Chief Minister’s Comprehensive Health Insurance Scheme
About the Chief Minister’s Comprehensive Health Insurance Scheme
The Chief Minister’s Comprehensive Health Insurance Scheme or the Amma Health Insurance was introduced in 2012 by the government of Tamil Nadu to address the financial and health care requirements of underprivileged residents of Tamil Nadu. There are strict criteria which make customers eligible for availing the benefits of the CM scheme.
The Chief Minister’s Comprehensive Health Insurance Scheme is a family floater health insurance policy where benefits are extended to family members including spouse, parents, and children.
From cashless treatments and coverage for surgical procedures to access to top-quality public and private sector hospitals, beneficiaries of the scheme are eligible for a range of useful benefits, medical and non-medical. The scheme also includes medical expenses for evaluation and diagnostic procedures, follow-up reports, and critical illnesses, among others.
Listed below are the key features of CMCHIS:
- Coverage for family members: CM Scheme is a family floater policy where family members whose names appear on the insured's ration card are eligible for availing the benefits of the plan.
- Cashless Claims: The CMCHIS has a network of 1395 hospitals across Tamil Nadu where policyholders enjoy the benefits of cashless treatment. This essentially means individuals don't have to scurry around for cash in the event of medical emergencies. They can begin treatment and obtain authorization later. However, this should go through in the next 24 hours.
This also means there is no reimbursement facility under the Amma Health Insurance.
- Health check-ups: The hospitals included on the Chief Minister's Comprehensive Health Insurance Scheme hospital list provide access to health camps organised once every month. Insured individuals are eligible to avail free-health check-ups and have follow-up treatments done at these camps.
- Coverage for Sri Lankan Refugees: Sri Lankan refugees who are able to produce proof of citizenship can avail coverage under the policy regardless of their income status.
- Customer assistance: The government of Tamil Nadu has provided an active call center to address CMCHIS-related queries customers might have. This helpline is available for assistance 24×7.
- Quality health care: The policy is designed to provide comprehensive medical coverage to low-income groups by ensuring adequate financial protection. It includes those with annual incomes less than Rs 72,000.
- Sum Insured: The scheme offers a high sum insured of Rs 5 lakh on a family floater basis so insured individuals are able to receive cover for minor health care needs.
- Benefits of the Chief Minister’s Comprehensive Health Insurance scheme are available to residents of Tamil Nadu only.
- Under the CM insurance, households where the annual is below Rs 72,000 are eligible for coverage.
- Individuals employed in unorganized sectors who have been registered under the labour welfare boards are also eligible to receive coverage under this scheme.
- The benefits can be extended to family members including the legal spouse, dependent children, and parents. Children are eligible for coverage until they reach 25 years of age or marry, or become employed (whichever happens first).
- In case of family members, their names should be included in the insured's ration card.
- CM insurance is applicable to Srilankan refugees who possess proof of citizenship.
- If citizens have migrated from other states, they should possess authorized migration certificates and have resided in Tamil Nadu for a minimum of six months).
- The CM scheme also includes orphans and rescued girl children regardless of whether they come from registered or unregistered organizations.
The Chief Minister's Comprehensive Health Insurance Scheme excludes civil pensioners, ESI beneficiaries, and government servants. Any household where the annual income is over Rs 72,000 also can not avail the benefits of this scheme. These exemptions extend to family members.
In order to enrol for the Chief Minister’s Comprehensive Health Insurance Scheme, applicants should:
- Present their income certificate acquired from the Village Administrative Officer or Revenue authorities.
- Visit the CM insurance enrollment centre and obtain verification for the documents by the kiosk operator.
- Provide your biometric details (fingerprints, photo, retina scan).
- Following this, an e-card will be issued to you.
Here is a list of documents required to enrol in the scheme:
- Income Certificate
- Ration card
- Self-declaration from the family head
- Identity proof
- Address proof
- The government of Tamil Nadu has included corona investigation (RT-PCR Test) and corona treatment in the scheme.
- Under the PMs Garib Kalyan Package, health care workers who die in the line of Covid19 duties are eligible to avail Rs 50 lakhs in insurance.
- Hospitalisation expenses incurred during treatment are included in the CM scheme.
- The scheme also covers evaluation tests, diagnostic and follow-up procedures. Such procedures are generally excluded from health insurance plans.
- The scheme also includes dental treatments which fall under outpatient treatments.
Here is a list of critical illnesses that are covered under the Chief Minister’s Comprehensive Health Insurance Scheme:
Paediatric intensive care
Endocrinology (follow up procedure)
Paediatrics plastic surgery
The Chief Minister's Comprehensive Health Insurance Scheme covers 1395 hospitals in its network across Tamil Nadu. Some of the top hospitals include the Bala Ortho hospital in Tirupur, Kongunad Kidney Center in Coimbatore, Arathana Hospital in Coimbatore, and DNV Ortho Care in Dharmapuri.
For the complete Chief Minister's Comprehensive Health Insurance Scheme hospital list, visit the insurance scheme's official website or check it out here.
The Chief Minister's Comprehensive Health Insurance Scheme is one of most beneficial and laudable initiatives undertaken by the Tamil Nadu Government in the interest of underprivileged people. The scheme has proved its worth in providing top-quality financial protection to insurers and ensuring overall health care.
The scheme was acknowledged with the ‘e-India Jury Award’ in 2012 for employing best-in-class Practices in Health Insurance with the help of IT-enabled solutions. It also won the Chief Minister Recognition Award to Project Director - CMCHIS scheme in 2012.
The government of Tamil Nadu had taken steps to ensure customers avail uninterrupted service under the scheme. There is a helpline available to customers to address any concerns or queries they might have. Currently, the helpdesk averages close to 600 calls per day providing assistance to customers.
Here are reviews by some of its customers:
Tamraparni Sirisena — I have been able to enrol for the Chief Minister’s Comprehensive Health Insurance Scheme and benefit from it economically while I had taken shelter at the camp.
Neera Salunkhe — Cashless facilities offered with Chief Minister’s Comprehensive Health Insurance Scheme was very helpful while my husband needed emergency medical care. I can’t think of how I would have arranged so much cash at the last moment had he not been a member of the Chief Minister’s Comprehensive Health Insurance Scheme.
Neeraj Das — I lost my parents to a fatal accident. Thankfully, my parents had enrolled our family under the Chief Minister’s Comprehensive Health Insurance Scheme. The benefits that they offer orphans ensured the financial security that I needed.
Chief Minister’s Comprehensive Health Insurance Scheme FAQs
Can I file a claim online for the Chief Minister's Comprehensive Health Insurance Scheme?
Yes, you can file a claim for the Chief Minister's Comprehensive Health Insurance Scheme on the Tamil Nadu Chief Minister's official website. All you have to do is fill in the required details – User ID and Password.
Can I include my family as the beneficiary of my plan?
Yes. The benefits of the Chief Minister's Comprehensive Health Insurance Scheme can be extended to family members. This includes your legal spouse, dependent children, and parents. Children are eligible for coverage until they reach 25 years of age or marry, or become employed, whichever happens first.
Does the scheme include diagnostic or follow-up procedures?
Yes, as per Annexure E the policy terms and conditions, there are 38 diagnostic procedures covered under the scheme. These include Mammography, ECHO, LFT, RFTn USG, MRI, among others.
Does the policy provide coverage for emergency cases?
In case of emergency cases, policyholders can begin treatment first and then seek authorisation afterwards. However, this period should not exceed 24 hours.
How do I enroll for the Chief Minister's Comprehensive Health Insurance Scheme?
Follow the steps to enroll for the scheme:
Ensure your eligibility for the Chief Minister's Comprehensive Health Insurance Scheme.
Visit a kiosk in your district or a collectorate office.
Present the required documemts such as income certificate and ration card.
How do I contact customer care if I need to?
You can reach out to the helpdesk that the government of Tamil Nadu has made under this scheme. The toll free number is 1800 425 3993. You can also write to the insurance provider at firstname.lastname@example.org and email@example.com
Customers can also reach out at the following address:
No 226, Om Sakthi Towers,
Kilpauk Garden Road, Kilpauk,
Chennai-600010, Tamil Nadu