Grant of fixed medical allowance for pensioners, family pensioners under NPS

In accordance with the existing instructions, Fixed Medical Allowance (FMA) is admissible to the Central Government civil pensioners/family pensioners (i) residing in areas not covered under Central Government Health Scheme or any corresponding Health Scheme administered by other Ministries/Departments and (ii) not availing OPD facility under CGHS. FMA is disbursed to the pensioners by the Pension Disbursing Authorities/Banks along with their monthly pension.

2. FMA is also admissible to retired National Pension System (NPS) employees who are granted pension under Old Pension Scheme on account of invalidation/disability and to the family members of deceased NPS employees, who are granted family pension as per the Old Pension Scheme on death of NPS employee during service. Grant of FMA in such cases is subject to fulfilment of the usual conditions therefor.
3. Ministry of Health and Family Welfare issued orders vide O.M. No S.11011/10/2012-CGHS(P)/EHS dated 28th March, 2017 extending the CGHS facility to Government servants who retire under NPS, if they fulfil the following conditions:

(i) Minimum years of qualifying service for eligibility of CGHS membership after retirement-10 years
(ii) No minimum qualifying years of service for availing CGHS facilities in case of death/disability.
(iii) In case of absorption in an Autonomous Body/Statutory Body, NPS subscribers can avail CGHS after their retirement only if the Autonomous Body/Statutory Body, where they are absorbed, is covered for their retired employees, subject to condition (i) above.
(iv) In case of deputation to an Autonomous Body/Statutory Body, no CGHS coverage till such period of deputation continues unless the entity to which the employee has been transferred on deputation is covered by CGHS.
(v) Status quo to be maintained for serving NPS subscribers subject to conditions at (iii) and (iv) above.
vi) Other conditions such as definition of family, CGHS contribution, conditions of dependency etc. will be applicable as per the existing rules.

4. The matter regarding grant of FMA to the employees who retire from NPS has been considered in consultation with the Department of Expenditure, Office of Controller General of Accounts (CGA) and Ministry of Health & Family Welfare. It has now been decided that such retired NPS employees, who otherwise fulfil the conditions for availing CGHS facility as mentioned in para 3 above, shall be eligible for grant of FMA on the same rates as in the case of pensioners drawing pension under Old Pension Scheme, if they are residing outside CGHS area and do not avail OPD facility under CGHS after retirement. Accordingly, those NPS retirees who are eligible for CGHS facility but are residing outside CGHS area shall be entitled to FMA as per the applicable rate, if they do not avail any CGHS facility or avail only the IPD facility under CGHS.

5. The modalities for sanctioning FMA to NPS retirees have been considered in consultation with the office of Controller General of Accounts (CGA) and the following procedure is laid down for sanction of FMA to the NPS retirees:
(i) The retiring Government servant shall submit the following forms/documents in triplicate to the Head of Office (HOO):
(a) Application-cum-undertaking in prescribed format (Form’1’) along with two copies of photograph, specimen signature and identification marks.
(b) Details of family in prescribed format (Form-2 of CCS (Implementation of National Pension System) Rules, 2021. (Referred to in Rule 10(3)of those Rules)
(c) Undertaking addressed to bank for recovery of overpayment prescribed format (Form-3)
(d) Nomination Form for payment of Arrears of FMA in prescribed format

(ii) The Head of Office, shall scrutinise the application and apply the necessary checks. After complying with the rules and instructions issued by the Government of India regarding eligibility for payment of FMA to the retired Government Servant, the HOO shall forward the FMA case along-with two sets of forms/documents referred to in sub-para (a) to (d) above to the Pay & Accounts Officer for issue of FMA payment authority. The Head of Office shall retain one set of each of the Forms/documents mentioned above. The Head of Office will maintain the files, registers and records relating to all such cases for future requirements.
(iii) The PAO shall apply the necessary checks and prepare FMA Payment Authority. The PAO will issue the FMA authority and send it to the Central Pension Accounting Office (CPAO) along with one set of forms documents mentioned in subpara (a) to (d) above and the copy of the forwarding letter sent to him by HOO. The FMA authority shall include the name of spouse/family member who would be eligible for FMA in the event of death of the retired NPS employee. For this purpose, the eligibility conditions for grant of FMA to the family would be the same as in the case of family pension under CCS (Pension) Rules. The Pay & Accounts Officer will endorse copy of FMA Payment Authority to the Head of Office as well as NPS retiree/beneficiary. The Pay & Accounts Officer will maintain the files, registers and records relating to all such cases for future requirements.
(iv) The Central Pension Accounting Office will feed the data of all such cases individually and also keep scanned copies of all documents received from Pay & Accounts Officer in its data base. After, carrying out necessary checks, CPAO will prepare Special Seal Authority (SSA) and send the same along with all the Forms received from Pay & Accounts Officer and mentioned in sub-para (a) to (d) above to the concerned Central Pension Processing Centre (CPPC) of the Authorised Bank for payment of FMA to the beneficiary. The Central Pension Accounting Office will endorse the copy to the PAO & beneficiary.
(v) The Central Pension Processing Centre (CPPC) of the Authorised bank, after receiving the Special Seal Authority for payment of FMA from CPAO, will credit the amount of FMA, at the rate notified from time to time by the Department of Pension & Pensioners’ Welfare, Ministry of Personnel, Public Grievances and Pensions in respect of retirees governed by CCS (Implementation of NPS) Rules, 2021, in the bank account of the beneficiary on monthly basis. The payment of FMA will be automatic and no bill is required to be submitted by the beneficiary. The CPPC will strictly follow the instructions mentioned in the Special Seal Authority for Payment of FMA issued by the CPAO and any other orders issued by the Government on the subject. The amount of FMA disbursed to the retired NPS employees and their families will be reimbursed by the Government to the banks as per the existing system.
(vi) In the case of change in option by the beneficiary from FMA to CGHS (OPD) facility, the instructions contained in the Department of Pension & Pensioners’ Welfare, Ministry of Personnel, Public Grievances and Pensions’ OM No. 4/05/2019-P&PW(D) dated 23.03.2022 as amended from time to time will be followed.
(vii) NPS retiree/beneficiary has option for getting FMA credited in their savings bank account opened or to be opened with any of the CBS enabled branch of concerned authorized bank (either single account in their name or joint account with member of their family in whose favour an authorization for FMA exists in the FMA Payment Authority) and operated either by “former or survivor” or “either or survivor” basis. The NPS retiree/beneficiary in whose favour FMA has been sanctioned should be the primary account holder in the joint account.
viii) For payment of FMA to NRI beneficiary, opening of bank account and facility for withdrawal of FMA to sick and physically handicapped beneficiary, the procedures/instructions laid down in the Para Nos. 16 & 17 respectively of the ‘Scheme for Payment of Pensions to Central Government Civil Pensioners by Authorized Banks’ (5th Edition) issued by Central Pension Accounting Office shall be followed.
(ix) For transfer of account from one branch/bank to another for payment of FMA, the procedure laid down in Para 15 of the ‘Scheme for Payment of Pensions to Central Government Civil Pensioners by Authorized Banks’ (5th Edition) issued by Central Pension Accounting Office shall be followed.
(x) After making payment of FMA, the CPPC, for the present, shall follow the procedure / instructions contained in 5th Edition of “Payment of Pensions to Central Government Civil Pensioners by Authorised Banks” issued by Central Pension Accounting Office, for reimbursement, accounting and submission of reports to the extent feasible and required. Further, instructions for payment of FMA to the beneficiary under National Pension System will be formulated and issued by the Central Pension Accounting office to CPPCs in due course.
(xi) The person drawing FMA shall submit life certificate (Digital or physical) every year in November in the concerned bank for continuing the FMA. The payment of FMA due in following January onwards will be made only after the retiree has submitted the life certificate due in preceding November.
(xii) The member of family of NPS retiree will intimate about the death of NPS retiree/FMA beneficiary at the earliest and not later than one month after the date of death so that the Payment of FMA is stopped by the CPPC. On death of a beneficiary, pro-rata FMA for the period after the last payment up to the date of death shall be paid to the next beneficiary/nominee.
(xiii) On the death of FMA beneficiary, if the name of the spouse/family member eligible for FMA is mentioned in the FMA Payment Authority, the spouse/family member will apply to the bank along with the Death Certificate for disbursement of FMA to him/her. The bank will accordingly start disbursement of FMA to him/her. If the name of family member eligible for FMA is not mentioned in the FMA authority, then, on death of an FMA beneficiary, the member of the family shall apply to the Head of the Office along with death certificate for issue of a fresh FMA authority. Thereafter, the exercise as for issuing an FMA authority shall be followed for issuing a fresh FMA authority in favour of the family member. This will, interalia, include satisfying of HOO about eligibility of the family member and forwarding case to PAO for issue of FMA authority. PAO, after exercising necessary checks will issue authority and send case to CPAO for making payment through CPPC. The eligibility conditions for grant of FMA to the family would be same as in case of family pension under CCS (Pension) Rules, 2021.
(xiv) On death of a serving employee, if the family is entitled to benefits of lumpsum and/or annuity under NPS, the procedure applicable for issuing PPO for family pension in favour of a family member would be adopted for issuing FMA authority in favour of eligible family member of deceased NPS employee.
(xv) The Bank shall make payment of FMA on quarterly basis in the following manner:

For the months of December to February – In the first week of March
For the months of March to May – In the first week of June
For the months of June to August – In the first week of September
For the months of September to November – In the first week of December

The payment of FMA to be made in the first week of December for the months of September to November and all subsequent payments of FMA will be subject to submission of life certificate (Digital or Physical) due in the month of November
(xvi) The amount of FMA disbursed to the retired NPS employees and their families will be disbursed by the Government to the banks as per the existing system.
(xvii) The FMA authority shall include the details of the Bank/Family/Nominee which may be utilised for payment of any arrears of the pay, etc., which may become due to the employee on account of implementation of recommendation of Pay Commission or any other reason.

(xix) The FMA payments, Account, Records and Registers maintained in the CPPC of Authorised Banks making FMA payments shall be open to audit by the Comptroller and Auditor General of India or any person appointed by Government in this regard. In addition to audit by C&AG, the Internal Audit Wing, Central Pension Accounting Office will also conduct audit of CPPCs of Authorised Banks in respect of FMA payments.
(xx) The existing procedure is for payment of FMA to those Pensioners/Family Pensioners who are governed by CCS(Implementation of NPS) Rules, 2021 and are in receipt of invalid or disability pension/family pension under CCS(Pension) Rules will continue.
(xxi) As informed by CGA, payments towards FMA may be done through same Head of Account and on the same lines as being done presently. The expenditure for booking FMA.

6. These orders will take effect from the date of issue of order.

7. All Ministries/Departments are requested to give wide publicity to these orders.

8. These orders issue with the concurrence of Ministry of Finance, Department of Expenditure, vide their I.D. Note No. 18(2)/EV/2021 dated 07.12.2022.

9. In so far as the persons serving in the Indian Audit and Accounts Department are concerned, these orders are issued in consultation with the Comptroller and Auditor General of India, as mandated under Article 148(5) of the Constitution of India.”