Health Insurance Government Scheme VIII

In Previous Post, we have mentioned some more Assam Government health care Scheme for the Poor and underprivileged section of the society. In Health Insurance Government Scheme VIII, we will provide more  Assam Government Schemes below

• Chief Minister’s Free Diagnostic Services
• Free operations for children having congenital (defect at the time of birth or before) heart disease
• Sneha Sparsha

In this Post we will describe scheme run by Meghalaya State Government

• Meghalaya Health Insurance Scheme (MHIS)

Meghalaya Government Health Insurance

Meghalaya Health Insurance Scheme (MHIS)

This Health Insurance Scheme is launched by Meghalaya Government in 2012. It provides financial help to its citizen at the time of hospitalization. It is a Universal Health Insurance Scheme for all the Residents of Meghalaya including State and central Employee.

Phases and Financial Help

• During Launch MHIS I (2012)—Enrolment fee Rs. 31 and Financial help up to Rs. 1,60,000/
• MHIS (II)— Financial help up to Rs.2,00,000/
• MHIS (III) – Financial Help up to Rs. 2,80,000/

Now currently After the announcement of Pradhan Mantri – Jan Arogya Yojana by Prime Minister Shri Narendra Modi on 23rd Sept 2018, It (Meghalaya Health Insurance Scheme IV) carries a coverage of Rs. 5,00,000/ per family with no limits on family age and size on a floater basis. Beneficiaries will get E-card.

The Beneficiaries under MHIS IV can take benefits in all Empaneled Hospital in State or Across the country. It means the Beneficiary can be treated in any Empaneled Hospital across the country.

Salient Features of Meghalaya Health Insurance Scheme

Some of the Salient features of this scheme is given below

• In MHIS Scheme, more than 01 family member is eligible for treatment in a single time.
• The Meghalaya Health Insurance Scheme follows Rashtriya Swasthya Bima Yojana (RSBY). So, The Beneficiaries will get RSBY card so that they can get all benefits and coverage deals.
• The Beneficiary can be admitted in general ward, private ward or thorough care unit but if the receiver/recipients want private ward then he has to donate some money for getting private ward.
• The Beneficiary can get single benefit, a sum of Rs. 2.50 lakh for severe care and post compulsory care cures (after treatment).

Benefits of Meghalaya Health Insurance Scheme (MHIS)

Some of the Benefits of Meghalaya Health Insurance Scheme is given below

• It delivers cashless treatment reimbursements for enrolled members of MHIS. During Medical care, the Beneficiaries have to bring RSBY Smart card for cashless treatment in empaneled hospital.
• The Meghalaya Government will reimburse/repay the premium burdens valid for the policy cover.
• It gives estimation of database of the population of Meghalaya State
• It helps in supporting universal health care scheme for the resident of Meghalaya.
• There is no specific age limit for becoming beneficiaries of this scheme

Cashless Treatment Benefit

Note: The Smart card is just for 01 year. You have to renew every year to take benefit

• It covers already existing disease under this scheme
• Senior Citizen gets additional coverage of Rs. 3,00,000/
• Day care medical action is also provided for some specific treatment.
• If you have taken family floater then you will get hospitalization benefit of Rs. 2.80 lakhs for up to 5 family members.

Exclusion of Meghalaya Health Insurance Scheme (MHIS)

MHIS scheme does not work under some conditions are given below

• If a person is injured/ill during nuclear activity or war.
• If a person is inherited external disorder/sickness/disease.
• If a person has created own wounds or suicide attempt
• Any kind of cosmetic or aesthetic/plastic surgery treatment
• Any disease occurred by consumption of alcohol or drugs
• Disorders that do not need hospitalization

Eligibility of Meghalaya Health Insurance Scheme (MHIS)

Below are the eligibility criteria to get benefits of MHIS

• The people must be resident of Meghalaya
• Government Employee (Central and State) will not be covered under this scheme.
• People who are authorized to vote will get this scheme or can become beneficiaries

Documents required during Registration for this Scheme

At least one documents in each column is required during registration for Meghalaya Health Insurance Scheme

 

Personal details	Add Members (IF required)	Family details
Birth Certificate	Marriage Certificate	Ration card
Aadhar card	Birth Certificate	Headman’s declaration
Voter ID	Ration card	PM Letter for SECC Beneficiary Category (Once received)
Ration card	Adoption certificate	RSBY/MHIS card for RSBY/MHIS category
Any Government ID/certificate with photo	Headman’s declaration	Any Government documents which list all members of family
MGNREGA job card

 

Registration Procedure Under MHIS and AB-PMJAY

AB-PMJAY= Ayushman Bharat- Pradhan mantri Jan Arogya Yojana

• The people have to go to any PMJAY/MHIS Registration center to register themselves in this Scheme.
• The people have to attach supporting documents like Birth Certificate, Ration card, Marriage Certificate or Declaration by the Head of the Family listing all members of his/her family.
• The person has to submit Photo ID card for individual registration process.
• When all the documents are submitted and verified, the beneficiary will get the PMJAY/MHIS card for Rs. 30 per beneficiary

Process of Enrolment to the MHIS scheme

Here the process for enrolling is physical, where the beneficiary has to go under biometric information and Identity Proofs. The process is

• The Recipient have to provide required document to insurance policy company at first.
• The Enlistment will take place with co-operation with each Area Level Authorities. The Enlistment will focus on every town and district in clear cut date.
• The Enlistment people with take Recipients Fingerprints, Photography, Personality evidence and so on.
• After that Smart card will be Printed and distributed to the Recipients with all the gathered data.
• The Beneficiary have to pay Rs. 50 for getting enrolled in this scheme.