A Guide to Government Health Schemes in Northeast India

The states of Northeast India have made significant strides in public healthcare by implementing a variety of health insurance schemes. The primary goal is to achieve universal health coverage, ensuring that every resident has access to medical care without facing financial hardship.

This is largely achieved through a dual approach. The central government's Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) provides a foundation of coverage for economically vulnerable families. To cover the remaining population, each state has launched its own unique scheme. These state-level initiatives either run parallel to PM-JAY, complement it, or are fully integrated with it to create a comprehensive safety net.

This guide provides a detailed overview of the primary government health schemes in Meghalaya, Manipur, Mizoram, Nagaland, Tripura, Arunachal Pradesh, and Sikkim. It covers key aspects such as insurance coverage, eligibility criteria, the enrolment process, and how each scheme interacts with the national PM-JAY framework.

Meghalaya: Megha Health Insurance Scheme (MHIS) at a Glance

• Coverage per Family — Up to ₹5.3 lakh per year
• Implementing Agency — Reliance General Insurance Company Limited (Phase 6)
• Toll-Free Helplines — 1800-102-4762, 1800-212-3650

Manipur: Chief Minister-gi Hakshelgi Tengbang (CMHT) at a Glance

• Coverage per Family — Up to ₹2 lakh per year
• Launch Year — 2018
• Toll-Free Helpline — 1800-103-2015

Mizoram: Mizoram Universal Health Care Scheme (MUHCS) at a Glance

• Coverage per Family — Up to ₹5 lakh per year
• Launch Year — 2025
• Toll-Free Helpline — 14555

Nagaland: AB PM-JAY CMHIS at a Glance

• General Coverage — ₹5 lakh per family per year
• Govt. Employee Coverage — ₹20 lakh per family per year
• Toll-Free Helpline — 14555

Tripura: Chief Minister Jan Arogya Yojana (CM-JAY) at a Glance

• Coverage per Family — Up to ₹5 lakh per year
• Launch Date — February 15, 2024
• Toll-Free Helpline — 14555, 1800-111-565

Arunachal Pradesh: Chief Minister Arogya Arunachal Yojana (CMAAY) at a Glance

• Coverage per Family — Up to ₹5 lakh per year
• Launch Date — August 15, 2018
• Toll-Free Helpline — 1800-233-5558

Sikkim: Health Schemes at a Glance

• SSSY Coverage (Govt. Employees) — ₹10 lakh per family per year
• MMJRK Assistance (General Public) — Up to ₹2 lakh
• Emergency Helpline — 9002433135, 9749341334

Rates shown are as per the Multiple Government and Public Health Information Portals (2024) and are subject to periodic revision. Always verify the latest approved rates on the official source.

Meghalaya: Megha Health Insurance Scheme (MHIS)

The Megha Health Insurance Scheme (MHIS) is a universal health insurance scheme for the residents of Meghalaya. First launched in 2012, it has evolved through several phases and since 2019 has been implemented in convergence with Ayushman Bharat PM-JAY. The current MHIS Phase 6 is active until August 2026.

The scheme aims to provide financial protection to all families in the state against catastrophic health expenses.

• **Coverage:** Beneficiaries receive coverage up to ₹5.3 lakh per family per year on a floater basis. This includes the standard ₹5 lakh from PM-JAY, plus a unique ₹30,000 top-up from the state for specific Out-Patient Department (OPD) services, including maternity, childcare, diagnostics, and follow-up care. It covers over 2,400 medical packages, pre-existing conditions, and pre and post-hospitalization expenses.
• **Eligibility:** All residents of Meghalaya are eligible, irrespective of income. The only exclusion is for State and Central Government employees who have their own health schemes. Families must be listed in the Meghalaya Electoral Roll or the SECC database.
• **Enrolment:** Enrolment is free and can be done at designated enrolment centres, District Kiosk Centres, or empanelled hospital registration desks. An Aadhaar card is mandatory for new registrations, along with other identity proofs like a Voter ID or ration card. A smart card or MHIS-PMJAY e-card is issued upon successful biometric authentication.
• **Relationship with PM-JAY:** MHIS is fully converged with PM-JAY. It uses the national scheme's IT framework and incorporates its ₹5 lakh coverage, enhancing it with state-funded benefits.
• **Using the Scheme:** The scheme provides cashless treatment. Beneficiaries must present their MHIS-PMJAY e-card at any empanelled hospital's helpdesk. The network includes all government health facilities in Meghalaya and empanelled private hospitals. Due to PM-JAY convergence, beneficiaries can also access treatment at any PM-JAY empanelled hospital across India.

Manipur: Chief Minister-gi Hakshelgi Tengbang (CMHT)

Launched in 2018, the Chief Minister-gi Hakshelgi Tengbang (CMHT) is Manipur's state health assurance scheme. It runs parallel to PM-JAY and is specifically designed to cover poor and needy families who are not eligible for the central scheme.

• **Coverage:** The scheme offers a dual coverage structure: up to ₹50,000 for primary and secondary care, and up to ₹2 lakh for seven specified critical illnesses like cancer, kidney diseases, and cardiovascular diseases. It also includes a travel allowance of ₹300 per hospital visit.
• **Eligibility:** CMHT targets families identified via SECC data who are not covered by PM-JAY. Eligibility is also extended to AAY cardholders, widows, persons with disabilities, ASHA workers, media persons, and newspaper hawkers.
• **Enrolment:** Enrolment drives are conducted at designated centres like District Hospitals. Applicants need an ID proof and proof of eligibility (like an AAY card or disability certificate). A CMHT Health Card is issued for a fee of ₹50, with exemptions for certain categories.
• **Relationship with PM-JAY:** CMHT is a complementary state scheme that runs parallel to PM-JAY. It fills the coverage gap by targeting beneficiaries not included in the PM-JAY database, though its coverage amount is lower.
• **Using the Scheme:** Beneficiaries can get cashless treatment by presenting their CMHT card at empanelled hospitals within Manipur. For treatment outside the state, a formal referral is required. As of September 2024, the state cabinet has decided to suspend the cashless facility under CMHT in private hospitals, though it continues in government hospitals.

Mizoram: Mizoram Universal Health Care Scheme (MUHCS)

The Mizoram Universal Health Care Scheme (MUHCS) was launched in 2025 and upgraded to MUHCS 2.0 in 2026. It is a comprehensive, universal scheme that merged and replaced all previous state and central health programs, including PM-JAY, into a single, unified system for all residents.

• **Coverage:** The scheme provides health coverage of up to ₹5 lakh per family per year. It covers all inpatient conditions through a package system and includes pre-existing diseases. A travel allowance of ₹1,000 for treatment within the state and ₹10,000 for referrals outside is also provided.
• **Eligibility:** All bona fide residents of Mizoram are eligible. Beneficiaries are categorized: PM-JAY beneficiaries are automatically included without fees; state government employees and pensioners contribute through salary/pension deductions; and the general population can enroll by paying an annual premium.
• **Enrolment:** Enrolment can be done online or at sub-centers. Aadhaar is mandatory. For the general population, the annual premium varies based on the desired hospital ward entitlement (General, Semi-Private, Private).
• **Relationship with PM-JAY:** MUHCS has fully integrated and merged with PM-JAY. PM-JAY eligible beneficiaries are automatically covered under MUHCS and are exempt from paying premiums, effectively using the central scheme as a base to build a universal system.
• **Using the Scheme:** The scheme provides cashless treatment at all government hospitals, empanelled private hospitals, and church-run facilities in Mizoram. A referral from the Medical Referral Board is necessary to avail treatment at empanelled hospitals outside the state.

Nagaland: AB PM-JAY Chief Minister's Health Insurance Scheme (CMHIS)

Launched in October 2022, the Chief Minister's Health Insurance Scheme (CMHIS) is a universal health insurance scheme implemented in convergence with Ayushman Bharat PM-JAY. The combined scheme, known as 'AB PM-JAY CMHIS', aims to provide coverage to all citizens of Nagaland, especially those not eligible under the central PM-JAY scheme.

• **Coverage:** The scheme has two tiers. The CMHIS (General) category provides ₹5 lakh coverage per family per year, similar to PM-JAY. The CMHIS (Employee & Pensioner - EP) category offers a significantly higher coverage of ₹20 lakh per family per year for state government employees and pensioners.
• **Eligibility:** The 'General' category is for all indigenous and permanent residents of Nagaland who are not beneficiaries of PM-JAY. The 'EP' category is for regular state government employees, pensioners, legislators, and their dependents.
• **Enrolment:** Registration can be done online or at offline centers. General category applicants need an Indigenous Inhabitant Certificate or Permanent Resident Certificate. Government employees use their PIMS code for registration. An e-card is issued after verification.
• **Relationship with PM-JAY:** CMHIS is a converged scheme designed to fill the gap left by PM-JAY. Together, they form a unified platform aiming for universal health coverage in the state.
• **Using the Scheme:** Beneficiaries in the General category can access cashless treatment at all PM-JAY empanelled hospitals across India. EP beneficiaries have access to an even wider network, which includes hospitals empanelled under the Central Government Health Scheme (CGHS) nationwide.

Tripura: Chief Minister Jan Arogya Yojana (CM-JAY)

Launched in February 2024, the Chief Minister Jan Arogya Yojana (CM-JAY) is Tripura's initiative to achieve universal health coverage. It is modeled directly on the Ayushman Bharat PM-JAY and runs in parallel to it, covering all families who were not eligible for the central scheme.

• **Coverage:** CM-JAY provides cashless coverage of up to ₹5 lakh per family per year on a floater basis, identical to the benefits under PM-JAY. It covers secondary and tertiary care hospitalization, pre-existing conditions, and post-discharge medicines for up to 15 days.
• **Eligibility:** The scheme is for permanent residents of Tripura who are not covered under AB-PMJAY or any other government-funded health scheme. This includes approximately 4.15 lakh families. State government employees can also join if they surrender their existing medical benefits.
• **Enrolment:** Beneficiaries can complete their KYC verification at government health facilities, Common Service Centers (CSCs), or Ayushman help desks at hospitals. An Aadhaar card is required for verification, after which a CM-JAY Ayushman card is issued.
• **Relationship with PM-JAY:** CM-JAY is a state-funded parallel scheme that is deeply integrated with PM-JAY. It uses the same IT infrastructure, benefit packages, and hospital network, effectively extending the PM-JAY model to the entire population of Tripura.
• **Using the Scheme:** The scheme is entirely cashless. Beneficiaries can use their CM-JAY Ayushman card to receive treatment at any of the thousands of public and private hospitals empanelled under PM-JAY across India.

Arunachal Pradesh: Chief Minister Arogya Arunachal Yojana (CMAAY)

The Chief Minister Arogya Arunachal Yojana (CMAAY), launched in 2018, is a state-funded health insurance scheme that complements the national PM-JAY. It is designed to provide health coverage to residents of Arunachal Pradesh who are not eligible for the central scheme.

• **Coverage:** The scheme provides up to ₹5 lakh coverage per family per year. This is divided into ₹1 lakh for secondary care and ₹4 lakh for tertiary care, and these limits cannot be combined. It covers over 1,300 procedures and includes pre-existing diseases, pre-hospitalization, and post-hospitalization expenses.
• **Eligibility:** The scheme is for residents of Arunachal Pradesh not covered by PM-JAY. This includes members of Arunachal Pradesh Scheduled Tribes (APST), certain non-APST permanent residents, and regular state government employees and pensioners. Central government employees are excluded.
• **Enrolment:** Enrolment can be done online through the CMAAY portal or app, or offline at designated kiosks. An APST Certificate or Resident Certificate and an Aadhaar card are required. A CMAAY e-card is issued after verification.
• **Relationship with PM-JAY:** CMAAY runs parallel to PM-JAY. It was created specifically to cover the state's population that is not eligible under PM-JAY's SECC-based criteria. A resident can be enrolled in only one of the two schemes.
• **Using the Scheme:** Beneficiaries can avail cashless treatment at a network of empanelled government and private hospitals within and outside the state. A referral from a government hospital is mandatory for seeking treatment outside Arunachal Pradesh, with some exceptions.

Sikkim: A Multi-Scheme Healthcare Approach

Sikkim employs a multi-scheme strategy to provide healthcare to its citizens. This includes a dedicated scheme for government employees, a financial assistance fund for the general public, and the implementation of PM-JAY with the goal of expanding it to all residents.

**1. Sikkim Su-Swasthya Yojana (SSSY):** This is an exclusive scheme for permanent, regular employees of the Government of Sikkim and their dependents. It provides a substantial coverage of ₹10 lakh per family per year, with an additional ₹10 lakh for critical care. The scheme offers cashless treatment at a network of high-quality hospitals across India and covers a wide range of procedures, including infertility treatments.

**2. Mukhya Mantri Jeevan Raksha Kosh (MMJRK):** This is a health assistance fund for all residents of Sikkim who are not government employees. Instead of being a pre-enrolled insurance scheme, it provides financial assistance of up to ₹2 lakh for treatment, particularly for patients who need to be referred to hospitals outside the state. For BPL patients, this can be combined with other funds for a total benefit of up to ₹3 lakh.

**3. Relationship with PM-JAY:** The Ayushman Bharat PM-JAY scheme is actively implemented in Sikkim. The state's long-term vision is to achieve universal coverage by expanding the benefits of PM-JAY to all residents under the name SAHI (Sikkim Arogya Health Insurance). In this framework, MMJRK acts as a parallel state-level fund to support patients, especially for referred treatments, complementing the insurance coverage provided by PM-JAY/SAHI.

Frequently Asked Questions

Can I use my state's health card in another state?

It depends on the scheme. If your state's scheme is converged with Ayushman Bharat PM-JAY (like in Meghalaya, Nagaland, and Tripura), you can use your card at any PM-JAY empanelled hospital across India. For other parallel schemes, portability is limited to a specific network of empanelled hospitals, and you may require a formal referral for out-of-state treatment.

Are government employees covered by these health schemes?

This varies by state. Nagaland (CMHIS-EP), Arunachal Pradesh (CMAAY), and Mizoram (MUHCS) include government employees in their schemes, often with enhanced benefits. Sikkim has a separate, dedicated scheme (SSSY) for them. In contrast, Meghalaya excludes government employees, while Tripura allows them to opt-in by surrendering other medical benefits.

What should I do if I lose my health insurance card?

You should immediately contact the scheme's toll-free helpline or visit an enrolment centre or designated kiosk. Since most schemes are linked to your Aadhaar number and use biometric verification, you can typically continue to avail services and get a duplicate card issued after re-verification.

Do these health schemes cover outpatient (OPD) expenses?

Most of these schemes are designed to cover inpatient hospitalization costs and generally do not cover routine OPD consultations or diagnostic tests. A notable exception is Meghalaya's MHIS, which provides a specific state-funded top-up amount for certain OPD services like maternity care, childcare, and preventive diagnostics.

How can I check if I am eligible for my state's health scheme?

The most reliable method is to visit the official website of your state's health scheme or the national PM-JAY portal (pmjay.gov.in). You can also call the scheme's helpline number or visit a nearby Common Service Centre (CSC), empanelled hospital, or designated enrolment kiosk for assistance.

What is the main difference between PM-JAY and my state's scheme?

PM-JAY is a central government scheme that targets specific, economically vulnerable families based on the Socio-Economic Caste Census (SECC) 2011 data. Most state-specific schemes in the Northeast were created to cover the remaining population that was not eligible for PM-JAY, with the goal of achieving universal health coverage for all residents of the state.

Related

• Government hospital OPD guides in Northeast India
• How to find an Ayushman Bharat (PM-JAY) hospital near you
• Government health schemes in India: a guide
• Ayushman Bharat PM-JAY eligibility check

Medical Disclaimer

The information provided in this article is for general informational and educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.