Chief Minister’s Health Insurance Scheme (CMHIS) Nagaland: Complete Features Guide

In summary

CMHIS Nagaland is a government-supported health insurance scheme designed to provide eligible residents of Nagaland with access to healthcare coverage. The scheme covers different beneficiary categories, including the general category, government employees, pensioners, and eligible beneficiaries under specified government provisions. Depending on the category, beneficiaries can receive family floater health insurance coverage for eligible medical expenses, subject to the scheme's applicable terms, conditions, and eligibility criteria.

CMHIS Nagaland comes down to one decision that matters more than anything else in this guide: which category you apply under. GEN is the default category — it's for residents who aren't government employees or pensioners and aren't already covered under AB PM-JAY or another government scheme, and it gets you Rs. 5 lakh a year in family floater cover. EP is the exception — reserved for regular state government employees, pensioners, legislators, and PSU staff — and it gets you Rs. 20 lakh. Get your category right, and you're covered cashless at empanelled hospitals anywhere in India, with pre-existing conditions included from day one. Get it wrong, and you could end up enrolled for a quarter of the cover you were actually entitled to.

Key takeaways

• Two categories: GEN gives ₹5L/family/yr; EP (govt employees, pensioners) gives ₹20L — 4x difference based on employment status, not choice.
• Complements AB PM-JAY: If you're already on AB PM-JAY, you're not eligible for GEN — CMHIS covers who AB PM-JAY doesn't.
• No waiting period: Pre-existing conditions covered from day one — most private insurers make you wait 1–4 years.
• Hospitalization only: OPD visits and standalone diagnostics aren't covered — only inpatient, surgical/medical, and daycare procedures.
• Nationwide cashless: Works at empanelled hospitals across India, not just Nagaland.
• Manual renewal: No auto-renewal — you must visit an enrolment centre each cycle, or lose cashless access.
• Category-specific documents: GEN needs IIC/PRC; EP needs a PPO book (pensioners) or PIMS code (employees).

CMHIS was launched on 14th October 2022 as part of Nagaland's push toward its 2030 Sustainable Development Goal of equitable, affordable healthcare for every citizen. It works alongside Ayushman Bharat (AB PM-JAY) rather than replacing it — so if you're already covered under AB PM-JAY, this scheme isn't meant for you. It exists specifically to catch the people AB PM-JAY doesn't: state government employees, pensioners, and residents who fall outside existing publicly funded health schemes.

Here's the part that catches most people off guard: CMHIS isn't one scheme with one benefit amount. It splits into two categories — CMHIS (GEN) and CMHIS (EP) — and which one you fall under changes your cover by 4x. Getting this distinction right matters, because it determines whether your family is protected up to ₹5 lakh or ₹20 lakh a year.

This is the first thing to sort out, because the two categories aren't just labels — they come from genuinely different eligibility pools and pay out very differently.

CMHIS (GEN) is built for residents who aren't already covered elsewhere. You fall under this category if you are:

• An indigenous or permanent resident of Nagaland, not already a beneficiary under AB PM-JAY or any other publicly funded government health scheme
• A non-dependent family member of someone in the CMHIS (EP) category
• A state government employee without a PIMS number, or a contractual, ad-hoc, or fixed-pay employee (including under various Centrally Sponsored Schemes), along with your household members

CMHIS (EP) is essentially the state's equivalent of CGHS (Central Government Health Scheme) entitlement, extended to:

• Regular state government employees eligible for monthly Medical Allowance or medical reimbursement
• Pensioners
• Serving or former legislators
• Employees of State Public Sector Undertakings, Corporations, and Autonomous Bodies
• Workcharge employees on scale pay, and their dependent family members

What this means for you

If you're a regular state government employee or pensioner, you're almost certainly in the EP category — and that's the ₹20 lakh cover, not ₹5 lakh. Don't assume you're automatically in GEN just because you haven't actively enrolled anywhere else; check your PIMS status and employment category before applying, since applying under the wrong category can mean a lower sum insured than you're actually entitled to.

Both categories cover:

• Cashless hospitalization at empanelled hospitals across India — including for pre-existing illnesses, which is a meaningful benefit most private plans make you wait years for
• Both surgical and medical interventions
• Specific daycare procedure packages
• Preventive and primary care services, aimed at catching problems early before they become expensive hospitalizations

What's excluded: OPD (outpatient) consultations and standalone diagnostic tests done independently of a hospitalization are not covered. If you're going in just for a blood test or a doctor's consultation with no admission involved, CMHIS won't pick up that bill.

You're also not locked out of other government healthcare initiatives just because you're on CMHIS — depending on your eligibility, you may be able to access additional schemes alongside it.

The documentation requirement depends entirely on which category and sub-group you fall into — so check this carefully before you show up at an enrolment centre.

For CMHIS (GEN)

• A valid mobile number
• Indigenous Inhabitant Certificate (IIC) or Permanent Residential Certificate (PRC), issued by the competent district authority after 2016
• If you hold a ration card, note that e-cards must be issued directly through the BIS portal using your ration card — not through the CMHIS portal itself

For CMHIS (EP) — Pensioners

• Valid mobile number
• First three pages of your PPO (Pension Payment Order) book, showing PPO number, last pay scale or designation, or last drawn pay before retirement

For CMHIS (EP) — Government Employees

• Valid mobile number
• PIMS code

For Dependent Family Members

• Proof of relationship to the primary beneficiary
• Disability certificate, where applicable

Renewal isn't automatic — you need to actively visit an enrolment centre with your existing card and required documents.

1. Visit your nearest CMHIS enrolment centre with your current card and documents
2. Provide updated details and verify your beneficiary information
3. Once verified, your coverage is renewed for the next policy period

Pro tip: Mark your renewal date somewhere you'll actually see it. A lapsed CMHIS card means you lose cashless access at empanelled hospitals until it's reinstated — not a gap you want to discover mid-emergency.

Renewal isn't automatic — you have to actively do it each cycle. Here's the process:

1. Visit your nearest CMHIS enrolment centre with your current card and required documents
2. Provide updated details and verify your beneficiary information
3. Once verified, your coverage is renewed for the next policy period

Pro tip : If you let it lapse, you lose cashless access at empanelled hospitals until you go through the renewal process again — not something you want to discover mid-emergency. Worth marking your renewal date somewhere you'll actually see it.

If you need enrolment or renewal support, you can reach out via nagaland.nhpm@gmail.com or check cmhis.nagaland.gov.in.

CMHIS Nagaland exists for a simple reason: not everyone in the state is covered by Ayushman Bharat, and healthcare costs don't wait for paperwork gaps to close. Whether you land in GEN or EP, the scheme gives you something most people underestimate until they need it — cashless treatment at hospitals across India, with pre-existing conditions covered from the moment you enrol.

The scheme rewards a little diligence up front. Confirm your category correctly, keep the right documents ready, and don't let your card lapse at renewal. Do that, and CMHIS quietly does its job — covering a hospital bill you'd otherwise be paying out of pocket. Skip any of it, and you find out the hard way, usually at the worst possible time.

If you're still unsure which category applies to you or what documents you need, the CMHIS support team (nagaland.nhpm@gmail.com) or the official portal (cmhis.nagaland.gov.in) is the fastest way to get a straight answer before you apply.