Shillong, March 11: The Governor of Meghalaya today has issued notifaction to approved the CM Care +Scheme to held thus beneficiaries as additional financial assistance to families facing financial hardship due to medical expenses beyond the coverage limit of the Megha Health Insurance Scheme (MHIS) operated in convergence with the Pradhan Mantri Jan Arogya Yojana (PMJAY).
The notification state that, whereas , the Government of Meghalaya recognizes the need to provide additional financial healthcare assistance to beneficiaries and families facing financial hardship due to medical expenses beyond the coverage limit of the Megha Health Insurance Scheme (MHIS) operated in convergence with the Pradhan Mantri Jan Arogya Yojana (PMJAY).
And whereas , the State Government has resolved to establish an enhanced financial assistance mechanism for high-end tertiary and critical care treatments not covered or inadequately covered under existing schemes; now therefore, in the interest of public health and welfare, the Governor of Meghalaya is pleased to approve and adopt the CM Care+ Scheme, effective from the date of issuance of this Notification.
The key provision, Scheme Implementation: The CM Care+ Scheme shall function under the Health and Family Welfare Department in alignment with the MHIS financial guidelines and its existing infrastructure.
The Coverage: The Scheme shall provide financial assistance beyond the MHIS-PMIAY COVerage limit of 5.30 lakhs per policy year, specifically for high-end tertiary and critical care treatments and other treatments which are not covered in the MHIS packages or the cost of packages which are not sufficient for those seeking assistance.
Funding Mechanism: The Scheme shall be funded through the MHIS State Corpus Fund, comprising refunded MHIS funds generated by public hospitals and additional budgetary support as and when required.
Eligibility: The Scheme shall benefit individuals who have exhausted their MHIS-PMJAYcoverage or require financial support for treatments not covered under existing packages. However, Government employees (State and Central) and their eligible dependents shall be excluded from availing benefits under the Scheme.
Approval Process: a. District-Level: A Committee headed by the Deputy Commissioner shalI approve cases up to 2 lakhs. b. State-Level: A High-Level Committee chaired by the Chief Executive Officer, State Nodal Agency, shall approve cases above R2 lakhs and up to 5 lakhs.
All the cases shall be approved through E-Proposal System for which Chief Minister’s office shall accord the necessary approval based on recommendation of the committees at District and State level.
Monitoring and Evaluation, the implementation of the Scheme shall be monitored by the Health and Family Welfare Department to ensure transparency, efficiency, and equitable distribution of funds.
The funds shall be provided directly to the institution providing treatment against the cost of treatment. For full details of the Scheme and treatments covered, reference may be made to the CM Care+ Scheme document.
This notification shall come into force from April, 2025, said Mr.Ramkumar, IAS Secretary to the Government of Meghalaya, Health & Family Welfare Department.
