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CMHIS ( Chief Minister Health Insurance Scheme Nagaland ) : Coverages, Steps to apply and How to Renew

Team AckoDec 6, 2024

It is difficult for some households to access quality healthcare owing to the financial burden it carries. This is where the government can intervene and introduce insurance schemes that provide the necessary medical care. In Nagaland, the Chief Minister Health Insurance Scheme helps residents to get health care at medical centres without worrying about the financial implications. This article will provide an overview of the Chief Minister Health Insurance Scheme Nagaland, including its eligibility requirements, benefits, and application process for coverage. Read on to learn more

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Contents

What is the Nagaland Chief Minister Health Insurance Scheme (CMHIS)?
What are the eligibility criteria for the Nagaland Health Insurance Scheme?
What are the benefits of the Chief Minister Health Insurance Scheme in Nagaland?
What are the coverages of the Chief Minister Health Insurance Scheme Nagaland?
Annual Health Coverage Limits
Steps to apply for the Chief Minister Health Insurance Scheme Nagaland
- Documents required for the CMHIS
- Mandatory Documents for Enrollment (EP) category
How to renew the coverage of CMHIS
- CMHIS ( Chief Minister Health Insurance Scheme Nagaland ) contact details
How to Verify and Update Your Details
- Special Instructions
Who Can Apply For The CMHIS (Gen) Category?
Who Can Apply for the CMHIS (Ep) Category?
What Does CMHIS(Gen) Define as a Household?
Who is Qualified to be Listed as a Household Member?
Who Should Not Be Considered A Household Member?
Medical Facilities Where Care Will Be Provided
Conclusion
Frequently Asked Questions

What is the Nagaland Chief Minister Health Insurance Scheme (CMHIS)?

The Chief Minister Health Insurance Scheme is meant for the people of Nagaland. This initiative will be carried out in collaboration with the Central Government's Ayushman Bharat scheme.

The Chief Minister Health Insurance Scheme is an important step toward achieving Nagaland's 2030 Sustainable Development Goal, which was launched in August 2021. This goal strives to guarantee that Nagaland citizens have access to fair, economical, and high-quality medical care by 2030. Any permanent and indigenous residents of the state who are not enrolled in Ayushman Bharat or any other publicly funded insurance programme can be covered under the Chief Minister Health Insurance Scheme.

What are the eligibility criteria for the Nagaland Health Insurance Scheme?

The Chief Minister Health Insurance Scheme is available to all permanent and indigenous residents of Nagaland. They are divided into two categories CMHIS (GEN) and CMHIS (EP).

CMHIS (GEN) include residents who are not enrolled in Ayushman Bharat or any other publicly funded insurance programme. The CMHIS (EP) category can enrol in the program's first phase, and the following groups of people are eligible for coverage.

State government employees
Pensioners
Legislators and former legislators
Employees in the state-run public sector and other organisations who are entitled to a monthly medical stipend or reimbursement.

What are the benefits of the Chief Minister Health Insurance Scheme in Nagaland?

The policyholders will get the following benefits from the Chief Minister Health Insurance Scheme Nagaland.

Financial coverage

The scheme provides enrolled families coverage of up to Rs 5 lakhs to cover hospitalisation costs and critical treatments. This high insurance amount aims to fully pay for expensive procedures like cancer surgery, kidney transplants, etc, without the patient having to bear any costs. It protects a safety net against catastrophic health expenses, especially for economically disadvantaged sections.

Since the coverage is on a family floater basis, the total sum insured can be utilised by any or all insured members under a single policy as per their medical requirements. This offers flexibility in providing financial aid as needed by individual family members.

Access to high-quality healthcare services

An important objective of the CM's insurance scheme is enabling beneficiaries to avail themselves of the best possible medical care for complex conditions at par with more privileged sections of society. It strives to ensure that low income or remoteness does not translate into sub-standard healthcare for Nagaland's citizens.

Besides getting quality treatment within the state, tie-ups are being proactively established with reputed hospitals and research centres across India that have excellence in organ transplantation, neurology, oncology, etc. Referral access is provided for advanced treatments that are not locally available. This pan-India network of specialised healthcare partners ensures patients can get advanced tertiary care services when needed.

Eligibility for other government health schemes

By being enrolled in the Chief Minister Health Insurance Scheme, eligible individuals and their families may also become eligible for other government-funded health schemes, such as the Ayushman Bharat program. This can provide even greater access to healthcare services.

Comprehensive healthcare

The scheme intended to provide comprehensive health care services (including preventive care) to the people of Nagaland. This can help identify and address health issues early on, leading to better health outcomes and lower healthcare costs in the long run.

What are the coverages of the Chief Minister Health Insurance Scheme Nagaland?

Here are the coverages of the Chief Minister Health Insurance Scheme Nagaland:

1. Medical treatments

The Chief Minister Health Insurance Scheme provides financial coverage for various medical treatments, including hospitalisation, surgeries, and post-surgery care. The coverage is intended to help alleviate the financial burden of high healthcare costs for eligible families.

2. Outpatient treatments

The scheme provides coverage for outpatient treatments such as diagnostic tests and doctor consultations, which are very important to prevent and manage diseases that are very common in a community.

3. Preventive and primary care services

The scheme covers preventive and primary care services. This coverage can help identify and address health issues early on and prevent chronic diseases, lowering healthcare costs in the long run.

Annual Health Coverage Limits

The scheme covers general families at Rs 5 lakh per family per year. Any or all members can use this money for their medical expenses.

The scheme covers government employee families at Rs 20 lakh per family per year. The family can use this higher amount for hospital charges as needed.

Additionally, if costs exceed the covered amount for government staff, the state government, on the advice of the Medical Board, may also pay back the additional expenses.

Steps to apply for the Chief Minister Health Insurance Scheme Nagaland

You can apply for the Chief Minister Health Insurance Scheme in Nagaland by following the steps:

Step 1: Registration

For online registration visit https://cmhis.nagaland.gov.in/login.
For offline registration you need to personally visit any CMHIS Kiosk with the documents mentioned below.

Documents required for the CMHIS

To apply for the CMHIS, you must provide the following documents.

Proof of residence in Nagaland
Identification, such as a driver's licence or passport
Any necessary medical records or documents
Bank account details (account number, IFSC code, etc.)
Other documents as requested

*Note: The above list of documents is indicative and may differ from the actual set required for registration.

Also, Read: Documents required for passport

Mandatory Documents for Enrollment (EP) category

For Pensioners:
- Valid mobile number
- The first 3 pages of the Pension Payment Order (PPO) indicate pension details
For Serving Employees:
- Valid mobile number
- Personnel Information Management System (PIMS) code
For Dependent Family Members:
- Proof of relationship like birth certificate, Aadhaar card, etc.
- Disability certificate for dependents with disabilities
- The documents confirm eligibility and dependency linkages with the primary insured member under the scheme.
Step 2: Assessment
- Once your application has been received and processed, you will receive a confirmation of your coverage.

How to renew the coverage of CMHIS

The CMHIS coverage must be renewed annually in order to continue receiving benefits.

Renewal can be done online or in person at a designated enrollment centre. Here is how you can renew the plan.

To renew your coverage online, visit the Nagaland government's health insurance website and follow the instructions provided.
To renew in person, visit a designated enrollment centre with your current CMHIS card and any necessary documents.

CMHIS ( Chief Minister Health Insurance Scheme Nagaland ) contact details

If you have any questions or need assistance with your CMHIS coverage, you can contact the Nagaland government's health insurance department.

Chief Minister Health Insurance Scheme Nagaland login	https://cmhis.nagaland.gov.in/
Contact number	14555
Email ID	[email protected]

How to Verify and Update Your Details

Enter the Portal's login credentials: Obtain your CMHIS ID at www.cmulis.gov.in.
Look up the mobile number: To confirm your registered mobile number, use an OTP.
Verify Family Information: See and validate the information about your family members covered by the plan.
Change the breadwinner:
Default: The family's head is identified as the breadwinner.
Change: If a government employee is absent, choose another family member.
Adjust Coverage for Accidental Insurance:
Default: Covered are the three oldest family members and the breadwinner.
Change: Family members can be added or removed as necessary.
Change the Claims Nominee:
Default: For others, the breadwinner is the nominee, and for the breadwinner, the next oldest is the nominee.
Change: As needed, update the nominee's information.

Special Instructions

Government Servants: Breadwinner status is automatically set and cannot be altered.
Expired Family Members: If a family member has died, update the portal to name a new provider.
Opening Bank Accounts: Families that indicate that members require assistance creating bank accounts can also use the platform. Special camps for creating bank accounts will be held later. Families can use these bank accounts to obtain supplementary insurance coverage through PMSBY and PMJJBY.

Who Can Apply For The CMHIS (Gen) Category?

Every Indigenous person and/or permanent resident of the state who is not covered by the CMHIS (EP) category and is not a beneficiary of the AB PM-JAY or any other government-funded health insurance program falls under the CMHIS (GEN) category.

CMHIS (GEN) membership is for the following types of persons: non-dependent family members of CMHIS (EP) categories, employees without PIMS numbers, ad hoc or contractual state employees on a fixed salary, and all others under any CSS, whether contractual or not, and their families.

Who Can Apply for the CMHIS (Ep) Category?

Medical Allowance (MA) and/or medical reimbursement scheme refers to the allowance available to state government employees under the Medical Reimbursement Head. CMHIS (EP) category includes (1) Normal Workers, (2) Pensioners, (3) Legislators and Former Legislators, (4) - Corporation Employees, Autonomous Bodies and State Public Sector Undertakings, (5) Scale-pay Workers along with dependent family members.

What Does CMHIS(Gen) Define as a Household?

A household is typically defined as a collection of people who live together and typically prepare their meals in a shared kitchen unless work-related obligations prevent any of them from doing so.

Institutional households—rescue homes, jails, ashrams, and orphanages—will be considered households under CMHIS (GEN). All prisoners will be listed as household members as long as that household meets the program's requirements and is not connected to any beneficiary households under AP PM-JAY, CMHIS, or any other government-financed insurance program.

As long as their PM-JAY card has been deactivated if it has already been issued, current PM-JAY beneficiaries who were included in their parent's household in SECC 2011 but have since gotten married or established a separate household may also designate themselves as a household under the CMHIS (GEN) category.

Who is Qualified to be Listed as a Household Member?

All individuals who typically reside together must be listed as household members.

All people who typically live together but are temporarily absent on seasonal migration and are expected to return within six months of the enumeration date must be listed as household members.

The household head's personal information will not be shared with the family if they have been absent from the home for more than six months in the past year. Nevertheless, members of the household presently serving in the military or paramilitary will be listed with their household.

According to the Central Services (Medical Attendant) Rules, 1944, any family members or household members of CMHIS (EP) Category families who do not meet the dependency requirements are eligible under CMHIS (GEN). Under CMHIS (GEN), these members will be grouped and treated as a single household.

Anyone living with a government employee or retiree who is not dependent must be declared by the Head of Household of CMHIS (EP) at registration. They shall be provisioned with a Special Household ID and incorporated into CMHIS (GEN) as a household.

Who Should Not Be Considered A Household Member?

Temporary tourists and guests who have spent less than six months in a single year overall. Members, even if they visit the HH sometimes, who have permanently moved away or left the family due to marriage, work, etc. A resident worker, domestic helper, or paying visitor who shares meals and resides in the home. Individuals who are not regarded as typical members.

Medical Facilities Where Care Will Be Provided

Treatment is available to CMHIS (GEN) beneficiaries at all hospitals accredited under AB PM-JAY in and out of the state. AB PM-JAY has more than 28,000 accredited hospitals nationwide. Please visit our website at https://cmhis.nagaland.gov.in for information about hospitals affiliated with AB PM-JAY.

Beneficiaries of CMHIS (EP) are eligible to get care at any hospital in the state affiliated with CGHS and hospitals affiliated with CMHIS (EP). CGHS has affiliations with around 1500 institutions nationwide. For further information, visit https://cghs.nic.in/reports/view_hospital.jsp. Visit https://cmhis.nagaland.gov.in to learn about the state's recognised hospitals and which hospitals are CGHS-empaneled.

Conclusion

The Chief Minister's Health Insurance Scheme in Nagaland is a groundbreaking effort to give good health coverage to permanent residents of the state. Combined with Ayushman Bharat, the central government scheme expands its scope so more people benefit.

The scheme offers robust coverage - hospitalisation, surgeries, outdoor patient treatment, and preventive care. This shows the state's dedication to improving the health and wellness of its people. The wide services covered and the large population targeted highlight Nagaland's aim to make quality healthcare affordable and accessible to all its citizens.

Frequently Asked Questions

Here are some common questions and answers about the Chief Minister Health Insurance Scheme Nagaland.

Who is eligible for the Chief Minister Health Insurance Scheme in Nagaland?

All permanent and indigenous residents of Nagaland are eligible, with specific categories for CMHIS (GEN) and (EP). There are two categories:

CMHIS (GEN) - For people who don't already have any other free/subsidised government health insurance.
CMHIS (EP) - For specific groups like government employees, pensioners who get payments from the state, members of state legislature and similar categories.

What does the CMHIS coverage include?

The CMHIS coverage includes hospitalisation, surgeries, post-surgery care, outpatient treatments, diagnostic tests, doctor consultations, and preventive and primary care services.

How can I apply for CMHIS in Nagaland?

You can apply online through the CMHIS official website or offline by visiting a CMHIS Kiosk. Necessary documents for identification, proof of residence, and medical documents must be provided.

What documents are required to apply for CMHIS?

Required documents include proof of residence in Nagaland, identification such as a driver’s licence or passport, any necessary medical records, and bank account details.

Can I add family members to my CMHIS coverage?

Yes, dependent family members can be covered under the CMHIS. You need to provide their details and necessary documentation during the registration process.

Can I choose my own hospital for treatment?

Yes, under the Chief Minister Health Insurance Scheme Nagaland, you can choose your own hospital for treatment. However, it's important to check if the hospital is part of the scheme's network of empanelled hospitals.

Can I renew my policy after it expires?

Yes, you can renew your Chief Minister Health Insurance Scheme Nagaland policy after it expires. It's best to check with the insurance provider or the Department of Health and Family Welfare for details on how to renew your policy.

Is there a cap on the sum insured under the scheme?

Yes, the sum insured is capped at Rs. 5 lakhs for CMHIS (GEN) beneficiary families and at Rs. 20 lakhs for CMHIS (EP) beneficiary families.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet, and is subject to changes.