Meghalaya Health Insurance Scheme

MHIS full form is the Meghalaya Health Insurance Scheme in convergence with the central plan of the Prime Minister’s National Security Mission. Under this phase, the government plans to insure 8.8 lakh families in the state.

This time it will also provide security to all the family members. Let’s now know in detail about the Meghalaya Health Insurance Scheme (MHIS) in this article below

Summary:

This Meghalaya Health Insurance Scheme (MHIS) keep an eye on the structure of the Rashtriya Swasthya Bima Yojana (RSBY) by the central government, which was planned to offer medical insurance exposure for poor and needy individuals.

What Is the Meghalaya Health Insurance Scheme?

Meghalaya Health Insurance Scheme (MHIS) is a health insurance plan launched by the Meghalaya government. This scheme focuses on offering free medical insurance welfare for the underprivileged sectors of civilization.

This Meghalaya Health Insurance Scheme (MHIS) can be occupied by anybody residing in Meghalaya excluding central and state government personnel.

It is a universal health insurance scheme for all the residents of Meghalaya, covering MHIS state and central government employees. The scheme, launched in 2012, is intended to provide financial assistance to citizens at the time of hospitalization, which they cannot afford.

When MHIS first started the cover accessible to registered recipients was INR 1,60,000/- for the enrollment fee of INR 31/-. But amendments and improvements have been made to this scheme over the years that surveyed, with the Insurance Cover growing to INR 2,00,000/- in MHIS II as well as INR 2,80,000/- in MHIS III.

Now, Meghalaya Health Insurance Scheme (MHIS) – Phase IV works in a meeting with Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana which was resourcefulness launched by the Hon’ble Prime Minister, Shri Narendra Modi on 23rd of September in the year 2018.

This convergence carries an improved coverage of up to INR 5,00,000 per family on a floater basis with no limits on family age and size. Beneficiaries will get an individual E-card/card on the endorsement of their ID.

Permitted beneficiaries under this scheme (identified as the Golden Records) can gain benefits in all PMJAY and MHIS empanelled hospitals in the state as well as identified hospitals/health facilities across the country.

To date, the MHIS has 4 phases named:

  • MHIS I
  • MHIS II
  • MHIS III
  • MHIS IV

NOTE

Reliance General Insurance Company Limited is the present Insurance Corporation recognized for applying in Meghalaya for MHIS nominated through a competitive bidding and rigorous process.

Key Features of the Meghalaya Health Insurance Scheme (MHIS)

pre existing diseases private hospitals critical care empanelled hospital state nodal agency

Some distinguishing features of the Meghalaya Health Insurance Scheme (MHIS) are provided below:

  • More than 1 family member can obtain treatment in this Meghalaya Health Insurance Scheme (MHIS) at a single time.
  • Some assured hospitals are impaneled outer the Meghalaya state for the assistance of this particular policy’s members.
  • As stated before, this Meghalaya Health Insurance Scheme (MHIS) follows the Rashtriya Swasthya Bima Yojana (RSBY) agenda. Recipients will get the Rashtriya Swasthya Bima Yojana (RSBY) smart card, to get coverage deals and added benefits in excess of the existing welfare provided by the RSBY.
  • Coverage is obtainable for admission in the general ward, private ward, or thorough care unit. But, recipients must recompense a little additional money for the private ward admittance.
  • The extreme benefit an individual can gain at a single time is INR 2.5 lakh for tertiary care and severe care cures.

Benefits Of The Meghalaya Health Insurance Scheme (MHIS)

Benefits Of The Meghalaya Health Insurance Scheme (MHIS)

The Meghalaya Health Insurance Scheme (MHIS) delivers cashless treatment reimbursements for the enrolled members of MHIS. The Meghalaya government compensates the premium burdens valid for the policy cover.

At the time of medical action taken, the pledged members have to bring their RSBY smart card to get cashless medical action in the impaneled hospitals or centers.

  • It enhances the hospital implementation, network, administration, utilization, and enrolment of the benefits under the Scheme.
  • The scheme is to make a practical and supportable universal health insurance plan for the inhabitants of the State of Meghalaya.
  • To follow to excellence database conservation of the populace of the State.
  • Ensuring highly-priced packages are checked thoroughly which is meant to be diminishing out-of-pocket expenses.
  • It provides adequate coverage after seeing the occurrence rate of local diseases or illnesses needful of tertiary care measures.
  • The scheme improves the inclusive service eminence, together with patient care services
  • It also provides strong excellence control, fraud, and monitoring control devices
  • To support citizens empower and voice patients by prompting their health looking for behaviors

The Cashless Treatment Benefit

This is based on the programmed package charges for particular medical conditions. Facts concerning the package charges, claim status, impaneled hospitals, and so many more can be retrieved from the Meghalaya Health Insurance Scheme’s (MHIS) official website.

  • Coverage for already existing diseases is available under this scheme
  • Senior citizens get additional coverage of INR 30000/-
  • Under this scheme, there is daycare medical action is provided for some specific treatment
  • This scheme provides hospitalization benefits of INR 2.8 lakh for up to 5 family members (Only if you have taken up the family floater cover)

Summary:

These covers are in force for one year only. After 1 year, you have to renew your smart card by repaying the mandatory enrollment charge.

Exclusions of the Meghalaya Health Insurance Scheme (MHIS)

Exclusions of the Meghalaya Health Insurance Scheme (MHIS)

Here are the exclusions of the Meghalaya Health Insurance Scheme (MHIS) given below:

  • Illnesses or injuries produced by nuclear activity or war
  • Self-inflicted wounds or suicide attempt
  • Sterilization or fertility-associated medical treatments
  • Inherited external ailments
  • Any aesthetic or cosmetic treatments
  • Any diseases produced because of alcohol or drugs
  • Disorders that don’t need hospitalization

Who are eligible for the Meghalaya Health Insurance Scheme (MHIS)?

Meghalaya Health Insurance Scheme eligibility

  • Only the electoral roll will be able to get this scheme.
  • This scheme is obtainable for individuals residing in Meghalaya
  • State and Central government workers will not be covered under this scheme.
  • Up to five members, the insured family will be able to enroll under this scheme (only on the family floater insurance)
  • There is no specific age limit in the Meghalaya Health Insurance Scheme (MHIS)

What Documents Are Needed For Registration?

Any One Of The Documents In Each Section Are Required During Registration
Sl. No.Personal DetailsAdd Member (If Required)Family Details
1.Voter IdBirth CertificatePM’s Letter for SECC Beneficiary Category (once received)
2.Birth CertificateMarriage CertificateOther Government Documents which list all members of the Family
3.Aadhaar CardAdoption CertificateRSBY/MHIS Card for RSBY/MHIS category
4.Ration CardRation CardRation Card
5.MGNREGA Job CardHeadman’s declarationHeadman’s declaration
6.Other Government ID/Certificate with Photo

What Is The Registration Procedure Under MHIS & AB-PMJAY?

  • A recipient can go to any Kiosk or PMJAY/MHIS Registration Centre to register themselves under this scheme.
  • The beneficiary will have to provide a lawful government Photo ID Card for the individual registration process
  • However, to add any members under the scheme, the beneficiary will have to give supporting documents as evidence of the relationship between members of the family such as a Birth Certificate, Marriage Certificate, Ration Card, or a Declaration from the head person of the family listing all the members of his or her family.
  • Upon completion of the registration process, the recipient will be given an individual PMJAY/MHIS card for a fee of INR 30 per beneficiary.

The Process of Enrollment to The Meghalaya Health Insurance Scheme (MHIS)

The process of Enrollment to The Meghalaya Health Insurance Scheme (MHIS)

The process for enrollment is mainly physical and includes an assortment of biometric information and identity proofs (IDs). The process is as follows:

  • You will have to provide the needed documents to the insurance policy company first.
  • The backup plan will facilitate the area-level authorities to think of an enlistment plan for different towns in a region.
  • The enlistment date will be declared for every town well ahead of time. Enlistment focuses will be set up in every town on an explicit date.
  • The enlistment focus will gather the recipient’s fingerprints, photography, personality evidence, and so forth.
  • A smart card that contains all the gathered data will be printed and given to the recipient in the enlistment focus.
  • To register in this plan, the beneficiary will have to pay INR 50/- for the enrollment fee.

NOTE:

Once you are enrolled, you can log in with your user name and password. To Login click here

FAQ:

Q. What is AB-PMJAY?

A. AB-PMJAY is the initiative of the Government of India to confirm that vulnerable sections and the poor of society are given health care. It is called the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana.

Q. What is MHIS?

A. MHIS has been presented as a health insurance plan by the Govt. of Meghalaya, resulting in the framework of Rashtriya Swasthya Bima Yojana (RSBY); and now working in convergence with AB-PMJAY. It’s called Megha Health Insurance Scheme (PMJAY + UHIS).

Q. How many members per family are entitled to the scheme?

A. There is no such restriction on the family size or age under MHIS.

Q. Who is entitled to the scheme?

A. All the citizens of the state of Meghalaya (APL and BPL Category) are entitled to the scheme, excluding State and central Govt. employees who are entitled to the State/Central reimbursement policy.

Q. Is there any age limit under MHIS?

A. No. There is no age limit under MHIS. Anybody can enroll under the scheme.

Q. How much does the MHIS beneficiary have to pay to avail of MHIS?

A. MHIS beneficiaries will have to pay INR 30 for each individual card during registration.

Q. Do the beneficiaries pay the premium to the insurance company?

A. No, the premium will be paid by the Government and not the beneficiary.

Q. What is the insurance cover for the scheme?

A. The Scheme delivers insurance coverage of up to INR 5,00,000 per family on a floater basis.

Q. Which hospitals are empanelled under the scheme?

A. All health centers and public hospitals of the state of Meghalaya are empanelled under MHIS. The list of hospitals is available on the website.

Q. What is the toll-free number for MHIS?

A.  The toll-free number for MHIS is 1800-102-4762

Q. What is the MHIS helpdesk number?

A. The MHIS helpdesk number is 0364-250 7477

Q. Who is the Insurance Company for MHIS – Phase IV?

A. Reliance General Insurance Company Limited is the Insurance company for MHIS – phase IV

Q. Is There Any Way For MHIS Card Online Apply?

A. As of now, you need to physically arrive at an MHIS Registration Centre to register yourself under this scheme. You will also have to give your Aadhaar details like Aadhaar number, registered mobile number, etc.

Q. Is MHIS Link With Aadhar Mandatory?

A. Since February 2023, linking Aadhaar card with your MHIS card download has been mandatory

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