CM Health Insurance Scheme: Benefits, Eligibility & Coverage

The Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS), now integrated with Ayushman Bharat as AB-PMJAY-CMCHIS, provides Tamil Nadu families earning under ₹1.2 lakh annually with ₹5 lakh cashless coverage per year. It covers over 1,000 procedures, including cardiac surgeries, organ transplants, cancer care, and diagnostics, with zero waiting period for pre-existing conditions. Enrollment requires an income certificate, ration card, and biometric verification, after which an e-card is issued for cashless treatment at empanelled hospitals across Tamil Nadu.

Quick Read 

• Launched by Tamil Nadu government; now integrated with Ayushman Bharat (AB-PMJAY-CMCHIS)
• Eligibility: Tamil Nadu residents with an annual family income below ₹1.2 lakh with a valid ration card
• Sum insured: ₹5 lakh per family per year shared across all registered members
• Family floater plan: The entire family is covered under one policy
• Zero waiting period for pre-existing diseases coverage starts immediately after enrollment
• Covers 1,000+ procedures, including cardiac care, organ transplants, oncology, and pediatric surgeries
• Cashless claims at empanelled public and private hospitals across Tamil Nadu
• Namma CMCHIS app tracks claims, finds hospitals, access digital e-card
• In emergencies, Aadhaar or Smart Ration Card number can replace physical e-card
• Enrollment: Income certificate → document verification → biometric capture → e-card issued

In times when healthcare costs are touching the roof, having affordable healthcare insurance for your family is tough. To resolve this problem, the Government has launched several insurance schemes that are not only affordable but also cover all the major health services. These schemes majorly focus on serving the unserved.

Government plans are designed especially for lower-income groups to provide them with financial coverage in case of unfortunate health events. One such plan is Chief Minister’s Comprehensive Health Insurance Scheme (CM insurance). This blog will provide you with information regarding the same scheme.

What is Chief Minister Health Insurance Scheme

Chief Minister’s Comprehensive Health Insurance Scheme was launched in Tamil Nadu by the Government of Tamil Nadu. The eligible people under the scheme can avail of cashless treatment at impanelled hospitals. The scheme shows a path for enrolled people to move toward universal healthcare insurance coverage. The scheme primarily targets low-income families, ensuring that the cost of surgery or critical care does not lead to a cycle of debt. It covers a vast range of medical procedures, including specialised life-saving treatments that were previously inaccessible to the underprivileged. By partnering with both public and private medical institutions, the government ensures that high-quality healthcare is a right for every citizen, regardless of their financial standing

Features of the CM Health Insurance Scheme

This insurance scheme offers a variety of features, some of which are listed below:

• Family Floater Plan: The scheme provides a family floater insurance plan to the people. This plan covers the entire family under one policy. The members enrolled in the scheme are eligible to avail of benefits under it.
• Cashless Claims: The policyholder can avail of cashless treatment at the network hospitals. This means you do not require to pay for medical expenses incurred during the treatment.
• Access to Health Camps: The network hospitals should organise health camps at least once a month. The policyholder can get free check-ups and follow-up treatments.
• 24*7 Assistance: If you are facing any issues, you can contact the call centre, which is available 24*7 to resolve your queries.
• High Sum Insured: This insurance plan comes with a sum insured of ₹5 lakhs for every family per year. This can cover minor health care expenses easily for any family.

CM Medical insurance Scheme Eligibility

The scheme provides various benefits to underprivileged families through various features like cashless treatment, regular health camps, etc. But not everyone is eligible to claim benefits under the scheme. The conditions for CM Insurance Scheme eligibility are mentioned below:

• The family must be a resident of Tamil Nadu and should have an annual income of less than ₹72,000.
• The family member should have a ration card or be mentioned in the ration card of the family.
• Migrants of other states, if they carry a migration certificate, are eligible.
• Orphans or rescued girl children from any registered or non-registered organisation are covered.
• Sri Lankan refugees with proof of citizenship are also eligible.

CM Insurance Scheme eligibility criteria are designed keeping in mind that the beneficiaries belong to underprivileged groups and can not save a part of their income for sudden health emergencies.

Inclusion Under CM Health Insurance Scheme

The Chief Minister Health Insurance covers the insured against the following expenses:

• Diagnostic Procedures: The expenses incurred during diagnostic tests and procedures are covered under the plan.
• Hospitalisation: In case of hospitalisation, expenses incurred are not to be borne by you. You can get a claim against it.
• Follow-Up Treatment: The government has provided a special service that is generally not provided by other insurance providers. Expenses on follow-up treatments are also covered under the plan, thus reducing the financial burden.

Enrollment Process Under CM Medical insurance

Enrolling in the plan is very easy if you match the eligibility criteria and have all the required documents. Here are the steps you need to follow for the same:

• You must get an income certificate from the Revenue Authority.
• You should carry all the necessary documents to the enrollment centre and get them verified.
• After this, biometric details will be captured.
• An e-card will be issued after the mentioned process is done.

Healthcare services are among the basic amenities of life, and the availability of affordable healthcare insurance is one the major part of the same. With schemes like CM Health Insurance, the lower-income group is provided with the hope of getting the best treatment for their family. An easy registration process, along with a high sum insured with affordable premiums, has helped many families to avail the services which are beyond their budget. Moreover, the scheme has also made people aware of the importance of health insurance.

Important Updates: The New Face of CM Health Insurance in 2026

To stay ahead of the curve, it is essential to understand how the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) has evolved. Recent integrations and expanded benefits have made it one of the most powerful social safety nets in India.

Integration with Ayushman Bharat (AB-PMJAY)

The CMCHIS is no longer a standalone state scheme. It has been integrated with the Central Government’s Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana. Now referred to as AB-PMJAY-CMCHIS, this partnership ensures a broader reach and a more robust digital infrastructure for claim settlements. If your card carries both logos, you are covered under this unified mega-scheme.

High-End Speciality Procedures

While the ₹5 lakh sum insured covers basic hospitalisation, the scheme is specifically recognised for covering high-end life-saving procedures that usually cost a fortune in private hospitals. These include:

• Cardiac Care: Heart bypass surgeries and valve replacements.
• Organ Transplants: Kidney and corneal transplants.
• Oncology: Comprehensive cancer care, including chemotherapy and radiation.
• Pediatric Care: Specialised procedures like Cochlear Implants for children.

Digitisation and the 'Namma CMCHIS' App

In an effort to make the scheme more user-friendly, the government has launched the 'Namma CMCHIS' mobile app. Beneficiaries can now:

• Find a real-time list of empanelled private and government hospitals in their specific district.
• Access a digital version of their e-card.
• Track the status of their claims and check their remaining balance.

Zero Waiting Period

A major update to remember is that, unlike private medical insurance, this scheme has no waiting period for pre-existing diseases. Whether it is long-term diabetes or a chronic heart condition, coverage begins the moment your enrollment is successfully processed.

Conclusion

The AB-PMJAY-CMCHIS is a vital safety net in Tamil Nadu, providing families earning below ₹1.2 lakh annually with a ₹5 lakh insurance cover. A major advantage of this CM health insurance scheme is the zero waiting period for pre-existing diseases, ensuring immediate support for chronic conditions. This CM medical insurance covers over 1,000 procedures, including organ transplants and oncology, via a seamless cashless claim process.

By covering pre- and post-hospitalisation costs through its vast network of empanelled hospitals, the scheme ensures that high-quality healthcare is accessible to all, effectively preventing medical bankruptcy. While government schemes offer a vital baseline, you may need higher coverage limits and global benefits as your family grows. At Niva Bupa, we provide advanced health insurance solutions with lightning-fast claim settlements and a wider range of specialised benefits. If you are exploring comprehensive coverage with higher limits and global benefits, it’s worth checking it.

FAQ

Who can apply for CM Insurance in Tamil Nadu?

Residents of Tamil Nadu with an annual family income less than ₹72,000 and a valid ration card can apply. Certain migrant workers and orphans are also included under the eligibility list.

Is the CM Insurance plan a family floater policy?

Yes, the policy covers the entire family under one insurance plan. The sum insured of ₹5 lakhs per year is available for shared use among all registered family members.

Can Sri Lankan refugees get CM health insurance?

Yes, Sri Lankan refugees with valid proof of citizenship are eligible for CM Insurance. They must also fulfil the income and documentation requirements set by the Tamil Nadu government.

What is meant by cashless treatment in this plan?

Cashless treatment means policyholders can receive medical care without paying upfront. The insurance directly covers hospital bills, reducing the financial burden during emergencies or planned medical procedures.

Which hospitals in Tamil Nadu accept CM Insurance?

Empanelled public and private hospitals across Tamil Nadu accept CM Insurance. You must confirm the hospital’s tie-up before treatment and carry your CM Insurance e-card to avail of services.

What does the ₹5 lakh sum insured include?

The ₹5 lakh coverage includes hospitalisation, diagnostics, medicines, surgery, and follow-up care for the entire family. It is provided annually and can be used across multiple treatments if needed.

What is the updated income limit for eligibility in 2026?

While the limit was previously ₹72,000, it has been revised to include families with an annual income of less than ₹1.2 lakh (₹1,20,000). Additionally, certain groups like transgender persons, registered construction workers, and Sri Lankan refugees in camps are eligible regardless of their income level, provided they have the necessary documentation.

Can I get treatment if I don't have the physical e-card with me?

Yes. In an emergency, if you are already enrolled but don't have the physical card, empanelled hospitals can verify your identity using your Aadhaar Number or Smart Ration Card number via the online portal. This ensures that life-saving treatment is not delayed due to missing paperwork.