Mizoram Universal Healthcare Scheme (MUHCS)

What is the Mizoram Universal Healthcare Scheme?

Mizoram Universal Healthcare Scheme (MUHCS) is the state's flagship health assurance programme, run by the Mizoram State Health Care Society under the Health & Family Welfare Department, Government of Mizoram. Locally the scheme is spoken of simply as the healthcare scheme, and the MUHCS guidelines published by MSHCS in 2025 state that the scheme "shall take effect from 1st April, 2025".

MUHCS replaces a patchwork with a single roof. According to the MUHCS guidelines, the scheme covers the whole population of Mizoram by converging the older Mizoram State Health Care Scheme with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and other vertical health programmes, then extending cover to people who had none. MUHCS also folds in the existing health arrangements for state government employees and civil pensioners, with special conditions for both groups.

The core design

• Cover is a defined benefit on a family floater basis, so one family's annual limit is shared across all its members.
• There is no waiting period for any covered beneficiary, and pre-existing conditions are covered from day one.
• Benefits are cashless and paperless at empanelled hospitals, processed end to end on an IT platform linked to the AB PM-JAY system.
• Unutilised cover does not carry forward to the following policy year.
• All public hospitals in Mizoram from Primary Health Centre level upwards are deemed empanelled, and every hospital already empanelled under AB PM-JAY is deemed empanelled under MUHCS.

Policy direction sits with a Universal Health Coverage Council chaired by the Minister for Health & Family Welfare, with the Chief Secretary, the Secretaries of Health, Finance and Food, Civil Supplies & Consumer Affairs, and the CEO of MSHCS as members.

Who is eligible for MUHCS and who is not?

You can join if you are a bona fide resident of Mizoram. The MUHCS guidelines set out six categories:

1. AB PM-JAY beneficiaries, as the list is revised by the National Health Authority from time to time.
2. State government employees and their dependents, identified from the IFMIS database.
3. Mizoram State Health Care Society employees and their dependents, as per the PDS database.
4. Provisional Employees and Muster Roll staff under the Government of Mizoram and their dependents, as per IFMIS.
5. Civil pensioners under the Government of Mizoram and their dependents, from the pensioner list held at each treasury, with dependents drawn from the PDS database.
6. The general population not in any of the above, treated as contributory beneficiaries who pay a premium.

You cannot apply if you are not a bona fide resident of Mizoram. MUHCS does not use an income cut-off to exclude anyone, so the more useful question is what is not covered rather than who. The following are not eligible for payment under Annexure 2 of the guidelines:

• Sterilisation and recanalisation.
• Normal and assisted vaginal delivery, except for regular state government employees. Provisional Employees and Muster Roll staff are not covered for it.
• Dental treatment that is corrective, cosmetic or aesthetic, cavity filling, root canal including extraction, dentures and dental implants.
• Vaccination or inoculation, and cosmetic or aesthetic treatment of any kind.
• Detoxification from alcohol or drug and substance abuse.
• External congenital anomalies, except club foot, cleft lip, cleft palate and other anomalies that disrupt bodily function.
• Convalescence, general debility, rest cure, and treatment at convalescent or nature cure establishments.
• Domiciliary care, with home dialysis the single exception, which is settled on reimbursement.
• Cost of spectacles and contact lenses, refractive eye surgery under 5.5 dioptre, and blepharoplasty below the age of 60.
• Illness or injury arising from war or nuclear weapons, and intentional self-injury except for regular state government employees.

How much does MUHCS pay and what does a family contribute?

MUHCS sets both the premium and the room entitlement by category.

Government employee contributions run at Rs 1,500 a month for pay level 13 and above, Rs 1,000 for levels 10 to 12, Rs 700 for levels 6 to 9, Rs 400 for levels 3 to 5 and Rs 300 for levels 1 and 2. Civil pensioners fall in Category A if monthly basic pension is Rs 20,000 or more and Category B below that. A Category B pensioner may buy up into Category A by paying Rs 1,000 a month, but the option must be exercised within one month of MUHCS implementation, or within one month of retirement for a new pensioner.

A household with two or three pensioners is eligible for double or triple the sum assured, and dependents can be split between them. Where a family has both a pensioner and a serving government servant, each draws their own benefit.

OPD and day care services are covered for every category except AB PM-JAY beneficiaries. Twenty-nine day care and OPD conditions are listed in Annexure 3, including dialysis, parenteral chemotherapy, hepatitis B and C treatment, cataract and glaucoma surgery, lithotripsy, AV fistula and thalassaemia transfusions. Travel expenditure for portable cases is reimbursed against tickets and boarding passes, for the patient only in most categories and for the patient plus one attendant for regular government employees.

How to apply for MUHCS

1. Check which category you fall into. Government employees, Provisional Employees and Muster Roll staff do not need to register at all — their eligibility is read directly from the IFMIS database. Their offices should approach MSHCS for verification and generation of the MUHCS ID.
2. Gather your Aadhaar and ration card. Aadhaar is the only accepted personal identity document and the ration card establishes the family unit. If you have no ration card, get a Village Council or Local Council recommendation letter that explains why and lists everyone living in the household.
3. Open the MUHCS enrolment portal at muhcs.mizoram.gov.in and register your family. Registration is done on a family basis, but each member has to go through identification and verification separately.
4. Choose your plan and pay the premium if you are a contributory beneficiary. Payment is accepted by UPI, credit card, debit card and internet banking. Premium once deposited is not refunded except as the guidelines allow, so pick the ward entitlement you actually want before paying.
5. Complete verification at a district kiosk, at a facility kiosk in a CHC or PHC, at an MSHCS beneficiary identification drive in your ward or village, or at the MSHCS office at Dinthar, Aizawl during office hours.
6. Collect your MUHCS card once MSHCS or the State/ISA approver clears the application. The card carries a unique MUHCS ID and can be printed and issued to you.

How to enrol in MUHCS offline

1. Go to your nearest sub-centre, which is the designated point for offline enrolment where online registration is not feasible.
2. Fill the physical enrolment form manually and produce your ration card or the Village Council or Local Council letter at the counter.
3. Keep your duplicate copy. The sub-centre sends the duplicate form and supporting documents to MSHCS within a stipulated timeframe, and the data is then keyed into the MUHCS IT system.
4. Follow up on verification. Enrolment alone is not enough; the MUHCS card is issued only after each family member is individually verified and the application is approved.

How do you actually use MUHCS at a hospital?

MUHCS runs cashless and paperless, so the hospital does the paperwork, not you.

1. Present your MUHCS card at the empanelled hospital. The card and its unique MUHCS ID are mandatory to get cashless benefits.
2. The hospital registers you as a patient on the IT platform. A back date of up to 5 days is permitted; anything older than that is not payable.
3. The hospital raises a pre-authorisation, auto-approved or configured as per the MUHCS Package Master, valid for 24 hours once approved.
4. For a longer stay the hospital requests a pre-authorisation enhancement of up to 5 days at a time, and must renew within 48 hours of the granted permission expiring.
5. Beyond 30 days of hospitalisation, the hospital must write to the CEO, MSHCS at muhcs.prolongedstay@gmail.com from the 31st day onwards. MSHCS may approve up to 5 more days per application.

Package rates cover bed charges, admission fee, patient diet, doctor consultation, nursing, relevant investigations, medicines and consumables, surgery and anaesthetist charges, oxygen and ventilator support, and bedside physiotherapy. High-end diagnostics such as MRI and PET scans may be booked additionally for selected packages. Items such as accommodation above your entitlement, attendant accommodation for ICU patients, implant cost beyond the package amount, diapers, wheelchairs, crutches and toiletries are chargeable to you.

Why MUHCS claims and cards get rejected

• No MUHCS ID. Cashless benefit is impossible without a verified card.
• Late patient registration. Hospitalisation booked more than 5 days back date on the IT platform is not payable.
• Lapsed pre-authorisation. If the hospital misses the 48-hour renewal window, the extra days fall outside cover.
• Treatment on the Annexure 2 exclusion list, such as sterilisation, normal delivery for a non-eligible category, or cosmetic dentistry.
• Portability without a referral. Treatment outside Mizoram without a Medical Referral Board referral and MSHCS final authorisation loses both cashless settlement and travel reimbursement.
• Family details not matching the ration card. Since the PDS database defines the family unit, a member missing from the ration card has to be added there first before MUHCS can add them.

Details on a MUHCS card, name, gender, date of birth, address; are corrected by redoing e-KYC with an updated Aadhaar, after which a fresh card is generated.

What happens for treatment outside Mizoram?

MUHCS beneficiaries other than AB PM-JAY households may be treated at non-empanelled hospitals outside Mizoram where the treatment is unavailable in the empanelled network or the case is an emergency. Settlement in that situation is by reimbursement at MUHCS package rates, or the closest matching package or CGHS rate where the treatment is not in the MUHCS Package Master. MSHCS is required to reimburse within 45 days of receiving the complete set of documents.

Home dialysis is the other reimbursement exception, paid on the quantity of usage at a rate fixed by the government from time to time.

How to raise a MUHCS grievance

MUHCS grievances run through a three-tier structure set out in the Grievance Redressal Guidelines:

1. District Grievance Redressal Committee (DGRC), with a District Grievance Nodal Officer as the point of contact.
2. State Grievance Redressal Committee (SGRC), with a State Grievance Nodal Officer.
3. State Appellate Authority (SAA), the final authority for all grievances, whether received directly or escalated.

Any beneficiary, empanelled or de-empanelled hospital, or implementing agency may file. Complaints are lodged online through the Central Grievance Redressal Management System at cgrms.nha.gov.in, and each one generates a Unique Grievance Number used to track status by email and SMS. Cases not resolved within the defined turnaround time escalate automatically to the next level. Vague feedback that cannot be acted on is not entertained.

MUHCS contact details

• Mizoram State Health Care Society, Dinthar, Aizawl, Mizoram 796009
• Landline: 0389-2328223
• Email: shamizoram@gmail.com
• Prolonged stay approvals: muhcs.prolongedstay@gmail.com
• MUHCS enrolment portal: muhcs.mizoram.gov.in
• MSHCS website: mshcs.mizoram.gov.in, which carries the empanelled hospital list, enrolment and payment reports, and current circulars

The scheme has continued to evolve since launch. MSHCS has notified revised package rates in June 2026, a corpus fund sanction in October 2025, dental procedures added to the package rate, rules for treatment at non-empanelled hospitals, and a set of MUHCS 2.0 enrolment and refund circulars in 2026. Check mshcs.mizoram.gov.in before enrolling so you pay against the current window and the current premium.