CMHIS covers nearly 96% of State households: Official

KOHIMA, JUN 19 (PTI): Chief Minister’s Health Insurance Scheme (CMHIS) now covers nearly 96 per cent of households in Nagaland, with the state government bearing a substantial financial burden to sustain the programme amid rising insurance premiums, an official said on Friday.
Addressing a seminar on CMHIS jointly organised by the High Court Bar Association (HCBA), Gauhati High Court’s Kohima Bench, and the Nagaland Health Protection Society (NHPS), NHPS Joint CEO Dr Kikameren Longkumer said the scheme was launched in 2022 to bridge healthcare gaps under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY).
He said while PM-JAY covers around 2.59 lakh families in Nagaland, CMHIS extends health insurance coverage to government employees, pensioners and the “missing middle” not covered under existing schemes.
Under the scheme, government employees and pensioners are entitled to health insurance coverage of Rs 20 lakh per family annually, while another component provides coverage to uninsured households in the missing middle category.
According to Longkumer, CMHIS currently covers around 97,185 households of government employees and pensioners and another 20,000 households under the missing middle category, taking overall coverage to about 96 per cent of the state’s 3.97 lakh households.
He said government employees and pensioners contribute 50 per cent of one month’s Dearness Allowance annually, generating around Rs 60 crore. However, the insurance premium has risen sharply from about Rs 1,500 per family initially to Rs 9,670 at present.
Against annual collections of around Rs 60 crore, the premium payable has increased to nearly Rs 94 crore, requiring an additional state contribution of Rs 30-34 crore, he said.
Besides this, the state contributes about Rs 40 crore towards PM-JAY and another Rs 10 crore for CMHIS coverage of the missing middle category.
Longkumer said the scheme currently covers only hospitalisation expenses due to financial constraints, though outpatient department (OPD) services may be included in future.
Beneficiaries can avail cashless treatment at empanelled hospitals both within and outside Nagaland.
Around 60 to 70 hospitals outside the state have been empanelled, with only NABH-accredited institutions included to ensure quality healthcare, he said.
He added that emergency treatment is covered even at non-empanelled hospitals.
Urging beneficiaries to obtain their CMHIS cards, Longkumer said NHPS operates a 24×7 toll-free helpline to receive complaints against hospitals charging beyond approved package rates. Hospitals found violating scheme guidelines face suspension from the empanelled network, he added.
Speaking at the seminar, Gauhati High Court Kohima Bench Judge Justice Nelson Sailo described healthcare as a constitutional right under Article 21 and said CMHIS has significantly expanded healthcare access beyond government employees to the general public.
Calling a robust healthcare system the backbone of a thriving society, he said the scheme protects families from financial hardship while improving public health and quality of life.