TAMILNADU HEALTH SYSTEM PROJECTS - DEPARTMENT OF HEALTH AND FAMILY WELFARE

Project Overview

Tamil Nadu is ranked among the high-performing States in India, in the area of human development. The State is noted for its low mortality rates and effective healthcare services. The State has a long track record of innovations in the health sector. It has pioneered many new approaches to enhance effective access to quality health care at low financial costs. Over the last few decades, healthcare in the state of Tamil Nadu has improved significantly, with more people having increased access to medical care. There is a strong commitment to high performance in the health sector.

Despite the speedy progress and development, the State continues to face challenges in the healthcare sector that need to be dealt with in a phased and systematic manner. The broad areas that need addressing are

• Coping with non-communicable diseases (NCD)
• Providing the highest quality of healthcare 
• Resolving equity-related issues
• Having an effective health financing system

Health Policy of 2003 

Chief Minister's Comprehensive Health Insurance Scheme - Tamilnadu

Introduction

Quality healthcare comes at a cost that is unaffordable for the economically weaker sections of society. One way to address this is to provide free healthcare in Government hospitals. But sometimes treatment is not possible at district and sub-district hospitals. Furthermore, the demand for advanced healthcare leads to long waitlists for emergency and life saving surgeries. To address these challenges and ensure availability of advanced healthcare, the Government of Tamilnadu introduced a scheme called the “Chief Minister Kalaignar Insurance Scheme for life saving treatments” on 23rd July 2009. This scheme is for the poorest of the poor/low income/unorganised groups who cannot afford costly treatment, as a supplementary facility for getting free treatment in empanelled Government and private hospitals for such serious ailments.

Chief Minister's Comprehensive Health Insurance Scheme

On January 11, 2012, the Chief Minister's Comprehensive Health Insurance Scheme aimed at benefiting 1.34 crore families was launched.

Eligibility

Tamilnadu Chief Minister's Comprehensive Health Insurance Scheme - SALIENT FEATURES OF THE SCHEME 2015

SALIENT FEATURES OF THE SCHEME

THE SCHEME

This is a lofty Insurance Scheme launched by the Tamil Nadu State Government through the United India Insurance Company Ltd (a Public Sector Insurer headquartered at Chennai) to provide free medical and surgical treatment in Government and Private hospitals to the members of any family whose annual family income is less than Rs.72,000/- (as certified by the Village Administrative Officers) .The Scheme provides coverage for meeting all expenses relating to hospitalization of beneficiary as defined in the Scope of the Scheme.

BENEFITS

The scheme seeks to provide cashless hospitalisation facility for certain specified ailments/ procedures. The scheme provides a coverage up to Rs.1,00,000/- per family per year on a floater basis for the ailments and procedures covered under the Annexure "C".
For certain specified ailments and procedures of critical nature, which are listed under Annexure "D" in the Scheme, the overall limit is increased from Rs.1,00,000/- to Rs.1,50,000/-

There are 2 other covers other than the hospitalisation benefits under Annexure "C" & "D" available under the Scheme. They are a) Follow-up Treatment as listed under Annexure "E"& b) Additional Diagnostic procedures listed under Annexure "F"

AVAILING THE BENEFITS

Free health camps / screening camps will be conducted by network hospitals as per the directions given by Project Director of Tamil Nadu Health Systems Society. Minimum of one camp per month per empanelled hospital will be held in the districts in each policy year. The persons who need treatment are identified in the Health camps. Such patients can approach the hospital in the network and follow the guidelines below:

1. A new Health Insurance identity card with biometrics is being issued to all those members who have been holding the smart cards in the earlier scheme. Till such time new cards are issued the public can use the earlier smart (Health) cards
2. This card should be shown at the Assistance Counter established at the empanelled hospital.
3. After due verification of the details and authenticating the identity of the patient by the Liaison Officer, the necessary Pre-authorisation request for cashless facility will be submitted by the DMO of the hospital.
4. The Project Office will approve the request on authentication of the identity and provided the procedure planned is within the Scheme

Even those patients who have the smart cards, though not identified through the Health Camps can also avail the benefit as above

HELPLINE

A 24 hour Call Centre has been set up at CMCHISTN Project Office with sufficient manpower with toll free help line. The Toll Free Number is 1800 425 3993. The Toll Free Line is competent to answer the query in Tamil.

திட்டத்தின் சிறப்பம்சங்கள்

Tamilnadu Chief Minister's Comprehensive Health Insurance Scheme Eligibility 2015

Eligibility 
இக்காப்பிட்டுத்திட்டம் ஏழை எளிய குடும்பங்களுக்கு ஆண்டு வருவாய் 72,000/க்கு கீழ் உள்ளவர்கள் பயன் பெரும் வகையில் செயல்படுத்தப்படுகிறது. இந்த வருமானத்திற்கு உரிய வருமானச் சான்று அருகில் உள்ள கிராம நிர்வாக அலுவலரிடமிருந்து உரிய பரிசீலனைக்குப்பிறகு பெற்றுக்கொள்ளலாம் இந்தத் திட்டத்தின்கீழ் தரமான அறுவை மற்றும் மருத்துவ சிகிச்சைப் பதிவு பெற்ற தனியார் மற்றும் அரசு மருத்துவமனைகளில் பெற்றுக் கொள்ள வழிவகை செய்யப்பட்டுள்ளது.

Tamilnadu Chief Minister's Comprehensive Health Insurance Scheme 2015

Every member of a family whose annual family income is less than Rs.72,000/- as certified by Village Administrative Officer and such other person who may be declared to be eligible for coverage under the "Chief Minister's Comprehensive Health Insurance Scheme" by the Government will be "Eligible Persons" under the Scheme.