Chief Minister Comprehensive Health Insurance Scheme: Amma Health Insurance

Tamil Nadu is one of the leading states in India, owing to its improved healthcare facilities. Of all the health schemes launched thus far, the Chief Minister Comprehensive Health Insurance Scheme is the most effective initiative taken by the Government of Tamil Nadu. This scheme aims to offer top-notch healthcare services to Tamil Nadu residents, especially lower-income group families.

Understanding every segment of the CMCHIS is necessary to maximize its benefits. Therefore, we have compiled all the relevant facts of this scheme in this comprehensive guide for your convenience.

Keep reading to know more!

Team Digit

What is the CMCHIS?
Features & Benefits
CMCHIS Coverage
Diseases Covered by CMCHIS
CMCHIS Eligibility Criteria
Registration Procedure for CMCHIS
Required Documents for CMCHIS
Steps to Download the CMCHIS Card
How to Claim CMCHIS?
How to Find a Hospital under CMCHIS?
Frequently Asked Question

What is the CMCHIS?

The Chief Minister Comprehensive Health Insurance Scheme, formerly known as Kalaingar Kaappittu Thittam, was introduced on July 23, 2009, to reduce financial hardship for enrolled families and advance towards universal health coverage by establishing an effective link with the public health system.

The scheme provides high-quality healthcare to eligible individuals through empanelled government and private hospitals. It was implemented through United India Insurance Company from January 2022 to January 2027. As of January 2022, the program reached over 1.37 crore families.

Who Created The Chief Minister Comprehensive Health Insurance Scheme?

On July 23, 2009, the Chief Minister's Comprehensive Health Insurance Scheme, or Amma Kapitu Thittam, was introduced by the Government of Tamil Nadu to combat the demands for advanced healthcare among low-income groups.

United India Insurance Company is currently in charge of the plan's execution from January 2022. It will remain in charge till January 2027 to provide assistance and ensure the smooth functioning of the scheme.

Salient Features of CMCHIS

The CMCHIS, also known as Amma Health Insurance, covers the costs of hospitalisation, diagnostic procedures, and follow-up treatments to mitigate the financial burden of healthcare on low-income families. Some of the features of Amma Maruthuva Kapitu Thittam are mentioned below:

Features	Description
Family floater health insurance policy	All the family members registered under this scheme can utilise the insured amount.
Cashless treatment	Medical treatments are available without having to pay cash to hospitals. This is one of the convenient features of the Chief Minister Comprehensive Health Insurance Scheme.
Access to health camps	The network hospitals organise health camps once every month for medical check-ups. Policyholders of this scheme can get free health check-ups from these camps.
Enrollment of Sri Lankan refugees	Sri Lankan refugees can avail of exclusive healthcare services at any centre regardless of income.
24*7 assistance	If you have any doubts or questions regarding this healthcare scheme, you can get 24*7 assistance by calling their toll-free helpline number.

The following section elaborates on the benefits you can avail of by registering yourself under this health insurance plan.

Benefits of the Amma Health Insurance Scheme

The Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) provides extensive health coverage to economically weaker sections, ensuring access to affordable and timely medical care. Here are some of its benefits:

Benefits	Description
Coverage for Expensive Treatments	This scheme covers expensive treatment expenses for the economically weaker sections of Tamil Nadu.
Wide Network of Hospitals	Due to the wide network of hospitals under this scheme, it is possible to locate a hospital nearby and get treatment without delay.
Affordable Treatment Options	Beneficiaries can get affordable treatments for several conditions by enrolling themselves under this scheme.
Coverage Limit	People of Tamil Nadu registering under CMCHIS can enjoy coverage of up to Rs. 5 lakhs.
Follow-up and Diagnostic Coverage	This health insurance plan also covers follow-up treatments and diagnostic tests for any ailments.

Chief Minister Comprehensive Health Insurance Coverage

This scheme covers around 1090 treatment procedures, including 8 follow-up procedures and 52 diagnostic procedures. It benefits orphans enrolled under this policy and migrants from other states. Therefore, from hospitalisation and diagnostic tests to follow-up treatments, this government initiative promises exceptional healthcare facilities at nominal rates.

In case of financial hardship, emergency medical aid is provided by the Amma health insurance plan. This health insurance plan's recipient is qualified for the following coverage:

Coverage	Description
Hospitalisation	It costs nothing to receive medical care at a hospital that has earned accreditation. However, the treatment should be included in the list of medical treatments covered by Amma Health Insurance.
Procedures for Diagnosis	Hospitalisation during a medical emergency is expensive, and diagnostic testing is frequently costly. This plan made sure that these procedures were covered in full.
Subsequent Care	In general, follow-up is not covered by a commercial health insurance plan. But this coverage is offered by Amma Kapitu Thittam, which further reduces the financial burden of medical expenses.

Know about: What are Pre-Post Hospitalization Expenses in Health Insurance?

What is Not Covered Under The Chief Minister's Comprehensive Health Insurance Scheme?

The Chief Minister's Comprehensive Health Insurance Scheme (Amma Health Insurance) does not cover the following items:

Non-residents of Tamil Nadu are not eligible to participate in this campaign.
Individuals earning over Rs. 72,000 are not eligible for this scheme.
Family members not mentioned on their ration card are not eligible for this program.
This program is not available to refugees who are not Sri Lankan citizens and do not possess proof of citizenship.
Immigrants from other Indian states who do not possess migration certifications from the appropriate authorities are ineligible for this scheme.
Orphans and rescued females not affiliated with registered or unregistered organisations are not eligible to participate in this program.

Diseases Covered by the Chief Minister Comprehensive Health Insurance Scheme

We have enlisted all the diseases and medical conditions included in this policy in the following section.

Neurosurgery	Bariatric Surgery	Obstetric Surgery
Pulmonology	Endocrine surgery	Interventional cardiology and radiology
Paediatric intensive care	Endocrinology (follow-up procedure)	Medical oncology
Paediatric surgeries	Dermatology	Infectious diseases
Paediatrics plastic surgery	Cardiology	Neonatology
OFMS	Cardiothoracic surgeries	Hepatology
Orthopaedic trauma	ENT	Nephrology
Psychiatry	Genitourinary surgery	Haematology
PMR	Gastroenterology	Neurology
Ophthalmology surgeries	Gynaecology	-

CMCHIS Eligibility Criteria

Before applying for this health scheme, one should be thorough with the Amma Maruthuva Kapitu Thittam eligibility criteria to secure maximum benefits.

Take a look at the eligibility criteria here:

Residents of Tamil Nadu with proper citizenship proof can register under this scheme. However, Sri Lankan refugees are an exception to this.
Families with an annual income below Rs. 72,000 are eligible to enroll.
As per the family floater plan, every member of the family can benefit from this scheme. Those family members include the legal spouse of the registered individual, children under 25 years (or before they are married), and parents.
Migrants residing in Tamil Nadu for six months or more should carry valid migration certificates to qualify for CMCHIS
Rescued girl children or an orphan from registered or unregistered institutions are eligible to register.

Registration Procedure for CMCHIS

The application process of registering yourself under this healthcare scheme is simple. For a hassle-free Amma procedure, here are some steps to follow:

Step 1: You need to obtain an income certificate from the Village Administrative Officer or revenue authorities.
Step 2: Present these documents in the enrollment centre.
Step 3: The kiosk operator will verify your documents.
Step 4: After successful verification, you can proceed with the biometric process, i.e., your photograph, eye scan, and fingerprint will be captured.
Step 5: Once verified, you will be assigned an e-card.

However, one cannot download the Chief Minister Comprehensive Health Insurance Scheme application form online or opt for CMCHIS online registration. One can access the smart card only by visiting the enrollment centre and applying for the scheme personally.

Required Documents for CMCHIS Enrollment

The list of documents you need to present during registration for the Amma Health Insurance Scheme is as follows:

Identification proof
Copy of Aadhaar card
PAN card copy
Address proof
Income certificate generated from VAO
Original and copy of Ration card
Family head’s self-declaration

Steps to Download the CMCHIS Card

Once you have enrolled under this health scheme, you will be issued a smart card. This card is essential to identify the beneficiaries registered under this scheme. The details of a beneficiary and his family members and available coverage amount are available in it. For cashless claims during hospitalisation, one needs to present this card to the authority.

To save multiple copies of the same, you can download the CMCHISTN card online. Here are the steps for Amma Maruthuva Kapitu Thittam card download:

Step 1: Visit the official website of CMCHIS.
Step 2: There will be an option named “Beneficiary” – select that.
Step 3: Choose the option “Member search/e-card,” and then choose “Instructions.”
Step 4: The member search page has a field where you can enter your CMCHISTN member ID or URN number from the smart card. This will allow you to check the members enrolled under this scheme and the available sum insured.
Step 5: From here, you can select “Generate e-card.”

How to Claim CMCHIS?

The beneficiaries can get cashless treatment from hospitals by showing their smart cards.

Hospital management will send your bills to TPA, i.e., a Third-Party Administrator, for settlement. They will settle charges and treatment bills with the hospital directly. In this way, you can successfully claim the insured sum under CMCHIS.
Additionally, you can check your CMCHIS claim status by visiting the website of Chief Minister Comprehensive Health Insurance Scheme Tamil Nadu and entering your member ID and password.

Furthermore, as per the Government’s announcement, linking crucial documents to your Aadhaar card increases the authenticity of an applicant. Although it is not a mandatory move, you can follow these steps to connect your URN number with the Aadhaar card.

Know about:

Steps to Link Aadhaar Card with a URN

Go to the official website of the Amma Health Insurance Scheme.
Choose “Beneficiary,” and you will get an option “Link Aadhaar with URN.”
On this page, enter your URN number.
Now check the box where the option to link your Aadhaar with a URN is visible.
Click on the “Enroll Now” option.
You must enter your contact details as mentioned in your Aadhaar card in this step.
Finally, enter your Aadhaar number and submit the application.
Once you receive an OTP, you can confirm that the linking is successful.

In addition to this, you can check the network of hospitals functioning under the CMCHIS from here.

Medical Packages Under Chief Minister Comprehensive Health Insurance Scheme

The table below shows the comprehensive list of all the packages available under the Chief Minister Comprehensive Health Insurance Scheme:

S. No	Package Name	Number of Packages
1	Interventional Cardiology	15
2	Cardiothoracic Surgery	102
3	Surgical Oncology	177
4	Medical Oncology	100
5	Neurosurgery	92
6	Rheumatology	25
7	Spine	9
8	Medical Gastroenterology	2
9	Gastroenterology	10
10	Plastic Surgery	147
11	Dermatology	8
12	Paediatrics	50
13	ENT	254
14	Neurology	59
15	Surgical Gastroenterology	108
16	Rehabilitation	2
17	Thoracic Medicine	3
18	Genitourinary Surgery	93
19	OFMS	17
20	Bariatric surgery	2
21	Cardiology	7
22	Interventional Radiology	199
23	General Surgery	184
24	General Medicine	249
25	Polytrauma	2
26	Ophthalmology Surgery	75
27	Endocrinology	17
28	Hepatology	17
29	Nephrology	11
30	Paediatric Surgery	66
31	Radiation Oncology	57
32	Vascular Surgery	166
33	Pulmonology	20
34	Paediatric Intensive Care	19
35	Neonatology	74
36	Haematology	17
37	Gynaecology Obstetrics Surgery	65
38	Orthopaedic	195
39	Psychiatry	24
40	Infectious Diseases (General Medicine)	2

How to Find a Hospital under CMCHIS?

CMCHIS functions in 800 Government 900 Private empanelled hospitals. To find a hospital under the Chief Minister Comprehensive Health Insurance Scheme (CMCHIS), follow these steps:

Step 1: Visit the Official Website: Check the Tamil Nadu Government or CMCHIS website for a list of network hospitals.

Step 2: Contact the Insurance Provider: Contact the insurance provider or the scheme’s helpline for information on affiliated hospitals.
Step 3: Inquire Locally: Consult with local healthcare centers or community health workers who can recommend participating hospitals.
Step 4: Check Hospital Listings: Many hospitals will display their affiliation with CMCHIS on their websites or in their admission areas.

Hospitalisation Process of CMCHIS

To undergo hospitalisation under the Chief Minister Comprehensive Health Insurance Scheme (CMCHIS), start by verifying your eligibility and selecting a network hospital. Upon admission, present your CMCHIS card and identification, and the hospital will seek authorisation from the insurance provider.

After treatment, the hospital will handle billing directly with the insurer. Coordinate with the hospital and insurance provider for follow-up care or diagnostics to ensure coverage. Finally, review your discharge summary carefully to confirm all details are correct before leaving the hospital.

Address And Toll-free Number for CMCHIS

The Chief Minister's Comprehensive Health Insurance Scheme of the state government strives to keep accessibility in all respects. To ensure transparency and the least inconvenience, the public has multiple ways to get in touch. This is a list of contacts who can help you with your questions:

Contact Method	Contact Details
Toll-free Number	1800-425-3993 If you are experiencing trouble reaching a call center representative, you can reach them at the following numbers- 7373004267 7373004924 7373002566
Email	cmchis@uiic.co.in, tnhealthinsurance@gmail.com
Address of The Project Director	Tamil Nadu Health Systems Project (TNHSP) 3rd Floor, DMS Annex New Building 259 Anna Salai, Teynampet Chennai – 600 006, Tamil Nadu.
Address of The CMCHIS Project Office	Chief Minister’s Comprehensive Health Insurance Scheme No.226, Om Sakthi Towers, Kilpauk Garden Road, Kilpauk, Chennai-600010, Tamil Nadu

Although access to proper healthcare facilities is vital, not every section of society can afford the same. Government-sponsored plans like the Chief Minister’s Comprehensive Health Insurance Scheme go a long way in providing everyone with an equal chance at a healthy life.

FAQs about CMCHIS

All

What is the helpline number of CMCHIS?

The toll-free helpline number of the Chief Minister’s Comprehensive Health Insurance Scheme is 1800-425-3993.

Does Amma Maruthuva Kapitu Thittam include reimbursement benefits?

No, you cannot claim for reimbursement under the Amma Health Insurance Scheme. You can claim cashless services under this scheme.

Can my grandchildren benefit from the Chief Minister’s Insurance Scheme?

Yes, your grandchildren is eligible to receive benefits under the CMCHISTN. However, he/she must be a child of the eligible family member until they are employed, married, or turn 25 years old.

What is the Chief Minister's comprehensive health insurance scheme?

The Chief Minister Comprehensive Health Insurance Scheme is a scheme to promote universal health coverage through efficient integration with the public health system and lower healthcare costs to lessen financial hardship for enrolled families.

What advantages does CMCHIS offer?

The following are the main advantages of the CMCHIS:

Comprehensive Medical Emergency Coverage
Broad Hospital Network
All-Inclusive Coverage for Various Treatments
High Sum Insured
Protection Against Additional Medical Services

How do I download a CMCHIS card?

The steps to get the Card from the Tamil Nadu government are as follows:

Step 1: To finish downloading the Chief Minister Health Insurance Smart Card.
Step 2: The beneficiary's information and the URN, or ration card number, must be provided together.
Step 3: Go ahead and select "Generate e-card."

What is the highest coverage provided under CMCHIS?

The annual maximum coverage offered by the CMCHIS policy is Rs 5 lakhs for each enrolled family.

Which family members are eligible to enroll in CMCHIS?

The following family members may apply for the programme if their combined annual income is less than Rs 72,000:

Head of the family
Legal spouse
Children of the qualified family member.
Dependent parents

How can one obtain a smart card or e-card through CMCHIS?

Visit the CMCHIS website, enter your ration card details and URN, and your e-card will be generated immediately. However, your information is checked before the smart card is issued in enrollment centres.

Do pre-existing conditions get covered by CMCHIS?

Yes, CMCHIS covers pre-existing conditions that existed before enrollment at different empanelled hospitals.

Is it possible for me to receive CMCHIS cashless treatment outside of Tamil Nadu?

No, the only location in Tamil Nadu where cashless treatment is offered under CMCHIS is the network of empanelled institutions.

Which medical procedures are covered by CMCHIS 2024?

The program covers hospitalisation, diagnostic tests, follow-up, and many medical conditions, including neurology, cardiology, cancer, surgery, and more.

How can one enroll in the Chief Minister’s Comprehensive Health Insurance Scheme?

Enrollment can typically be done through local government health centres, online portals, or designated enrollment centres. Eligible individuals may need to provide proof of identity, residence, and income.

What should be done in case of a claim or medical emergency?

In case of a medical emergency or needing to file a claim, contact the nearest network hospital or the insurance provider's helpline. Ensure that you have all necessary documents and follow the claim process outlined by the scheme.