Chief Minister’s Comprehensive Health Insurance Scheme Objective
The "Chief Minister's Comprehensive Health Insurance Scheme" is launched to improve access of the poor families of Tamil Nadu, to provide quality medical care for identified specialty services requiring hospitalization for surgeries and medical procedures.
The main objective of the Scheme is to provide cashless medical and surgical treatment in all government and Empanelled private hospitals.
"Eligible person" means a Head of the 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
The Person is entitled to a provisional coverage up to Rs. 1lakh per family per year and with provision to pay upto Rs. 1.5 lakhs for certain specified procedures.
"Family" includes the eligible member, and the members of his or her family who may be the legal spouse of the eligible person, Children of the eligible person till they get employed or married or attain the age of 25 years, whichever is earlier and who are dependent on the eligible person;
Dependent parents of the eligible person.
Scope of the Scheme.
The Scope of the Scheme shall be to provide coverage as per entitlement for the eligible expenses incurred by the eligible person on behalf of himself or any member of his or her family for thetreatment of procedures listed.
A total of 1016 procedures inclusive of 23 Diagnostic Procedures and 113 follow up packages are covered inthe scheme.
Sum insured on Family Floater Basis
1) The Scheme shall provide coverage for the treatment from the date of commencement of the Scheme in any of the empanelled hospitals.
2) The benefit will be on floater basis and can be availed of individually or collectively by members of the Family during the policy year with no restriction on the number of times the benefit is availed. The unutilized Entitlement will lapse at the end of every policyyear.