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!

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. 

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.

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.

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.

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.

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

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.”

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:

• Cashless Claim in Health Insurance
• Reimbursement Claim in Health Insurance

• 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.

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.

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.