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CMHT Health Insurance Scheme

CMHT Health Insurance

CMHT Health Insurance Scheme

Government of Manipur has launched the Chief Minister-gi Hakshelgi Tengbang (CMHT) health assurance scheme for the poor and disabled people. The CMHT Health Insurance Scheme provides cashless treatment to poor at government hospitals, health centres and other empanelled selected private hospitals and cover up to Rs. 2 lakhs per eligible family every year identified from the Socio-Economic Caste Census (SECC). In this article, we will look at the Chief Minister Hakshelgi Tengbang Health Insurance Scheme in detail.

Objectives of the CMHT Scheme

The key objective of the Chief Minister Hakshelgi Tengbang Health Insurance Scheme is to offer insurance cover for primary and secondary healthcare and treatment expenses for the following critical diseases provided the insured is admitted to an empanelled hospital:

  • Cardiovascular diseases
  • Kidney diseases
  • Neo-natal diseases
  • Neurological conditions
  • Burns
  • Liver ailments

Treatments for the above-listed diseases are available under district hospitals, empanelled hospitals and Community Health Centre.

Know more about the Rashtriya Swasthya Bima Yojana (RSBY)

Benefits of the Scheme

The benefit of the Chief Minister-gi Hakshelgi Tengbang Health Insurance Scheme (CMHT)  is explained in detail below:

Cashless Treatment

By showing CMHT-Manipur Health card, the beneficiaries can get cashless treatment without making any payment to the empanelled hospitals up to a limit of Rs 50,000 for a general ailment, Rs 2 lakhs for seven critical ailments per year per family on floater basis. Total entitlement for a family will be Rs 2 lakhs per year on floater basis. The benefit will apply to hospitalization procedures only. This capped benefit of Rs 2 lakhs will include the capped travel and daily allowance.

Finance for Critical Ailments

The maximum cover for a family is Rs 2 lakhs. In case of the specified seven critical ailments, the total benefit will be admissible up to the ceiling amount of Rs 2 Lakhs per year per family, including transport and daily allowances.

Transport Allowance

  • Provision for transport allowance of Rs. 300 per hospital visit, subject to an annual ceiling of Rs.3000 will be a part of the total coverage of Rs 2 lakhs per family for treatment within Manipur.
  • The CMHT scheme has provision for payment of Air or Train fare to the beneficiary plus one Attendant for treatment outside the State. This amount will be capped at Rs 30000 per annum and will come within the annual limit of Rs 2 lakhs.

Allowance for Outside Treatment

  • For treatment outside Manipur, a daily allowance of Rs. 1000 per day will be given for the period of hospitalization subject to a limit of Rs.10000. This will be within the annual limit of Rs 2 lakhs.

Eligible Criteria

The eligibility Criteria for Chief Minister Hakshelgi Tengbang Health Insurance Scheme is explained in detail below:

  • The CMHT scheme is for the poor and needy, as identified in the Socio-Economic Caste Census (SECC) data.
  • Widows, Disabled Persons and Antyodaya Anna Yojana (cards holder will get the CMHT scheme

Enrolment and Issuance of Card

The Eligible family will be intimated through the Asha worker to get enrolled into the CMHT scheme, two days before the enrolment commences.

  • Each eligible beneficiary will get a CMHT – Manipur Health card with a unique family identification number.
  • Up to five members of the family will be printed on the card. If there are more than five members, then additional members count will be written next to the 5th name.

Enrolment Fee

To get the enrolment card, the family will be charged Rs.50 and no fees will be taken from the AAY cardholder, Disabled person and Widows.

Prescribed Authority

State Nodal Cell (SNC) will be set up by the Government of Manipur for the implementation of the CMHT Scheme.

Empanelled Hospitals

As stated above, All CHCs, Sub District Hospitals, District Hospitals, RIMS, JNIMS and other empanelled hospitals are in the network of CMHT Scheme. The beneficiary can choose hospitals within the State in the first instance, provided there is the availability of capacity and the treatment procedure.

Health Coordinators appointed by the ISA at the empanelled Hospitals, within the State, will guide the beneficiary in the empanelled hospitals, from enrolment to admission to discharge, including ensuring payments of the allowances to the beneficiaries as per policies

Referral Process for Other State Treatment

  • For treatment outside the State, the beneficiary needs to undergo a Referral process.
  • For treatment in the hospitals outside Manipur, a referral needs to be generated from an approved referral authority at Health Directorates.
  • This will allow the ISA to coordinate the travel and treatment arrangements of the beneficiary outside the State.
  • There will be a procedural exemption rule in case of emergencies which will be notified by the SNC.

Documents Required

Documents required for Chief Minister Hakshelgi Tengbang Health Insurance Scheme is listed as follows:

  • ID Proof – Original EPIC (Voter ID) card, Aadhaar card, PAN card, Driving License, Ration Card, Passport, Government ID card or ID card issued by recognized educational institute
  • Eligibility Proof: Disability certificate, SECC based Eligibility, AAY card, a certificate from Deputy Commissioner regarding economic status
  • Note: In case the family is not listed in the SECC database, any other documents approved by the Government of Manipur can be submitted
  • Optional Document: Any document which is notified as acceptable and issued through the Government of Manipur.

Aadhar Number:  To enrol in the CMHT Scheme, Aadhaar number is essential, and the copy of the aadhar credential to be shared along with the consent. At least, the family head or minimum one member of the family must provide Aadhaar details for enrolling the family. If the beneficiary is not having the Aadhaar card and they still want to get enrolled in the CMHT scheme, they have to get enrolled into Aadhaar and provide the Aadhaar application number and consent form.

Application Procedure

The application procedure to avail the benefit of the Chief Minister-gi Hakshelgi Tengbang Health Insurance Scheme is explained below:

  • Beneficiaries who have CMHT Manipur Health Card can visit nearest CHC and contact the Health coordinator of CMHT Manipur Scheme
  • At CHC, they have to provide the CMHT Manipur Health Card along with the ID proof of the beneficiary who needs treatment.
  • The Health Coordinator will coordinate with the Hospital administrator after verification and ensure the patient gets cashless admission.
  • They support the Hospital administrator to submit Pre-authorization to ISA through Hospital portal provided by ISA.
  • ISA does the following with Preauthorization request
    • Approve if all the details are correct.
    • Ask for more information, in case of Hospital has not provided during preauthorization.
    • Deny if the treatment is not listed as per the CMHT scheme conditions. Or the ID proof is not matching with the CMHT health card.
  • Once the ISA approves the preauthorization, the treatment continues to the beneficiary.
  • After successful completion of the treatment, the Hospital will furnish the claim documents online through Hospital portal provided by ISA.
  • The Health Coordinator coordinates with the beneficiary, for smooth discharge of the beneficiary.
  • The Health Coordinator facilitates the beneficiary with a TA through the respective Hospitals.
  • Feedback from the beneficiary will be collected by the Health Coordinator.
  • The Claim will be submitted to ISA online. The ISA will verify all the supporting documents of claims and submitted the float once a week to SNC.
  • SNC will verify all the details of claims submission by ISA and makes payment to respective Hospital online.

Note: If the treatment facility is not available at CHC, the beneficiary will be referred to the Sub District Hospital or District Hospital or RIMS or JNIMS or other empanelled network Hospitals respectively.