Secure your Tomorrow with the CM Insurance Scheme

A healthy and well-educated population is regarded as the harbinger of a bright future. It is thus of utmost importance that national and regional governments invest in the well-being of their citizens. On these lines, the Tamil Nadu government launched the CM Comprehensive Health Insurance Scheme in 2012 to improve the health outcomes of underprivileged families in the state.

Offered through United India Insurance Company Ltd, this scheme safeguards 1.37 Crore families as of January 2022. Also known as Amma Health Insurance, it covers 1090 procedures, 8 follow-up procedures and 52 diagnostic procedures. Let’s discuss this scheme in detail.

CM Insurance Scheme Eligibility

The CM health insurance scheme aims to usher in the era of universal health coverage by providing a sum insured amount of  ₹5 Lakh to every family per year. To be able to avail the benefits of this scheme, families must meet the following eligibility conditions:

• They must be residents of Tamil Nadu.
• Sri Lankan refugees are also covered if they have proof of citizenship.
• Similarly, migrants from other Indian states having migration certificates are covered. However, they must have been Tamil Nadu residents for at least 6 months.
• Girl children rescued from any organisation and orphans are also eligible.
• The family income should not exceed ₹72,000 per annum.
• Members to be included in the policy must be mentioned in the family’s ration card.

CM Insurance Scheme Features and Benefits

After checking the eligibility criteria, a question may arise in your mind: what was the need for such a scheme, and what does the government seek to achieve with this policy? The following policy characteristics will provide answers to such questions:

• It is a family floater plan, which means that all members of a family can be included under a single insurance plan. Family plans serve as an affordable option and are also easier to manage.
• It provides the facility of cashless claim settlement. Policyholders can thus get treated at the empanelled government and private hospitals without incurring any out-of-pocket expenses. The free medical treatment saves policyholders from the hassle of filing for a reimbursement claim later and the anxiety surrounding claim rejection.
• This scheme recognises the age-old wisdom that prevention is better than cure. It, thus, requires the network hospitals to organise free health camps at least once every month. This not only has preventative benefits but also helps to diagnose any disease in its early stages.  Follow-up treatments can also be availed at such camps to maintain good health.
• As this scheme covers citizens from the lower-income group, it is mindful of the possibility that the majority of its target group will consist of first-time buyers. They will naturally have various doubts regarding insurance, premium payments, claim settlement, etc. It thus has the provision of 24*7 call centre assistance to help resolve any such doubts.

CM Insurance Scheme Enrolment

If, after going through the impressive features of this policy, you feel motivated to apply for it, the following section is crucial for you. Read on to know how to enrol yourself and your family under this scheme:

• Approach your village administration authorities for an income certificate (annual family income must be less than ₹72,000).
• Along with the income certificate, submit the ration card, identity and address proof, and self-declaration to the enrolment centre.
• After your documents are verified by the enrolment centre’s operator, your biometric details, like fingerprint scan, eye scan, etc., will be taken.
• Once the biometric details are entered and verified, you will be issued an e-card. You will be able to avail medical treatment at the network hospitals by presenting this e-card.

Summing Up

By introducing the CM insurance scheme, the government has done its part to support the healthcare needs of citizens. However, the insured amount of ₹5 Lakh may not be sufficient in the face of major illnesses and medical emergencies. It is, therefore, wiser to supplement this government plan with another affordable and best health insurance plan from a private insurer.

Niva Bupa one of the best health insurance company in India offers a diversified portfolio of health insurance plans for every segment of the population. You can select a reasonably priced plan depending on the coverage you desire. Browse through our plans on our website or contact us for more assistance.

Frequently Asked Questions

1. What is the CM Insurance Scheme and how does it secure your future?

   The Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS) is launched by state governments to provide quality healthcare to eligible persons through empanelled government and private hospitals. The scheme offers substantial coverage of up to ₹5 lakhs per family per policy year, providing adequate financial protection for most healthcare needs. 

2. Who is eligible for the CM Insurance Scheme coverage?

   The applicant's name must be on the family card, and their family's yearly income must be less than Rs. 1,20,000 to be eligible for benefits under the scheme. Eligibility requires producing a family card, Aadhaar card, and income certificate by VAO/Revenue Authorities along with self-declaration. 

3. What medical treatments and procedures are covered under the CM Insurance Scheme?

   The scheme covers 1090 procedures, 8 follow-up procedures, and 52 diagnostic procedures across 800 government and 900 private empanelled hospitals. It reimburses hospitalisation and treatment charges for specific conditions, diagnostic testing costs, doctor visits, and hospital follow-ups.

4. How much coverage does the CM Insurance Scheme provide to beneficiaries?

   The scheme's beneficiaries are assured an amount of Rs. 1 lakh per year for four years, totalling Rs. 4 lakh at the end of four years. Some medical procedures that cost more may have the ceiling limit raised to 0.5 lakhs per annum, ensuring sufficient financial coverage. 

5. How does the CM Insurance Scheme provide cashless treatment?

   The scheme provides cashless hospitalisation for specific ailments and procedures at empanelled hospitals. Beneficiaries receive cashless and paperless treatment without upfront payments, as expenses are settled directly between hospitals and the insurance provider. You can contact the 24-hour call centre that operates with toll-free helpline 1800 425 3993 to assist beneficiaries with scheme-related queries and support. 

6. What documents are required to avail benefits under the CM Insurance Scheme?

   Required documents include family card, Aadhaar card, and income certificate issued by VAO/Revenue Authorities along with self-declaration by the family head. The family card must contain the applicant's name, and income certification must prove annual family income below Rs. 1,20,000.