Chief Minister’s Health Insurance Scheme (CMHIS) - Nagaland

Why was the Chief Minister’s Health Insurance Scheme Introduced

Prior to the launch of the Chief Minister's Health Insurance Scheme (CMHIS), Nagaland's people with severe illnesses or those requiring specialised hospital treatment were forced to pay high out-of-pocket costs. Those working in the state government were compelled to go through a cumbersome and time-consuming reimbursement procedure to pay for their medical expenses, and many people who were not covered by the central government were without financial security.

To fill this gap, the Government of Nagaland introduced the Cashless Medical Healthcare Insurance (CMHIS) on October 16, 2022, providing cashless health insurance to all the citizens of Nagaland. It provides complete coverage for secondary and tertiary care in empanelled hospitals across the country, with higher coverage caps for state employees and pensioners and specific caps for general residents.

Chief Minister’s Health Insurance Scheme (CMHIS) Nagaland - Key Highlights

Who is Eligible for Chief Minister’s Health Insurance Scheme (CMHIS) Nagaland

The eligibility is divided into two distinct categories:

1. CMHIS (EP) Category - Employees & Pensioners

   • Serving State Government employees, legislators, and ex-legislators.
   • Pensioners of the Nagaland State Government.
   • Employees of State Public Sector Undertakings (PSUs), autonomous bodies, and corporations.
   • Work-charged employees working on a scale-pay basis, alongside their dependent family members.

2. CMHIS (GEN) Category - General Public

   • Permanent Residents or Indigenous Inhabitants of Nagaland who are not covered under AB PM-JAY or any other government-funded health insurance.
   • Contractual, ad-hoc, or fixed-pay employees without a PIMS code.
   • Non-dependent family members of government employees.

Documents Required to Apply for Chief Minister’s Health Insurance Scheme (CMHIS)

List of the required documents is as follows-

Mandatory KYC Document Required for CMHIS (GEN) category:

(a) For General Population :

• Mobile Number: You need a working mobile phone number.
• Residency Proof: You need an Indigenous Inhabitant Certificate (IIC) or Permanent Residential Certificate (PRC) issued by your local district office in 2017 or later.
• If You Have a Ration Card: You don't need to register on the main CMHIS website. Instead, go straight to the NHA BIS portal to get your eCard, as your ration card details are already saved in the system.

(b) For employees without a Personnel Information Management System (PIMS) Code:

• Valid Mobile Phone number
• Govt-issued Photo ID card
• Engagement/ Appointment Order.
• Proof of continuity of being engaged (Letter from the controlling officer)
• Filled and downloaded the online registration form with household member details (Form), countersigned by the Village council Chairman/Ward Chairman.
  
  

Mandatory KYC Document Required under CMHIS (EP) category:

(a) For Pensioners:

• Valid Mobile Phone number.
• First three pages of the Pensioner’s PPO book indicating PPO number, last pay scale or designation of the post held or last pay drawn prior to retirement.

(b) For Government employees:

• Valid Mobile Phone number
• Personnel Information Management System Code (PIMS) code.

(c) For dependent family members:

• Document proving dependency for each dependent member to be added:
• Proof of Relationship/DOB- Birth Certificate/Aadhaar/Class X Admit Card/voter‘s ID/Pancard or any other Govt. issued ID indicating the relationship with any one of the parents and Date of Birth.
• Disability Certificate in case of PwD

What the Chief Minister’s Health Insurance Scheme (CMHIS) Covers

Coverage Limits (Sum Insured)

• CMHIS General Category: Up to ₹5 lakh per family per year is covered on a family floater basis.
• CMHIS Employees & Pensioners: Up to ₹20 lakh per family per year covered on a family floater basis. Expenses beyond ₹20 lakhs for government employees can be reimbursed on a case-by-case basis upon recommendation by the State Medical Board.

Medical Treatments & Services Covered

• Inpatient Hospitalisation: Full coverage for medical and surgical treatment requiring hospital admission.
• Pre-existing Conditions: All existing illnesses and conditions are covered from day one of enrollment.
• Daycare Procedures: Coverage for specified surgical and medical treatments that do not require an overnight hospital stay.
• Specialities: Over 1,950 medical and surgical packages spanning 27 major clinical specialities.

What the Chief Minister's Health Insurance Scheme (CMHIS) Does Not Cover

• Outpatient Department (OPD) Treatment Services: Normal doctor visits and consultation services.
• Diagnostic Services: Blood test, X-ray, scans, or any lab tests done on an outpatient basis (unless the same is included in any inpatient or daycare treatment package).

How to Apply Step by Step for Chief Minister's Health Insurance Scheme (CMHIS)

Step 1: Log in to the Portal

Log in to the Official website (cmhis.nagaland.gov.in) of the Chief Minister’s Health Insurance Scheme (CMHIS), Nagaland.

Step 2: Registration & Understanding of Terms & Guidelines

Go to the Register. The applicant is required to check the terms and guidelines of the scheme, rules and regulations, and eligibility criteria before applying to choose the right category (General category & Government employees/pensioners category).

Step 3: Fill out the Application Form

Applicants have to fill out the application form by providing their personal information, dependent details, and other information according to their income and residency category. Applicants may add their medical or service information as well. The PIMS number of government employees or the PPO number of pensioners will also be included.

Step 4: Submission of Application Form and Documents in Local Support Centre

Once the application form is filled out, the form with all required documents needs to be submitted to the nearest Common Service Centre (CSC) in the local area or an empanelled hospital.

Step 5: Document Submission & Preliminary Verifications

The document is physically examined and authenticated with regard to the state database, and then digitised or uploaded to the online CMHIS portal.

Step 6: Approval of Insurance Policy

The insurance provider will verify the application and approve or reject it based on the eligibility criteria.

Helpline and Support

Other Government Schemes

• Ayushman Bharat (PM-JAY): The national health insurance scheme of India that covers up to ₹5 lakh per family per year.
• Atal Amrit Abhiyan: Government-funded healthcare program of Assam, which gives cashless coverage of up to ₹2 lakh per family per year for critical illnesses.
• Chief Minister Free Cancer Chemotherapy: This is a state government scheme in Assam providing free chemotherapy treatments as well as necessary medicines for treating cancer to the beneficiaries who are suffering from the disease.
• Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS): State health insurance scheme in Tamil Nadu that provides cashless hospitalisation up to Rs 5 Lakh per year for poor families.
• West Bengal Health Scheme (WBHS): A healthcare scheme for eligible West Bengal Government employees, pensioners and their families, offering medical treatment through government and empanelled healthcare facilities.