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Meghalaya Health Insurance Scheme (MHIS): Benefits, Eligibility & How To Enrol

TeamAckoDec 26, 2024

Universal healthcare is the need of the hour with the advent of a growing population. A large number of Indians are unable to afford the expenses for medical treatment. Treatment expenditure pushes many of them into poverty. With the rise in costs of medical treatment, one must have health insurance. Therefore, considering this scenario, the Meghalaya government wants to protect its residents against medical and financial crises. Meghalaya Health Insurance Scheme (MHIS) is an initiative implemented with the convergence of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. Keep reading to learn about MHIS, its manifold benefits, and the steps to enrol.

Meghalaya Health Insurance Scheme

Contents

Meghalaya Health Insurance Scheme (MHIS)
Benefits of MHIS
Eligibility Criteria For MHIS
Who Is Not Included Under MHIS?
Documents Required For Enrolling For MHIS
- Documents For Verifying Personal Details
- Documents For Verifying Family Details
Fees for MHIS registration
How To Enrol For MHIS?
Grievance Redressal Under MHIS
- Conclusion
Frequently Asked Questions (FAQs)

Meghalaya Health Insurance Scheme (MHIS)

To provide affordable healthcare to all its residents, Meghalaya started the MHIS in 2012. It assures insurance coverage of up to Rs 5,30,000 per family on a floater basis. It is a ‘floater’ as the total amount can be used by either one member or the entire family. Currently, the Meghalaya health insurance scheme is in its fifth phase (MHIS V). Since 2019, it has been running along with the Central government’s Pradhan Mantri Jan Arogya Yojana (PMJAY).

The National Insurance Company Limited provides the insurance under MHIS scheme. As per the official website, it was selected after a thorough and competitive bidding procedure. The insurance coverage under MHIS has increased over the years. This is how it has risen over the years.

MHIS I: Rs. 1.6 lakh
MHIS II: Rs. 2 lakh
MHIS III: Rs. 2.8 lakh (plus Rs. 30,000 cover for senior citizens)
MHIS IV: Rs. 5 lakh
MHIS V: Rs. 5.3 lakh

Benefits of MHIS

The MHIS enrollment offers the following benefits to its beneficiaries.

Insurance coverage of up to Rs. 5,30,000 per family on a floater basis. This is more than the coverage of Rs. 5 lakh offered by PMJAY.
The scheme is open to all Indians from Meghalaya.
No cap on family size.
No age limit.
Secondary care covers pre- and post-hospitalisation costs until 1 day before hospitalisation and up to 5 days after discharge from the hospital.
Coverage for tertiary care is 15 days from the date of discharge.
Pre-existing diseases are covered from day one.
A newborn child will be covered from birth up to the expiry of the policy for that year.
Pregnant women will be covered for antenatal and postnatal care.
Coverage for cardiac and diabetic patients.
Treatment is available throughout India at PMJAY-empanelled hospitals.

Eligibility Criteria For MHIS

All Indian citizens from Meghalaya are eligible for enrolment under MHIS. It does not, however, include central and state government employees. Additionally, the scheme aims to provide affordable healthcare coverage to the marginalised and economically weaker sections of society. Beneficiaries must meet the criteria set by the government to qualify for the scheme.

Who Is Not Included Under MHIS?

A person will not be eligible for enrollment under an MHIS card in the following cases.

Patients with conditions which do not require hospitalisation and can be taken care of with outpatient care are not covered by MHIS packages.
Apart from pre- and post-hospitalisation expenses, costs for diagnosis at a hospital or nursing home during the hospitalisation period are not covered by MHIS insurance.
Unless a physician has prescribed vitamins or tonics as part of treatment, they will not be covered under the MHIS Meghalaya.
Dental operations of a corrective, prosthetic, cosmetic nature, filling of the tooth cavity, root canal, and dental implants are excluded from MHIS coverage.
Unless an assisted reproductive technique or infertility-related procedure is part of the National Health Benefits Package list, it will not be covered.
MHIS claims do not include vaccination and immunisation.
Surgeries for an ageing face and body, laser procedures for removing tattoos, augmentation surgeries and other entirely cosmetic procedures like neck lifts, aesthetic rhinoplasty, fat grafting, etc., will not be included by MHIS.
Patients who are in a permanently vegetative state are excluded from MHIS.
Central and state government employees are excluded.
MHIS does not cover suicide cases.

Documents Required For Enrolling For MHIS

You will have to submit certain documents to verify your personal and family details. They have been listed below:

Documents For Verifying Personal Details

You must submit any of the following documents to verify your personal details.

Voter ID
Aadhaar card
Birth certificate
MGNREGA job card
Ration card
Any other Government ID or certificate with a photo

Documents For Verifying Family Details

You must submit any of the following documents to verify your family details:

Ration card.
RSBY/MHIS Card for the RSBY/MHIS category.
PM’s letter for the SECC beneficiary category.
Any other government document which lists all family members.
Headman’s certificate.

Fees for MHIS registration

A fee of Rs. 30 has to be paid to get the MHIS card.

How To Enrol For MHIS?

Here are the steps to follow to register for the MHIS card.

Go to your nearest district kiosk or empanelled hospital.
Provide the relevant document for personal identification.
To add family members, furnish documents proving your relations with them.
Pay the registration fee.
After the officials complete the authentication process, they will issue your MHIS card.

Grievance Redressal Under MHIS

For grievance redressal, you can call the toll-free number 1800-102-4762, the helpdesk number 0364-250 7477 or fill up the ‘Contact Us’ form on the official website. On the ‘Contact Us’ page, you will get the email IDs of all the district managers for the scheme.

It is advisable to secure yourself with an insurance scheme. It will protect you and your family against financial and medical hazards. Explore your options and select a coverage which best serves you.

Conclusion

The Meghalaya Health Insurance Scheme-NHIS is an essential initiative that provides the entire Meghalaya population with comprehensive health coverage. MHIS has extensive benefits, an easy enrollment process, and coverage for a diversified range of medical needs. This is an excellent scheme to protect your health and the future. Secure yourself and enjoy the health benefits of affordable and high-quality healthcare.