Subsequent to Government letter No.HFW-45/B/1 l/CMHIS/2024/ 449 dated 19th July 2024; Government employees under CMHIS (EP) upon exhaustion of annual insurance cover of Rs. 20 lakhs per family will be allowed to reimburse any additional expenses exceeding the insurance cover under Salaries (MR) head from respective employee's department, subject to the following:

1.      All concerned Beneficiaries are to apply for reimbursement through the CMHIS Portal (cmhis.nagaland.gov.in) and to upload all supporting documents. The Guideline on submitting of the application is given in Annexure: 1 and is also available on the CMHIS website:- https://cmhis.naealand.gov.in.

2.      The cost of treatment shall be considered for reimbursement as per the approved CMHIS (EP) Health benefit Package rate or as recommended by the State Medical Board constituted under the NHPS. The finalized claim will be forwarded to the respective employee's department for payment to the beneficiary under the Salaries (MR) head.

3.      The concerned department is to submit a proposal for fund allocation under the Salaries (MR) head to the Finance Department for Reimbursement of additional expense beyond Total Insurance Cover under CMHIS for Government Employees.

4.      The reimbursement of such claims is permissible for treatment undergone in hospitals empanelled under CMHIS (EP) or for treatment in non-empanelled hospitals in case of emergency or when the specific procedure is not available in any of the empanelled hospitals with the approval of the State Medical Board.

NB:

1.      Pensioners are NOT entitled for reimbursement of claims Expenditure beyond the insurance cover in a given Policy Period as they not covered under MR scheme-

2.      For any assistance, please call any of these helpline numbers: 8880515012, 8880515013, or 8880515014.

(DIPR)