Chief Minister's Comprehensive Health Insurance Scheme - Tamil Nadu

What is the Chief Minister's Comprehensive Health Insurance Scheme?

Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS) is Tamil Nadu's state health insurance scheme, run by the Health and Family Welfare Department, Government of Tamil Nadu. The scheme pays for cashless hospital treatment worth up to Rs 5,00,000 per family per year at empanelled government and private hospitals across the state.

CMCHIS began life as the Chief Minister Kalaignar's insurance scheme for life saving treatments, launched on 23 July 2009, the reason many families in Tamil Nadu still call it Kalaignar Kaappeettu Thittam. At launch, 1.34 crore families were enrolled with cashless cover of Rs 1 lakh each, and the government paid the entire premium. The scheme was recast in its present form as the Chief Minister's Comprehensive Health Insurance Scheme from 11 January 2012.

According to the Health and Family Welfare Department's 2025-26 policy note, 1.48 crore families in Tamil Nadu are currently enrolled. The state pays the whole premium: Rs 849 per family per year for the policy year 11 January 2025 to 10 January 2026, covering 1,48,57,459 families at a total cost of Rs 1,262.91 crore. Nothing is collected from the beneficiary at enrolment or at the hospital.

What CMCHIS covers

• 2,053 medical and surgical treatment procedures.
• 8 high-end procedures, the transplant and implant list.
• 11 follow-up procedures, so post-operative care is not left uncovered.
• 52 complete diagnostic procedures.
• 2,175 empanelled hospitals, 943 government and 1,232 private.

Who is eligible for CMCHIS, and who is not covered?

A family can be enrolled if:

• The family holds a Tamil Nadu family card (ration card). The family card is the unit of the scheme, and everyone named on it shares the Rs 5 lakh limit.
• Annual family income does not exceed Rs 1,20,000. This ceiling was raised from Rs 72,000 with effect from 11 January 2022.
• The family is resident in Tamil Nadu.

Special categories enrolled without the ordinary income test. The department has separately enrolled groups whose need is established by status rather than by an income certificate:

A family is not eligible if:

• Annual family income exceeds Rs 1,20,000 and the family does not fall into one of the notified special categories.
• There is no Tamil Nadu family card. Families outside the family card system cannot be enrolled, because the card is what defines the insured unit.
• The family is not resident in Tamil Nadu. Beneficiaries of other states' PM-JAY schemes can be treated at Tamil Nadu hospitals through portability, but they are not enrolled into CMCHIS itself.

A procedure that is not on the 2,053-item package list is not covered, however serious it is. Checking the package list before admission is the single most useful thing a family can do.

How to apply for CMCHIS

1. Collect the documents; family card, Aadhaar card for every member to be enrolled, and an income certificate from the Village Administrative Officer or Tahsildar showing annual family income at or below Rs 1,20,000.
2. Go to the enrolment kiosk at your District Collector's Office. Registration of new beneficiaries is done through these kiosks. In Greater Chennai, additional kiosks operate at Central Chennai and Saidapet to serve the expanded corporation area.
3. Let the operator verify the documents and capture biometrics. The kiosk operator checks the papers and records fingerprints, photograph and iris scan for each member.
4. Collect the e-card. The kiosk issues the CMCHIS card carrying the family's details. Keep it with the family card.
5. Renew before expiry. An expired card can be renewed at the nearest e-Sevai centre, and cards can also be checked and downloaded through cmchistn.com.

How to use the CMCHIS card at a hospital

1. Check the hospital is empanelled. The list of 2,175 empanelled hospitals is published on cmchistn.com and is displayed at the hospital entrance.
2. Report to the CMCHIS help desk inside the hospital, not to the ordinary billing counter. Every empanelled hospital runs a scheme kiosk staffed by a medical coordinator.
3. Produce the CMCHIS card, family card and Aadhaar. The coordinator verifies the beneficiary by biometrics.
4. Wait for pre-authorisation. The hospital raises a pre-authorisation request with the insurer for the specific package. Treatment under the scheme is cashless once it is approved.
5. Pay nothing at discharge for a covered package. Charges for items outside the approved package are the only amounts a family should be asked for, and these should be questioned in writing.

How much has CMCHIS actually paid out?

CMCHIS is one of the largest state health schemes in India by claim volume. From 23 July 2009 to 5 March 2025, a total of 1,48,20,170 beneficiaries received treatment with claims approved worth Rs 14,302 crore. Of these, 48,54,648 beneficiaries were treated in government hospitals, with approvals of Rs 5,508 crore. A useful corrective to the belief that the scheme mainly funds private care.

High-end procedures. From 11 January 2012 to 31 March 2025, 16,777 beneficiaries received high-end procedures worth Rs 1,421.25 crore:

The everyday packages matter more than the headline ones. Across 11 January 2012 to 31 March 2025, kidney dialysis alone accounted for 18,48,385 approvals worth Rs 1,547.52 crore, cardiac stents for heart attack 1,53,977 approvals worth Rs 1,038.11 crore, cardiac valve replacement 8,46,668 approvals, knee replacement 2,63,919, kidney stone surgery 1,77,957, hearing aids 1,74,040 and newborn diseases 1,68,484. Total approvals across all specialties reached 71,65,701 worth Rs 12,485.95 crore.

How CMCHIS works with Ayushman Bharat PM-JAY

Tamil Nadu issued orders integrating Pradhan Mantri Jan Arogya Yojana with CMCHIS from 23 September 2018. 86.50 lakh families are identified as PM-JAY beneficiaries in the state. After integration, CMCHIS beneficiaries receive the enhanced cover of Rs 5 lakh per family per year, and hospitals empanelled under CMCHIS also provide PM-JAY coverage, including portability for PM-JAY beneficiaries visiting from other states.

For a family in Tamil Nadu, this means one card and one hospital network rather than two parallel systems.

What Innuyir Kappom covers that CMCHIS does not

Road accident victims are treated separately. Innuyir Kappom Thittam — Nammai Kaakkum 48, launched on 18 December 2021, provides free emergency care during the first 48 hours after a road accident. 723 hospitals are empanelled to 250 upgraded government hospitals and 473 private hospitals, and 101 designated treatment modalities costing up to Rs 2 lakh per individual are provided cashless.

Crucially, this applies irrespective of whether the victim holds a CMCHIS card, including people from other states and foreigners, as long as the accident occurs within Tamil Nadu. From 18 December 2021 to 31 March 2025, 3,57,137 patients were treated at a cost of Rs 318.90 crore, of whom 3,30,003 were treated in government hospitals.

Why CMCHIS claims get rejected

• Procedure not in the package list. The 2,053 packages are specific; a treatment outside them is not payable however necessary.
• Hospital not empanelled. Treatment at a non-empanelled hospital cannot be reimbursed later. Verify empanelment before admission, not after.
• Card expired. Renew at an e-Sevai centre; an expired card blocks pre-authorisation.
• Income above Rs 1,20,000, discovered at verification.
• Name mismatch between the family card, Aadhaar and the CMCHIS record.
• No pre-authorisation raised before the procedure, except in genuine emergencies where the hospital must raise it immediately after stabilisation.

Help and grievance redressal

• 24-hour toll-free number: 1800-425-3993, which handles queries and complaints from the public, scheme members, hospitals and other stakeholders.
• Hospital medical coordinator. The first point of contact for a pre-authorisation that is delayed or refused.
• District level, the enrolment kiosk at the District Collector's Office, for enrolment, card and eligibility problems.
• Portal, cmchistn.com for the hospital list, package list, card status and enrolment guidance.

CMCHIS enrolment and treatment are free. No agent can charge a fee to enrol a family, and no empanelled hospital may demand payment for an approved package.

How to check your CMCHIS application status

CMCHIS does not use a single online "application" that gets approved or rejected in stages the way a form-based subsidy does. What a family actually needs to track falls into two separate checks: whether the family's enrolment and e-card are active, and whether a hospital's pre-authorisation request for a specific treatment has been approved. The two are checked differently.

Checking enrolment and card status

1. Visit cmchistn.com. The portal lets a family look up whether its family card is linked to an active CMCHIS record and whether the e-card has been issued or has expired.
2. Call the 24-hour toll-free helpline, 1800-425-3993, if the portal lookup is unclear or the family does not have internet access. The helpline handles status queries from members directly.
3. Go back to the enrolment kiosk at the District Collector's Office (or the Central Chennai and Saidapet kiosks for Greater Chennai) if the card shows as not issued weeks after biometrics were captured. The kiosk operator can pull up the application by the family card number and explain any hold-up, such as an income certificate query or a biometric mismatch.
4. Use an e-Sevai centre for a card that has expired or needs reprinting; the centre can confirm whether the renewal has gone through before issuing a new card.

Checking the status of a hospital claim

A pending or rejected treatment is not tracked by the family directly, it moves between the empanelled hospital and the insurer:

1. Ask the hospital's CMCHIS medical coordinator at the help desk. The coordinator raised the pre-authorisation and can see whether it is still pending with the insurer, approved, or queried for more documents.
2. Escalate to the helpline (1800-425-3993) if the hospital reports an unusual delay in pre-authorisation, or if the hospital is unable to explain a refusal. The helpline also takes complaints from hospitals and other stakeholders, not only from beneficiaries, so it can chase a stuck approval on the family's behalf.
3. Do not assume silence means rejection. A pre-authorisation that is still under review should not be treated as denied until the hospital or insurer confirms it in writing; asking for that confirmation in writing is the safest way to get a clear answer rather than a verbal "not approved."