What is the coverage limit under CMCHIS?

The scheme provides coverage of ₹5 lakh per family per year

Who provides insurance coverage under CMCHIS?

United India Insurance is the insurance provider for 2022-2027.

How many hospitals are covered under CMCHIS?

Over 1,700 hospitals are covered, including 800 government and 900 private hospitals.

How can I apply for CMCHIS?

Applications are done offline through enrollment centers.

What treatments are not covered under CMCHIS?

Cosmetic surgeries and treatments for self-inflicted injuries are not covered.

What is the coverage limit under CMCHIS?

The scheme provides coverage of ₹5 lakh per family per year

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CMCHIS Scheme: Comprehensive Cashless Health Insurance For Families

Alankar Mishra

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Updated: 28-01-2025 at 7:04 AM

CMCHIS Scheme: Comprehensive Cashless Health Insurance For Families

The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) seeks to focus on improving the health conditions of the poor sections in Tamil Nadu by providing budget-friendly health facilities. Beneficiary members of the government scheme would be able to undergo various kinds of medical procedures including that of serious diseases at the networked government and private hospitals without paying cash at the time of treatment.

Feature	Details
Scheme Name	Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS)
Coverage Limit	₹5 lakh per family, per year
Insurance Provider	United India Insurance (2022-2027)
Hospitals Covered	800 government, 900 private
Procedures Covered	1,090 procedures, 8 follow-ups, 52 diagnostics
Application Process	Offline
Beneficiaries	1.37 crore families

What Is CMCHIS?

CMCHIS, which was launched with the Tamil Nadu government’s support in 2009, seeks to promote good health amongst the poorer sections of society. Under the insurance scheme, no payments are made for treatment, reducing the hardships for families. It provides coverage for hospitalisation, diagnosis and after-treatment.

Features

The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) offers the basic details aimed at providing the necessary coverage expected from this plan. Here are its key features:

Cashless Treatment: Enables beneficiaries to avail of treatments without upfront payment.
High Coverage: Annual coverage of ₹5 lakh per family.
Network of Hospitals: Treatment is available in both public and private empanelled hospitals.
Comprehensive Coverage: Includes diagnostic procedures and follow-up treatments.
Managed by United India Insurance: Valid until 2027 with efficient claim management.

Benefits

The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) has additional advantages as it guarantees patients’ care at affordable prices and also provides financial help to them. Some of the advantages are:

Financial Relief: Reduces the burden of expensive medical bills.
Access to Quality Healthcare: Ensures access to high-end treatments.
Broad Hospital Network: Available in remote and urban areas.
Coverage for Multiple Treatments: No out-of-pocket expenses for covered treatments.
Follow-up coverage: Covers diagnostic and post-hospitalisation care.

What Is Covered Under CMCHIS?

Under the CMCHIS, enrollees or beneficiaries are provided with ample health care support in a way that they do not feel burdened by the costs involved. It is worth noting that among other benefits covered are:

Inpatient Treatment: Hospitalisation for approved procedures.
Critical Illness Coverage: Includes cancer treatments, surgeries, and organ transplants.
Diagnostic Procedures: 52 tests are included in the package.
Follow-Up Care: 8 follow-up procedures are covered post-discharge.

What Is Not Covered?

The Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) has excellent coverage benefits, however, there are limits regarding procedures and ailments to properly manage the treatment of patients. Listed are the exclusions:

Cosmetic surgeries or non-essential treatments
Injuries caused by self-harm or substance abuse
Treatments taken at non-empanelled hospitals
Experimental treatments not approved by medical bodies
Outpatient consultations and over-the-counter medications

Disease & Medical Treatment Covered Under CMCHIS

The extraordinary benefit of CMCHIS is that it has an extensive medical coverage scheme which aims to make sure its beneficiaries can afford any kind of treatment that is necessary for them.

Critical Illnesses: Cancer, heart disease surgery operations, and kidney surgery operations.
Surgery: Orthopedics, neurosurgery, gastrointestinal surgery
Diagnostics: Includes essential blood tests, scans, and follow-up assessments.

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Eligibility Criteria

The Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS) seeks to provide healthcare access to the poor section of the population especially in Tamil Nadu. The beneficiaries can use the Insurance on certain eligibility criteria and some of them are as follows:

Residency: Must be a resident of Tamil Nadu.
Income Limit: Annual family income below ₹1,20,000.
Family Inclusion: Legal spouse, children, and dependent parents.
Documentation Requirement: Listed in the family’s ration card and Aadhaar card.

Application Process

The CMCHIS application procedure provides sufficient offline mechanisms for households that qualify to enrol without any difficulties. Here’s a concise explainer of this step-by-step procedure:

Get Income Certificate Credentials from the Village Administrative Officer (VAO) or Revenue authorities.
Gather Required Documents: Get all Aadhaar cards, ration cards and income certificates.
Visit Enrollment Center: Go to the nearest centre for registration.
Verification: Biometrics such as fingerprints, eye scanning and photographs will be taken from the applicants.
Delivery of E-Card: The e-card will be ordered afresh after the verification process takes place.

Required Documents

Applicants need to provide specific documents to complete the CMCHIS registration process smoothly. Below is the detailed list:

Income Certificate: From VAO or Revenue authorities.
Ration Card: Proof of family details.
Aadhaar Card: Identity and address proof.
Self-Declaration: From the head of the family.
Optional: PAN card, if available.

Claim Procedure

The CMCHIS offers a streamlined claim process to ensure cashless treatment for beneficiaries at empanelled hospitals. Here’s a step-by-step breakdown:

Hospital Admission: Visit an empanelled hospital with your CMCHIS e-card.
Approval Process: The hospital will verify the card and seek approval for treatment.
Cashless Treatment: Receive treatment without paying upfront.
Discharge and Documentation: The hospital submits the necessary discharge summary for claim settlement.
Follow-up: Use the e-card for follow-up consultations as per the scheme’s guidelines.

How To Download CMCHIS e-Card?

Beneficiaries can download their CMCHIS e-card online through the official portal. Follow these simple steps:

Visit Website: Go to the CMCHIS portal www.cmchistn.com.
Log In: Enter your family’s Member ID and registered mobile number.
Download Card: Click on the "Download E-Card" option and save it.

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Steps To Link Aadhaar And URN

Linking Aadhaar with your Unique Registration Number (URN) ensures smooth access to CMCHIS benefits. Follow these steps:

Step 1: Log in to the Portal: Use your URN and registered mobile number.

Step 2: Link Aadhaar: Enter the Aadhaar details of all family members.

Step 3: Verification: Complete biometric verification at the nearest centre.

Steps To Search CMCHIS Member ID

Finding your CMCHIS Member ID is simple through the official portal. Here’s a step-by-step guide:

Step 1: Access Portal: Visit www.cmchistn.com.

Step 2: Enter Details: Provide the family ration card number and registered mobile number.

Step 3: Search ID: The portal will display the Member ID linked to the provided details.

Conclusion

CMCHIS guarantees the provision of low-cost healthcare services to economically weaker families in the state of Tamil Nadu. The government scheme has comprehensive hospitalisation coverage for major ailments and a wide network of hospitals which is intended to reduce the cost of getting treated.

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