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.

List of Genitourinary Surgery under CMCHIS

 List Genitourinary Surgery under Chief Minister's Comprehensive Health Insurance Scheme.

S.No.	SPECIALTY	PROCEDURE NAME
1	Genitourinary Surgery	TN0795 : A.V. Fistula (Pre-Transplant Procedure Only)
2	Genitourinary Surgery	TN0796 : Renal Transplantation Surgery
3	Genitourinary Surgery	TN0799 : Open Pyelolithotomy
4	Genitourinary Surgery	TN0800 : Open Nephrolithotomy
5	Genitourinary Surgery	TN0801 : Open Cystolithotomy
6	Genitourinary Surgery	TN0802 : Laparoscopic Pyelolithotomy
7	Genitourinary Surgery	TN0803 : Cystolithotripsy
8	Genitourinary Surgery	TN0804 : PCNL
9	Genitourinary Surgery	TN0805 : Eswl
10	Genitourinary Surgery	TN0806 : URSL
11	Genitourinary Surgery	TN0807 : Nephrostomy
12	Genitourinary Surgery	TN0808 : DJ Stent (One Side)
13	Genitourinary Surgery	TN0809 : TURBT
14	Genitourinary Surgery	TN0810 : Single Stage Urethroplasty for Stricture Urethra
15	Genitourinary Surgery	TN0811 : Double Stage Urethroplasty for Stricture Urethra - Stage I

List of Gynaecology & Obstetric Surgery under CMCHIS

List of Gynaecology & Obstetric under Chief Minister's Comprehensive Health Insurance Scheme.

S.No.	SPECIALTY	PROCEDURE NAME
1	Gynaecology & Obstetric Surgery	TN0616 : Caesarean Hysterectomy with Bladder Repair
2	Gynaecology & Obstetric Surgery	TN0617 : Rupture Uterus with Tubectomy (Reserved for Govt. Hosp.)
3	Gynaecology & Obstetric Surgery	TN0618 : Eclampsia with Complications Requiring Ventilatory Support (Reserved for Govt. Hosp.)
4	Gynaecology & Obstetric Surgery	TN0619 : Abruptio-Placenta with Coagulation Defects (DIC)
5	Gynaecology & Obstetric Surgery	TN0620 : Laproscopic Assisted Vaginal Hysterectomy (LAVH)
6	Gynaecology & Obstetric Surgery	TN0621 : Vaginal Hysterectomy with Pelvic Floor Repair (Reserved for Govt. Hosp.)
7	Gynaecology & Obstetric Surgery	TN0622 : Vaginal Hysterectomy with Mesh Repair
8	Gynaecology & Obstetric Surgery	TN0623 : Cystocele, Rectocele & Perineorraphy (Reserved for Govt. Hosp.)
9	Gynaecology & Obstetric Surgery	TN0624 : Pelvic Floor Reconstruction with Mesh
10	Gynaecology & Obstetric Surgery	TN0625 : Mc Indo-S Repair for Vaginal Atresia
11	Gynaecology & Obstetric Surgery	TN0626 : Slings with Mesh Repair for Prolapse
12	Gynaecology & Obstetric Surgery	TN0627 : Vault Prolapse Abdominal Repair
13	Gynaecology & Obstetric Surgery	TN0628 : Vault Prolapse Abdominal Repair with Mesh
14	Gynaecology & Obstetric Surgery	TN0629 : Laparoscopic Cystectomy
15	Gynaecology & Obstetric Surgery	TN0630 : Laparoscopic Ectopic Resection
16	Gynaecology & Obstetric Surgery	TN0631 : Laparoscopic Ovarian Drilling
17	Gynaecology & Obstetric Surgery	TN0632 : Laparoscopic Myomectomy
18	Gynaecology & Obstetric Surgery	TN0633 : Laparoscopic Recanalisation
19	Gynaecology & Obstetric Surgery	TN0634 : Laparoscopic Sling Operations
20	Gynaecology & Obstetric Surgery	TN0635 : Laparoscopic Adhesolysis
21	Gynaecology & Obstetric Surgery	TN0636 : Vaginal Hysterectomy for BENIGN CONDITIONS (Reserved for Govt. Hosp.)
22	Gynaecology & Obstetric Surgery	TN0637 : Abdominal Hystrectomy for Benign Conditions (Reserved for Govt. Hosp.)
23	Gynaecology & Obstetric Surgery	TN0638 : Staging Laprotomy for Ovarian and Uterine Ca
24	Gynaecology & Obstetric Surgery	TN0639 : Wertheims Hystrectomy for Carcinoma Cervix
25	Gynaecology & Obstetric Surgery	TN0640 : Diagnostic Hystero- Laproscopy (Reserved for Govt. Hosp.)

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