Chief Minister's Comprehensive Health Insurance Scheme (CMCHIS)

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

Chief Minister's Comprehensive Health Insurance Scheme, usually written as CMCHIS and known in Tamil households simply as the "Muthalvar kaappeedu" card, is Tamil Nadu's state health assurance scheme. CMCHIS is run by the Health and Family Welfare Department through the Tamil Nadu Health Systems Project, and the insurance risk is carried by United India Insurance Company Limited, a public sector insurer headquartered in Chennai.

CMCHIS pays for hospital treatment so that a poor family does not have to sell land, pawn jewels or borrow at high interest when a member falls seriously ill. According to the scheme portal cmchistn.com, the cover is Rs 5,00,000 per family per year on a floater basis, the entire family shares one limit rather than each member having a separate cap.

Main features

• Cashless treatment at the point of admission; the hospital claims from the insurer, not from the patient.
• Cover of Rs 5 lakh per family per year, renewed each policy year.
• More than 1,700 empanelled hospitals, both government and private, across the state.
• A package list running to over 1,000 procedures, together with follow-up treatment packages and diagnostic procedures.
• Premium paid entirely by the Government of Tamil Nadu.

The current policy cycle runs under an agreement with United India Insurance beginning 11 January 2022. Package lists and hospital empanelment are revised during the cycle, so the list published on cmchistn.com is always the operative one.

Who is eligible for CMCHIS?

You can be covered if:

• Your family is resident in Tamil Nadu.
• Your family's annual income is below Rs 1,20,000.
• Your name appears in the family ration card, which is the unit of enrolment.
• You are a Sri Lankan refugee or an eligible migrant holding a valid migration certificate. These families are covered even without an ordinary ration card.

Cover is by family, not by individual. Every person named on the ration card, husband, wife, children, and dependent parents where they are listed: draws on the same Rs 5 lakh floater.

You are not eligible if:

• Your family's annual income is Rs 1,20,000 or above.
• You are not a resident of Tamil Nadu and hold no Tamil Nadu ration card or migration certificate.
• You are already covered as a serving government employee or pensioner under the New Health Insurance Scheme for state government employees, which is a separate contributory scheme with its own cover and its own claim route.

A person whose name is missing from the ration card cannot apply separately. The fix is to have the name added to the card by the Civil Supplies Department, after which the CMCHIS database picks the member up.

What documents are required for CMCHIS?

How to apply for CMCHIS and get your e-card

1. Confirm that every member of your household is named on the family ration card. If a name is missing, get it added through the Civil Supplies Department or the TNPDS portal first.
2. Open the official portal cmchistn.com and go to the Enrolment section.
3. Select Member Search / e-Card, enter your URN (unique reference number) or your Aadhaar number, and search for your family record.
4. Check that the names, ages and photographs shown are correct, then click Generate e-Card and download or print it.
5. If you cannot find your record online, visit the insurance help desk at any empanelled government hospital or the Primary Health Centre with the ration card and Aadhaar. The scheme coordinator will search the database and print the e-card free of charge.

There is no application fee at any stage. No agent can charge money to "add your name" to CMCHIS.

How to use CMCHIS at the hospital

1. Choose a hospital from the empanelled hospital list on cmchistn.com. Treatment at a non-empanelled hospital is not covered.
2. Report to the CMCHIS help desk or insurance kiosk inside the hospital with the e-card, ration card and Aadhaar before admission.
3. The scheme coordinator verifies your identity, matches your illness to a notified package, and raises a pre-authorisation request with the insurer.
4. Once pre-authorisation is approved, you are admitted and treated cashless — no deposit, no bill for the covered package.
5. Collect the discharge summary and, where the package includes it, the follow-up entitlement for review visits and medicines after discharge.

Emergency admissions do not wait for pre-authorisation; the hospital admits first and files the request within the permitted window.

How much does CMCHIS pay and what does it cover?

CMCHIS covers a defined package list rather than open-ended reimbursement. The list runs to over a thousand medical and surgical procedures and includes cardiac surgery, neurosurgery, cancer treatment, orthopaedic and trauma work, urology, nephrology including dialysis, ophthalmology and neonatal care, along with follow-up packages and a set of diagnostic procedures.

Each package has a fixed rate that the insurer pays the hospital. The family's Rs 5 lakh floater is drawn down package by package across the policy year, and it resets at the start of the next year. Unused cover does not carry forward.

Treatment outside the package list, at hospitals that are not empanelled, or where pre-authorisation was never raised, falls outside the scheme. CMCHIS is designed as a cashless scheme, so a family that pays a private bill in full and seeks reimbursement afterwards will usually not be paid.

How to check your CMCHIS status and hospital list

1. Open cmchistn.com and use Member Search with your URN or Aadhaar number to confirm that your family is active in the database.
2. Use the Hospital Search option, filtering by district and by specialty, to find an empanelled hospital that performs the procedure you need.
3. Ask the hospital scheme coordinator for the pre-authorisation number after admission; that number is what you quote in any later query.
4. Call the toll-free helpline 1800-425-3993 to check enrolment, package coverage or the status of a pre-authorisation.

Why CMCHIS claims get rejected, and how to fix them

• Name not on the ration card. The single most common reason a family is told it is not covered. Add the name through the Civil Supplies Department and regenerate the e-card.
• Income above Rs 1,20,000 a year, established from the ration card or income records.
• Hospital not empanelled; verify on the portal before admission, not after.
• Procedure outside the package list, ask the coordinator to check the package master before you commit to treatment.
• No pre-authorisation raised for a planned admission.
• Mismatch between Aadhaar and ration card details, which stalls identification at the kiosk. Correct the mismatch at the ration card end first.

Help and grievance redressal for CMCHIS

• 24-hour toll-free helpline: 1800-425-3993, answered in Tamil.
• Hospital insurance help desk: every empanelled hospital has a CMCHIS coordinator and a district coordinator above them.
• Portal: cmchistn.com carries the hospital list, package list and e-card tools.
• District route: the Joint Director of Health Services in each district oversees scheme implementation locally.

CMCHIS costs the beneficiary nothing. Any demand for payment for a covered package, or for the e-card itself, should be reported to the helpline immediately.