CMCHIS - Chief Minister's Comprehensive Health Insurance Scheme (Amma Health Insurance)

The Chief Minister’s Comprehensive Health Insurance Scheme is a positive move towards providing world-class health care to millions of people in the south Indian state of Tamil Nadu. The scheme is proving to be a success with more than 65% of the state’s population enrolled under health insurance.

This article lists various details about Amma Health Insurance. Read on to know more about the scheme.

Contents

• What Is CM’s Health Insurance Scheme (CMCHIS)?
• What Is Covered Under CMCHIS (Amma Health Insurance)?
  • 1. Hospitalization:
  • 2. Diagnostic Procedures:
  • 3. Follow-up Treatments:
• Features Of Chief Minister Comprehensive Health Insurance Scheme:
  • 1. Family-floater Plan:
  • 2. Cashless Claims:
  • 3. Frequent Heath Camps:
  • 4. Coverage for Sri Lankan refugees:
  • 5. 24×7 Assistance:
  • 6. High Sum Insured:
  • 7. Wide Network of Hospitals:
• Benefits Of Amma Health Insurance (CM’s Health Insurance Scheme):
  • 1. Coverage For Medical Emergencies:
  • 2. A Huge Number Of Network Hospitals:
  • 3. Multiple Treatments Are Covered:
  • 4. High Sum Insured:
  • 5. Additional Coverages:
• Diseases And Treatments Covered Under CM’s Health Insurance Scheme:
• Eligibility Criteria For CM’s Health Insurance:
• How To Enroll In Chief Minister’s Comprehensive Health Insurance Scheme?
• Documents Required To Apply To CM’s Health Insurance:
• How To Link An Aadhaar Card With A URN?
• Amma Kapitu Thittam Card Download:
• How To Download CM Health Insurance Application Form?
• Period Covered & Maximum Limit:
• How To Search CMCHIS Member ID?
• Beneficiary’s Minimum Electronic Medical Records:
• How To Claim CMCHIS?
• CMCHIS Package List:
• Chief Minister Comprehensive Health Insurance Scheme Hospital List:
• CMCHIS Toll-free Number And Address:
• The bottom Line
• Secure Your Future with ACKO Life Flexi Term Plan:
• Frequently Asked Questions:

What Is CM’s Health Insurance Scheme (CMCHIS)?

The Amma Health Insurance scheme is designed for underprivileged families that have low annual income. With the “Amma Maruthuva Kapitu Thittam”, they do not have to go through a financial struggle at the time of a medical emergency. This TN CM Insurance Scheme offers coverage to the entire family with the help of cashless facilities.

What Is Covered Under CMCHIS (Amma Health Insurance)?

Amma health insurance plan offers financial aid when a medical emergency strikes. With this health insurance plan, a beneficiary can avail the following coverage:

1. Hospitalization:

The cost of availing treatment at an empanelled hospital is covered. However, the treatment should be specified in the list of allowed medical procedures under Amma Health Insurance.

2. Diagnostic Procedures:

The cost of hospitalization takes up a large chunk of money during a medical emergency. However, a considerable amount of money is also required for diagnostic tests. These procedures are covered under the plan.

3. Follow-up Treatments:

Usually, follow-up is not covered under a commercial health insurance plan. But this coverage is offered under Amma Kapitu Thittam. This reduces the financial burden of medical treatments even further.

Features Of Chief Minister Comprehensive Health Insurance Scheme:

This is a useful health insurance plan with the following features:

1. Family-floater Plan:

Amma health insurance is a family-floater type of health insurance plan. All the registered members of an eligible family can avail health insurance benefits under this plan. One does not have to worry about future medical emergencies when covered under the TN CM Insurance Scheme.

2. Cashless Claims:

The beneficiaries of this health insurance plan do not have to pay money while availing treatment at an empanelled hospital. This is a huge benefit for the beneficiary as he/she does not have to think about arranging money for treatment. They can focus their attention on the well-being of the patient.

Also, read: Cashless Health Insurance

3. Frequent Heath Camps:

Empanelled hospitals are instructed to organize health camps at least once a month. The beneficiary can get free check-ups and follow-up treatments frequently.

4. Coverage for Sri Lankan refugees:

There is no cap on the income of a Sri Lankan refugee to enrol under Amma Health Insurance. He/she can thus avail seamless healthcare at the desired centre.

5. 24×7 Assistance:

An active call centre has been set up to answer various queries regarding Amma Health Insurance. If a person faces any problem related to the health insurance being offered, they can easily seek a solution.

6. High Sum Insured:

The CMCHIS policy provides good health insurance coverage of up to Rs. 5 lakhs per enrolled family annually. This relatively high coverage amount enables beneficiaries to access treatments and procedures for significant illnesses without worrying about large medical expenses or exhausting their insurance coverage. It serves as a crucial financial safety net for economically underprivileged households to obtain healthcare services.

7. Wide Network of Hospitals:

CMCHIS has partnered with several hundred hospitals across Tamil Nadu to provide cashless medical services to policyholders. This vast network includes primary health centres, nursing homes, as well as multi-specialty hospitals across districts and towns. Such an extensive network ensures enrolled families can easily and conveniently access quality healthcare close to their hometown during medical emergencies rather than bearing difficulties and expenses related to travelling long distances. The cashless facility at these partner hospitals further reduces the financial burden on beneficiaries.

Benefits Of Amma Health Insurance (CM’s Health Insurance Scheme):

The following benefits can be availed by enrolling under CMCHIS:

1. Coverage For Medical Emergencies:

Some families are not financially equipped to handle a medical emergency due to the increasing costs of healthcare treatments in India. The Amma Health Insurance plan is a step towards eliminating this hurdle and giving access to high-end medical treatments.

2. A Huge Number Of Network Hospitals:

A large number of hospitals are empanelled to give service under Amma Health Insurance. This is beneficial for people because they can reach a medical facility faster. Thus, ensuring treatment at the right time in an emergency situation.

3. Multiple Treatments Are Covered:

Numerous treatments are offered under Amma Health Insurance. This reduces the chances of beneficiaries paying money from their pocket. They can avail any treatment that is covered under the policy free of cost.

4. High Sum Insured:

CMCHIS provides high coverage of 5 lakh rupees to each family for every policy year. This amount of sum insured seems sufficient to avail most of the minor health treatments. 

5. Additional Coverages:

A typical health insurance policy does not always provide coverage for follow-up treatments or diagnostic procedures. However, these are covered under Amma Health Insurance. Thus, one does not have to spend extra money on carrying out follow-up treatments or diagnostic procedures.

Also Explore: Travel Medical Insurance

Diseases And Treatments Covered Under CM’s Health Insurance Scheme:

A large number of treatments are covered for various diseases under this health insurance plan. Here is the list of medical procedures that are covered under the plan.

Eligibility Criteria For CM’s Health Insurance:

The Chief Minister’s Comprehensive Health Insurance Scheme is created for underprivileged families that may not receive the required health care facilities that a person requires. A person willing to enroll under this plan should strictly fulfil the eligibility criteria. Here are the conditions:

• The family should be residents of Tamil Nadu.

• Annual income should be less than Rs.72, 000/- per annum.

• The member should be mentioned in the ration card of the family.

• The applicant may be a Srilankan refugee with proof of citizenship.

• Migrants from other Indian states who carry migration certificates from the suitable authority (they should reside in Tamil Nadu for at least six months).

• Orphans/Rescued girl children from any registered/unregistered organization.

How To Enroll In Chief Minister’s Comprehensive Health Insurance Scheme?

The enrollment process for CMCHIS is not complicated. It can be done rapidly if the applicant has all the required documents in place. The documents are also easy to fetch. Here are the steps for enrollment:

1. Acquire an income certificate from the Village Administrative Officer/Revenue authorities.

2. Carry all the required documents to the enrollment centre.

3. Get the documents verified by the kiosk operator.

4. Next, your biometric details like fingerprints, photograph, eye scan, etc. will be captured.

5. After verification and biometric scanning, your e-card will be issued.

Documents Required To Apply To CM’s Health Insurance:

Mainly the following things are required to apply for the CM’s health insurance policy:

1. Income Certificate

2. Ration Card (a copy and original both)

3. Self-declaration from the head of the family

One should also carry the following documents at the time of enrollment

• Proof of identity

• Address proof

• Aadhar card

• Pan card

Also, read: Do’s and Don’ts of Buying Health Insurance Policy

How To Link An Aadhaar Card With A URN?

Sometimes it may happen that the Aadhar card of the beneficiary was not linked to the provided URN at the time of enrollment. This is not a major cause of concern as one can easily link their Aadhar card with the URN number of CMCHIS. Here are the steps.

1. Visit CMCHIS official website

2. Click on Beneficiary

3. Click on LINK AADHAAR to URN

You will be redirected to this page.

1. Enter the URN number in the box 

2. Click the checkbox to select the option for linking your Aadhar card to URN

3. Click on Enroll Now

4. Select the family member from the list of beneficiaries

5. Enter the mobile number that is linked to the Aadhar card of that family member

6. Enter Aadhar Number

7. Click Submit

8. Enter the received OTP

After successful registration, you will see a message that says “Your Aadhar number registered successfully.” If your Aadhar number was already linked, you will see this message – “Already Registered.”

Also, read: Is Group Health Insurance Mandatory for Employees in India?

Amma Kapitu Thittam Card Download:

The smart card is issued at the time of enrollment. In case, a beneficiary loses their card, they can easily download the Maruthuva Kapitu Thittam Card online. Here are the steps for Tamil Nadu Government Maruthuva Kapitu Thittam Card Download:

1. Visit this page to complete Chief Minister Health Insurance Smart Card Download

2. Enter the beneficiary’s details with along with URN or ration card number

3. Click on ‘Generate e-card’ 

Your e-card is now ready. To end the Tamil Nadu government health insurance card download process, you need to save the generated e-card. You can use the Maruthuva Kapitu Thittam ID card downloaded file in case of a medical emergency.

How To Download CM Health Insurance Application Form?

One does not need to apply separately with the help of a CM Health Insurance Application Form PDF. An eligible person should simply visit the enrollment centre with the required documents. The beneficiary can use the smart card d

uring a medical emergency after the enrollment process is complete.

Period Covered & Maximum Limit:

The policy period of the Amma Health Insurance scheme is one year after which the policyholder needs to get the policy renewed. 

The maximum limit of this policy is 5 lakh rupees. This amount can be used by all registered family members to avail treatment for ailments/diseases listed under the policy.

How To Search CMCHIS Member ID?

The beneficiary of CMCHIS needs to at least have either the URN number or ration card number to search the member ID. Here are the steps to search member ID:

1. Visit CMCHIS website. It is the official website of Amma health insurance.

2. Click on beneficiary.

3. You will see a list that contains links for Member search/ e-card and Member ID.

4. Click on the desired option. 

5. You will see a page that asks for relevant information regarding URN number and other details.

6. Fill the form and click on ‘Search.’

7. The result for corresponding member ID will be displayed.

Also, read: Arogya Sanjeevani Policy

Beneficiary’s Minimum Electronic Medical Records:

To access the minimum electronic medical records of the beneficiary use the following steps:

1. Visit Claims section at CMCHIS website

2. Click on Beneficiary

3. Click on Minimal Health Record

You will be redirected to this page. Here you will see a form for accessing the medical records. Fill the following fields in the box provided on the right side of the screen:

Now you will see the available medical records.

How To Claim CMCHIS?

A wide number of hospitals are empanelled to serve under Amma Health Insurance scheme. The nature of a claim will mostly be cashless. It means that the beneficiary might not need to pay the hospital bill from their pocket. 

During a medical emergency, the beneficiary should produce the Maruthuva Kapitu Thittam Card or the smart card to the hospital. A beneficiary receives this card at the time of enrollment under the Amma Health Insurance. The hospital authorities will send the related information to the Third Party Administrator (TPA) or insurance company. 

The CMCHIS claim amount will be settled directly between the hospital and the insurance company. Usually, no additional intervention from the beneficiary is required. 

CMCHIS Package List:

An array of procedures is covered under the Amma Health Insurance plan. You can access the complete list by visiting this page.

Chief Minister Comprehensive Health Insurance Scheme Hospital List:

In order to provide quick and seamless healthcare facilities, the Amma Health insurance plan has a large network of empanelled hospitals. The hospital list is available at www.cmchistn.com/hospitalList.php.

Learn more about ABHA health id card

CMCHIS Toll-free Number And Address:

Chief Minister’s Comprehensive Health Insurance Scheme is a state-government project that strives to remain approachable in all senses. To ensure transparency and least trouble, various contact details are made available to the general public. Here is a list of contacts that will help you resolve queries.

Toll-Free number: 1800-425-3993

In case you are having difficulty getting in touch with a call centre operative you can use the following contact numbers

• 7373004267

• 7373004924

• 7373002566

For queries or grievances use the following addresses:

Email:

• [email protected]

• [email protected]

Address:

• The Project Director

• Tamil Nadu Health Systems Project (TNHSP)

• 3rd Floor, DMS Annex New Building

• 259 Anna Salai, Teynampet

• Chennai – 600 006, Tamil Nadu.

• CMCHIS Project Office

• Chief Minister’s Comprehensive Health Insurance Scheme

• No.226, Om Sakthi Towers,

• Kilpauk Garden Road, Kilpauk,

• Chennai-600010, Tamil Nadu

Contact information of Chief Medical Officers:

The bottom Line

The Chief Minister's Health Insurance Scheme provides important health insurance coverage to low-income families in Tamil Nadu. This helps them avail quality medical treatment without worrying about the costs. Easy enrollment, claim settlement, and helplines also make the scheme more accessible. This valuable support from the state is essential to ensure proper welfare of the people.

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Frequently Asked Questions:

What is the maximum coverage amount provided under CMCHIS?

The CMCHIS policy provides a maximum coverage of Rs 5 lakhs per enrolled family per year.

How can one check their eligibility for the CMCHIS scheme?

You can check the eligibility criteria set by the government for factors like income, residence proof, ration card, etc., on the official CMCHIS website or at the nearest enrollment centre.

Which family members are eligible to enrol under CMCHIS?

The following members of a family with an annual income of less than 72 thousand rupees can enrol under the scheme:>Head of the family>Legal spouse>Children of the eligible person>Dependant parents

What documents do I need to submit to enrol in CMCHIS?

The main documents required are: Income Certificate, Ration Card (original + copy), Self-declaration by family head, Proof of ID, Address proof, Aadhar card, and PAN card for annual income above taxable limit.

How can I change my mobile number registered under CMCHIS?

You can visit the nearest CMCHIS enrollment centre with relevant ID/URN proof and submit a request to change your registered mobile number.

What is the procedure to get an e-card or smart card under CMCHIS?

You can download an e-card by visiting the CMCHIS website, entering your URN/ration card details and generating your e-card. The smart card is issued at enrollment centres after your documents and biometrics are verified.

Are bariatric surgeries covered under CMCHIS?

Yes, bariatric surgery is one of the treatments covered for insured patients under the Chief Minister's insurance scheme.

Does CMCHIS cover pre-existing diseases?

No, CMCHIS does not cover pre-existing diseases that have occurred prior to enrollment. Only newly diagnosed diseases or ailments after policy purchase are covered.

Can I get cashless treatment outside Tamil Nadu under CMCHIS?

No, the cashless treatment under CMCHIS is limited only to the network of empanelled hospitals within Tamil Nadu.

Are reimbursement claims allowed under Amma Health Insurance?

No, only cashless claims can be availed at an empanelled hospital. This is to reduce the financial burden on the beneficiary of the health insurance plan.

What if the head of the family is not present at the time of enrollment?

If the head of the family is not present at the time of enrollment, the spouse is considered as the head. The enrollment process is still carried out for all family members present.

Are dental treatments included in CMCHIS?

Yes, various types of dental treatments are covered under CMCHIS. Dental procedures come under outpatient treatments.

Is abdominal hysterectomy listed in CMCHIS?

Yes, a beneficiary of Amma Health Insurance plan can undergo abdominal hysterectomy for both benign and malignant conditions. These costs will be covered under the plan.

How long is the renewal process for CMCHIS policy every year?

The CMCHIS policy is valid for 1 year from enrollment, after which beneficiaries have to renew their policy annually to continue coverage.

TN Sets Package Rates For COVID-19 Treatment Under the Chief Minister’s Health Scheme

– June 8, 2020

Under the CM’s Health Insurance Scheme, the Tamil Nadu Government has set the prices for packages related to the treatment of COVID-19 infection. The statement said that all empanelled hospitals can charge up to Rs.5,000 per day for asymptomatic and mildly symptomatic patients in the general ward. The government is yet to release the prices for private hospitals to adhere to. As per the statement by the TN Government, all network hospitals categorised as A1 and A2 with ICU can charge between Rs.10,000 and Rs.15,000 and for A3 and A4, the charge can be between Rs.9,000 and Rs.13,500. Also, the government added that 25% of the beds should be allocated for COVID-19 treatment under the CM’s health insurance scheme.

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