the cap, package-rate carve-out above ₹3 lakh, ₹3 lakh–₹10 lakh sub-committee review, above ₹10 lakh board or trust quorum, CGHS October 2025 rates, FIFO scrutiny, matching State contribution, and committees still to be constituted.

Until the trust names its committees and hospitals settle the first cashless claims under the new circular, the scheme is paper in force. The ₹3 lakh episode line is the public picture. The enrolment ledger is not on this card.