Chief Minister Ayushman Health Insurance Scheme (Madhya Pradesh Employees and Pensioners)

What is the Chief Minister Ayushman Health Insurance Scheme?

Chief Minister Ayushman Health Insurance Scheme is the working name of a cashless health insurance cover that the Government of Madhya Pradesh has announced for its own employees, contractual staff and pensioners. The scheme is being designed by the Public Health and Family Welfare Department together with the Finance Department, and it is intended to give state staff something close to what the Central Government Health Scheme (CGHS) gives central government employees.

This guide describes an announced scheme, not an open one. As of the last fact check, Madhya Pradesh had not published a notification, a set of rules, a premium table or an enrolment portal for the scheme. Everything below is reported from state announcements and press coverage, and is marked as such. No employee should pay money to any agent claiming to enrol them.

The core promise, as announced, is simple. Instead of paying a hospital bill from their own pocket and claiming it back months later, a Madhya Pradesh government employee or pensioner would carry a card, walk into an empanelled hospital, and have the treatment billed directly to an insurer.

What benefits has Madhya Pradesh announced under the scheme?

According to state announcements reported in 2025, the proposed cover is:

• Up to Rs 5 lakh per family per year for ordinary or general illness.
• Up to Rs 10 lakh per family per year for serious or critical illness.
• A higher limit in exceptional cases, subject to approval by a medical board, for conditions that exhaust the Rs 10 lakh ceiling.
• About Rs 10,000 a year for outpatient (OPD) consultation and tests, reported in the Free Press Journal account of the draft.
• Treatment at empanelled government and private hospitals, including hospitals outside Madhya Pradesh, so that a patient referred to Delhi, Mumbai or Vellore is not left uncovered.

The cover is described as a family floater; one limit shared by the employee or pensioner, their spouse and their dependants; rather than a separate limit per person.

An earlier version of the same idea was approved by the Madhya Pradesh cabinet in January 2020 as an employees health insurance scheme for about 12.55 lakh employees, with the same Rs 5 lakh and Rs 10 lakh structure and an intended start date of 1 April 2020. That version did not become operational. The current announcement revives it with a wider beneficiary list.

Who will be eligible for the scheme?

The following groups are named in the announcements as covered:

• Permanent Madhya Pradesh government employees, in all departments.
• Temporary and contractual employees drawing salary from the state.
• Government school teachers and staff of education department cadres.
• Retired state government employees drawing pension, and their families.
• Employees of state corporations, boards and autonomous institutions.
• Anganwadi workers and Anganwadi helpers.
• ASHA and Usha workers.
• Home guards and Kotwars.
• Panchayat secretaries and Gram Rozgar Sahayaks.

Taken together, the announcements put the covered population at more than 15 lakh people.

Who cannot apply or is not eligible:

• The general public cannot apply. This is an employer-funded scheme for people on the Madhya Pradesh government payroll or pension roll. A private sector worker, a self-employed person or a farmer is not eligible.
• Central government employees posted in Madhya Pradesh are not eligible, because they are covered by CGHS or their own departmental arrangements.
• Employees of private schools, private colleges and private hospitals are not eligible, even if the institution receives a state grant, unless the final notification specifically includes grant-in-aid staff.
• Families already covered under Ayushman Bharat Niramayam (PM-JAY) as poor or vulnerable households are a separate group; PM-JAY does not cover government employees, which is exactly the gap this scheme is meant to fill.

Because the rules are not notified, the boundary cases, for example outsourced staff hired through agencies, or dependent parents of a serving employee — cannot be stated with certainty and are not stated here.

How will employees pay for the cover?

The scheme is being designed as a contributory one, not a free benefit. Reported plans put the employee and pensioner share at roughly Rs 250 to Rs 1,000 a month, graded by pay level or pay matrix band, with the state government paying the balance of the premium to the insurer. An alternative figure that has appeared in Hindi coverage puts the annual employee deduction at Rs 3,000 to Rs 12,000 a year, which is the same Rs 250 to Rs 1,000 a month expressed annually.

For serving employees the contribution is expected to be deducted at source from salary through the state's IFMIS payroll system. For pensioners it would most likely be deducted from the monthly pension. Neither mechanism has been notified.

How to apply for the Chief Minister Ayushman Health Insurance Scheme

There is no application form and no portal open today. The realistic steps for a Madhya Pradesh employee or pensioner are these:

1. Do not pay anyone. No agent, insurance broker or "CSC operator" can enrol you in a scheme that has not been notified. Any demand for money for registration is a fraud.
2. Watch the two departments that will issue the order. The Public Health and Family Welfare Department at health.mp.gov.in and the Finance Department at finance.mp.gov.in. The scheme will begin with a gazette notification and a Finance Department circular fixing the contribution slabs.
3. Keep your service and family records correct now. When enrolment opens it will almost certainly be driven off existing databases, the IFMIS employee record for serving staff and the Pension Payment Order for pensioners. Get your spouse, children and dependants correctly recorded in your service book and in your Samagra family ID before that happens, because a missing dependant is the commonest reason a family floater card is issued short.
4. Keep your Aadhaar linked to your mobile number. Every Ayushman-branded card in Madhya Pradesh is issued against Aadhaar e-KYC, and this one is very unlikely to be different.
5. Once notified, enrol through your Drawing and Disbursing Officer (DDO) if you are serving, or through the district treasury if you are a pensioner. That is the standard route for any payroll-linked benefit in the state.

How do MP employees get medical treatment paid for until then?

Until the scheme starts, Madhya Pradesh government employees and pensioners continue under the existing medical reimbursement system. Under that system the employee pays the hospital, then submits bills, the discharge summary and the prescribed claim form to their Drawing and Disbursing Officer, who forwards them to the sanctioning authority for reimbursement at approved rates. Treatment at a government hospital, or at a hospital recognised for the purpose, is normally required for a full claim.

Employees needing a large, unaffordable treatment can also apply to the Chief Minister's Relief Fund (Mukhyamantri Sahayata Kosh), and residents below the poverty line can use the Ayushman Bharat Niramayam state health assistance route through the district Chief Medical and Health Officer, where sanctions up to Rs 1 lakh are made at district level, Rs 1 lakh to Rs 2 lakh at divisional level and above Rs 2 lakh at state level.

What is still unconfirmed about this scheme?

Being honest about the gaps matters more than filling them:

• No notification date. No gazette notification or scheme rulebook has been published.
• No insurer named. The scheme is to be run through an insurance company, chosen presumably by tender; no company has been announced.
• No hospital empanelment list. The list of empanelled government and private hospitals inside and outside Madhya Pradesh does not exist yet.
• No confirmed contribution table. The Rs 250 to Rs 1,000 a month range is from press reports, not from a Finance Department order.
• No confirmed treatment of dependent parents, of outsourced staff, or of employees who are also covered by a spouse's CGHS card.

Any website that publishes a confident, precise premium table or a "download your card" link for this scheme today is not quoting a government source.

Where to raise a query or complaint

• Madhya Pradesh CM Helpline: 181, the state's single grievance number, which accepts complaints against any department including Public Health and Family Welfare.
• CM Helpline portal: cmhelpline.mp.gov.in, where a complaint can be filed online and tracked by its complaint number.
• Your Drawing and Disbursing Officer is the correct first stop for any serving employee's medical reimbursement question.
• District treasury office is the first stop for pensioners.

The scheme is sometimes written in Hindi as Mukhyamantri Ayushman Swasthya Bima Yojana and was earlier discussed as Mukhyamantri Karmachari Swasthya Bima Yojana; both names refer to the same proposed employee health cover.