Sarkari Yojana
Mukhya Mantri Himachal Health Care Scheme-HIMCARE
About Mukhya Mantri Himachal Health Care Scheme-HIMCARE
Run by the Department of Health & Family Welfare, Government of Himachal Pradesh, Mukhya Mantri Himachal Health Care Scheme-HIMCARE is a health insurance scheme that gives families cashless treatment cover of up to ₹5,00,000/- per year in empanelled hospitals. Where a family has more than five members, the extra members are enrolled as a separate unit, with each additional unit also capped at five members. The scheme works on a co-payment basis. Hospitals in the State empanelled under Ayushman Bharat are empanelled for HIMCARE as well and give beneficiaries cashless treatment by making online entries in the Transaction Management System. After the full claim papers submitted online by these institutions are checked, claims are reimbursed straight into the hospital’s bank account via the host-to-host payment system.
1. No premium (Zero Premium) is charged for the target groups below.
- BPL (Not covered under Ayushman Bharat),
- Registered Street Vendors (Not covered under Ayushman Bharat),
- MNREGA workers with at least 50 days of work under MNREGA in the previous financial year or the current financial year.
- Children who live in Orphanages.
1. A premium of ₹365/- per year applies to the target groups below.
- Ekal Naaris,
- Disabled >40%,
- Mid-Day meal workers,
- Daily Wage Workers (Govt., Autonomous Bodies, Societies, Boards & Corporations etc. under the control of State Government),
- Part Time Workers (Govt., Autonomous Bodies, Societies, Boards & Corporations etc. under the control of State Government)
- Contractual Employees (Govt., Autonomous Bodies, Societies, Boards & Corporations etc. under the control of State Government)
- Outsource Employees.
1. All other beneficiaries outside category-I and category-II, who are not Govt. servants/pensioners or their dependent family members, pay a premium of ₹1,000/- per year.
Scheme Overview
State Government
Himachal Pradesh Swasthya Bima Yojna Society
Individual
01 Jan 2019
Scheme Details
Eligibility Requirements
To qualify for Mukhya Mantri Himachal Health Care Scheme-HIMCARE, applicants must satisfy the following conditions:
Only permanent residents of Himachal Pradesh may apply
Only permanent residents of Himachal Pradesh may apply.
HIMCARE is open to families that are not…
HIMCARE is open to families that are not covered under the Ayushman Bharat Yojana (Pradhan Mantri Jan Arogya Yojana).
Holding a HIMCARE card is required
Holding a HIMCARE card is required.
Below Poverty Line (BPL) families, Above Poverty Line…
Below Poverty Line (BPL) families, Above Poverty Line (APL) families, Senior citizens and daily wage earners, widows, single women, and persons with disabilities can all join.
Benefits Provided
Mukhya Mantri Himachal Health Care Scheme-HIMCARE provides the following benefits to eligible applicants:
Cashless Treatment
Cashless Treatment: beneficiaries get medical care at empanelled hospitals without paying anything upfront.
Comprehensive Coverage
Comprehensive Coverage: each family is covered up to ₹5,00,000/- a year, so quality healthcare does not become a financial burden.
Inclusion of Previously Uncovered Families
Inclusion of Previously Uncovered Families: families left out of the Ayushman Bharat scheme are brought under health insurance, widening coverage.
Categorization for Differential Premium Rates
Categorization for Differential Premium Rates: premium rates differ by group, based on occupation or socioeconomic status, to keep healthcare affordable for everyone eligible.
Wide Range of Eligible Beneficiaries
Wide Range of Eligible Beneficiaries: BPL families, registered street vendors, MNREGA workers, senior citizens above 70 years, children in orphanages, disabled individuals, Anganwari workers, ASHA workers and others are covered.
Easy Enrollment Process
Easy Enrollment Process: beneficiaries can enrol and upload documents online on the official website or at Lok Mitra Kendra/Common Service Centers.
Empanelled Hospital Network
Empanelled Hospital Network: cashless treatment is available at empanelled hospitals in Himachal Pradesh and at leading institutions such as PGIMER Chandigarh and GMCH Sector 32 Chandigarh.
Documents Required
Applicants should keep the following documents ready before starting the application:
Enrollment under HIMCARE requires the following documents, by category:
BPL:
a copy of the BPL certificate, attested by the Panchayat Secretary within the previous one month.
Registered Street Vendors:
the Registration Certificate, attested by the Executive Officer, MC/NP/NAC within the previous one month.
MNREGA Worker:
the MNREGA Job Card plus an Online MIS Report showing 50 days of work under MNREGA in the previous or current financial year, attested by the Panchayat Secretary/BDO concerned.
Ekal Naaris:
a certificate from the Child Development Program Officer (CDPO) of the area, covering Widows/Divorced/Legally Separated /Unmarried women over 40 years.
Disabled >40%:
a Medical Disability Certificate that shows permanent disability.
Mid-Day meal workers:
a certificate from the Block Elementary Education Officer of the area.
Contractual Employees:
certification by the department concerned.
Daily Wage Worker:
certification issued by the department concerned.
Part Time Workers:
the department concerned must certify them.
Outsource Employees:
a certificate from the department concerned.
2019-01-01
How to Apply
Online - via CSC Application
Applicants can apply for Mukhya Mantri Himachal Health Care Scheme-HIMCARE through the online - via csc application process outlined below.
Application Portal: Open Application Portal ↗
Find your nearest Lok Mitra Kendra (LMK) or…
Find your nearest Lok Mitra Kendra (LMK) or Common Service Center (CSC).
Go to the LMK or CSC and tell…
Go to the LMK or CSC and tell them that you want to apply for HIMCARE.
Hand over the required information and documents to…
Hand over the required information and documents to the staff at the centre.
The VLEs help you complete the application form…
The VLEs help you complete the application form and upload the documents online.
Applying via Lok Mitra Kendra/Common Service Centers may…
Applying via Lok Mitra Kendra/Common Service Centers may involve an enrollment fee of ₹50/- for each family unit of up to five members.
After submission, the application goes for verification, during…
After submission, the application goes for verification, during which the authorities check the application and documents for authenticity and eligibility.
When approved, the eligible family is issued an…
When approved, the eligible family is issued an E-card.
This E-card is the proof of enrollment and…
This E-card is the proof of enrollment and is used to get cashless treatment under the scheme.
Online Application
Applicants can apply for Mukhya Mantri Himachal Health Care Scheme-HIMCARE through the online application process outlined below.
Apply for the HIMCARE card on the official
website .
Provide the ration card details and upload a…
Provide the ration card details and upload a scan of the Ration card with the application.
Enter the required details correctly, covering personal information,…
Enter the required details correctly, covering personal information, contact details and family details.
After confirming the Application form, the applicant can…
After confirming the Application form, the applicant can no longer edit it, and anyone liable for a Premium Amount must pay within 30 days.
Upload scans of the documents required for your…
Upload scans of the documents required for your category.
Submit the form together with the uploaded documents
Submit the form together with the uploaded documents.
Exclusions / Who Is Not Eligible
1. Non-Coverage of Government Servants and Pensioners: The scheme does not provide coverage for government servants, pensioners, or their dependent family members. They are not eligible to enroll in HIMCARE.
1. Non-Coverage of Beneficiaries Already Covered Under Ayushman Bharat: Families that have already been selected and covered under the Ayushman Bharat scheme, based on SECC 2011 and RSBY, are not eligible for coverage under HIMCARE. The scheme targets those left out of Ayushman Bharat.
1. Non-Coverage of Beneficiaries Who Do Not Fall under Eligible Categories: Individuals who do not fall under the eligible categories defined by the scheme, such as those not belonging to BPL families, registered street vendors, MNREGA workers, senior citizens above 70 years, or other specified groups, are excluded from the coverage provided by HIMCARE.
Official Application & Website
Verify the latest eligibility, dates and instructions before applying.