The Nagaland Health Protection Society (NHPS) has provided a comprehensive update on the ongoing implementation of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (ABPM-JAY) and the Chief Minister Health Insurance Scheme (CMHIS), underscoring its commitment to transparency and effective management of public health funds.
According to NHPS, the ABPM-JAY, with an annual insurance cover of Rs 5 lakhs per household, and the CMHIS, which covers government employees and pensioners with a Rs 20.00 lakh insurance policy, have collectively supported thousands of families across Nagaland. These schemes aim to reduce out-of-pocket expenses for hospitalized care and promote access to quality healthcare services.
In terms of financing, the ABPM-JAY is supported by both the Central and State Governments, with the funding ratio split at 90:10. However, due to a cap on the Central share at Rs. 1052 per household, the State Government contributes additional funds, raising its share to 51% for the policy year 2024-25. This ensures that coverage remains intact despite the funding cap.
Meanwhile, CMHIS, specifically for employees and pensioners, is funded by converting 50% of their monthly medical allowance, and the corpus is managed by the Finance Department. Any expenses exceeding the Rs. 20.00 lakh per household insurance cover are reimbursed through the concerned department’s salary head.
As of February 16, 2025, a total of Rs 57.34 crores has been approved for 30,379 claims under the ABPM-JAY scheme, with Rs 42.71 crores already disbursed to various hospitals. Similarly, under the CMHIS, 17,501 claims amounting to Rs 72.32 crores have been processed, with Rs 47.20 crores paid out to healthcare providers.
In total, Rs 90 crores out of the Rs 92 crores premium payable for the policy period have already been paid to the insurance company, Future Generali India Insurance Co. Ltd (FGI), ensuring that there has been no default in premium payments, in line with the Insurance Regulatory and Development Authority of India (IRDAI) regulations.
The NHPS encourages all stakeholders, including beneficiaries, empanelled hospitals, and insurance companies, to utilize the schemes ethically and responsibly. With efficient claims processing and responsible management of funds, these schemes aim to provide sustainable healthcare coverage for the people of Nagaland.
For more information, citizens are encouraged to contact the NHPS Helpline at 1800-202-3380 or email support-nhps@cmhis.nagaland.gov.in.