Nagaland's CMHIS offers free health insurance coverage

Accessing quality medical care remains a challenge for many people, especially the economically challenged section of society, due to the financial burden it entails. To address this pressing concern, governments often introduce and implement affordable and accessible insurance schemes to cover these sections of society and provide essential healthcare.the state of Nagaland launched one such initiative, the Chief Minister Health Insurance Scheme ( CMHIS ). It is the first state-specific welfare initiative to provide cashless treatment for various healthcare services to every state citizen without financial constraints.The scheme was introduced as a significant step towards achieving Nagaland's 2030 Sustainable Development Goal, launched in August 2021. The initiative strives to ensure that the citizens of Nagaland have access to economical, fair and high-quality healthcare services by 2030.

• The Chief Minister Health Insurance Scheme Nagaland offers free health insurance coverage to eligible families
• Eligible individuals for the coverage are divided into two heads - the general category and EP category
• The maximum coverage amount is ₹5 lakhs under the General category and ₹20 lakhs for the EP category
• Coverage is allowed for hospitalisation expenses, outpatient treatments, preventive care, cancer treatments, etc.

Chief Minister Health Insurance Scheme ( CMHIS ) is an initiative by the Government of Nagaland to provide health insurance coverage to the employees of the state government & pensioners households, and the other households that are not covered under Pradhan Mantri Jan Arogya Yojana (PM-JAY). CHMIS Nagaland initiative is carried out in collaboration with the Central Government’s Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY).The scheme is designed especially for the people of Nagaland to provide comprehensive health insurance coverage by offering financial protection against rising medical costs. The scheme aims to provide access to healthcare services for the economically weaker section of the state and make quality medical care affordable.

The Chief Minister Health Insurance Scheme (CMHIS) Nagaland was introduced with the following objectives:

Health Awareness Initiatives

CMHIS aimed to focus on health awareness initiatives through campaigns promoting preventive healthcare practices among citizens and residents of Nagaland.

Inclusivity and Equity

CMHIS focuses on equity and inclusivity in healthcare services by ensuring that all eligible citizens, regardless of their economic status, can benefit from the scheme.

Improve Health Outcomes

The CMHIS scheme in Nagaland aims to improve the overall health outcomes of the people. It ensures affordable and timely healthcare treatment access without financial burdens on beneficiaries.

The CM Health Insurance Scheme Nagaland is meant for the permanent and indigenous residents of Nagaland, including the CMHIS (GEN) and CMHIS (EP) categories. The eligibility criteria under both categories are different. The below table provides key details of the two categoriess:

CM Health Insurance Scheme Nagaland provides coverage on a family floater basis, which can be used by any or all family members as per their medical requirements. The annual health coverage limit for the CMHIS (GEN) category is ₹5 lakhs per year per family, and for the CMHIS (EP) category is ₹20 lakhs per year per family.Further, for government employees, the additional medical expenses beyond the maximum annual coverage amount may also be covered or reimbursed by the state government on a case-to-case basis at the discretion of the state medical board.

The Chief Minister Health Insurance Scheme in Nagaland incorporates the following key features:

Comprehensive Coverage

CMHIS Nagaland offers comprehensive coverage and health care services, including hospitalisation, pre-existing health conditions, critical medical care, kidney transplants, cancer surgery, preventive care services, diagnostic tests, surgeries, and outpatient treatments for specified diseases and conditions.

Empanelled Healthcare Providers

CMHIS Nagaland beneficiaries can get treatment at the network of empanelled hospitals, clinics, and healthcare providers. CMHIS (GEN) category can get cashless treatment at network hospitals under the AB PM-JAY scheme within or outside the state of Nagaland. More than 28,000 network hospitals are empanelled under the AB PM-JAY scheme. CMHIS (EF) category can get cashless treatment at more than 1500 network hospitals empanelled under the CGHS (central government health scheme) across the country and hospitals within the state empanelled under CMHIS (EF) category.

No Age Limit

There is usually no upper age limit for enrolment under the scheme. It ensures that the elderly citizens also benefit from it and get much-needed coverage in their old age.

Government Funding

The scheme is funded by the state government of Nagaland, often with contributions from the central government or other stakeholders.

The CMHIS offers various significant benefits to the residents of Nagaland:

Financial Protection

CMHIS Nagaland aims to provide financial protection to policyholders in the event of emergencies. It provides financial coverage for treatment expenses of up to ₹5 lakhs, covering hospitalisation costs and critical treatment without creating a financial burden.

Access to Quality Healthcare

CMHIS Nagaland makes quality healthcare accessible and affordable to all the citizens of Nagaland. With the scheme, all the residents of Nagaland can get the best possible medical care at empanelled hospitals and healthcare facilities across Nagaland.

Inclusion of Vulnerable Sections

The scheme focuses on economically vulnerable people, ensuring they get the necessary healthcare treatment without financial burden.

Healthcare Equity

CMHIS aims to promote equality in medical access and improve health outcomes across the state by promoting universal medical coverage.

Eligibility for Other Government-Funded Health Schemes

By enrolling in the Chief Minister Health Insurance Scheme , you and your family may also become eligible for other government-funded health insurance schemes, such as the Ayushman Bharat Yojana, which provides greater access to medical services. It is important to know how to apply for chief minister health insurance scheme . Also Read: Types Of Government Health Insurance Schemes In India

Here is the list of what is covered under the Chief Minister Health Insurance Scheme Nagaland :

The process to apply for the Chief Minister Health Insurance Nagaland is as follows

Online Registration

Registration under the Chief Minister Health Insurance Nagaland can be done online for the beneficiary family by self or through the authorised registration centres. Simply log in to the official website of CMHIS for self-registration online.

Registration Through Authorised Registration Centres

All the community health centres or primary health centres that are empanelled under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in the state and the partner BIS agencies or operators are deemed Authorised Registration Centres.Even various departments at the district or directorate offices and empanelled private hospitals are also designated as Authorised Registration Centres. You can walk into any of these centres for registration under the Chief Minister Health Insurance Nagaland .

Registration Through Outreach Enrolment Camps

You can also get the registration done during the outreach enrolment camps conducted for e-SHRAM, AB PM-JAY CMHIS , or camps of other government welfare schemes in the locality.

Verification of Registration

Post registration, your details will be verified for eligibility conditions. Registration alone does not confirm the eligibility of the applicant under the scheme unless it is verified by the verifying authority. Upon verification and approval of the registration application, you will get a confirmation on your registered mobile number with the household ID assigned to you and your family/household.

The list of documents required to enrol under the CHMIS Scheme Nagaland includes:

• Proof of residence in Nagaland
• Bank account details such as account number, IFSC code, etc.
• ID proof, such as passport or driver's licence
• Any other necessary medical documents or records
• For pensioners, their mobile number and the first three pages of the Pension Payment Order (PPO) indicate their pension details.
• For serving employees, their mobile number and their Personnel Information Management System (PIMS) code
• For Dependent Family Members, relationship proof such as an Aadhaar card, birth certificate, etc. and for dependents with disabilities, disability certificate is to be submitted.
• Other documents as requested

Also Read: Health Insurance 101: Guide on the Basics of Health Insurance

You need to renew your coverage under the Chief Minister Health Insurance Scheme every year to continue enjoying the healthcare benefits. You can renew it both online and offline at the authorised enrolment centres.Simply visit the official website of CMHIS and follow the instructions for renewal or visit the authorised centres with your CMHIS Nagaland card and other necessary documents.

For any assistance or query for Chief Minister Health Insurance Scheme Nagaland , you can reach the Nagaland government's health insurance department through their official website, contact them at their helpline number 14555 or e-mail at nagaland.nhpm@gmail.com .To make a successful claim, here's the process that you should follow -

Medical Reimbursement Eligibility Criteria

Here are the key documents required:

• Government Employees : Applicable for treatments till December 31, 2023.
• Government Pensioners: Applicable for treatments which are undertaken after the deduction of Medical Allowance (MA) has commenced and till December 31, 2023.
• Applicable for the network hospitals that are empanelled under the old MR scheme and/or CMHIS scheme Nagaland .
• Applicable for emergency procedures and treatment conducted in non-empanelled hospitals.
• Reimbursement requests will undergo a verification and approval procedure as per the Government's Guidelines.
• Claims which meet the eligibility criteria will be approved for reimbursement.
• Treatment costs will only be reimbursed based on approved CMHIS scheme Nagaland rates or State Medical Board recommendations, subject to specific terms and conditions.

Medical Reimbursement Documents

Here are the key documents required: Personal Documents

• Bank Account details of beneficiary Head of Household (HOH) (Employee/Pensioner).
• Ayushman Card of the Employee/Pensioner and/or dependent beneficiary patient.
• Declaration of deduction of monthly medical allowance duly signed by an authorised signatory. The monthly medical allowance deduction form can be downloaded after logging into the official portal of CMHIS .

Hospital Bills and Invoices for Surgical Treatments and Medical Conservative Management

Here are the key documents required:

• Detailed indoor case paper/case sheet with treatment details and prescriptions.
• All investigation reports with the treating doctor's signature and stamp.
• Detailed discharge summary.
• Signed death summary (if applicable)
• Copy of FIR from police/Medico-Legal certificate (if applicable).

Documents for Surgical Treatment Claims

Here are the key documents required:

• Clinical photograph of a post-operative scar
• Post-procedure X-ray films
• Reports for orthopaedic surgery/implant procedure
• Implant invoice bill with a sticker (if applicable).

The Chief Minister Health Insurance Scheme Nagaland offers free health insurance coverage to the citizens of the State. This allows individuals to get quality healthcare facilities without worrying about expensive medical bills.You can check your eligibility for the scheme and enrol under it. You can also buy an independent health insurance policy to supplement your coverage. Enjoy complete financial protection and get quality treatments without the financial strain of the underlying costs.