Frequently Asked Questions

1. What is MHIS?
MHIS has been introduced as a health insurance scheme by the Government of Meghalaya, following the
framework of RSBY; and now working in convergence with AB-PMJAY (Ayuhsman Bharat Pradhan Mantri Jan
Arogya Yojana). It is called Megha Health Insurance Scheme (AB-PMJAY + Universal Health Insurance
Scheme).

2. What is AB-PMJAY?
AB-PMJAY is the initiative of the Government of India to ensure that poor and vulnerable sections of society
are provided health care. It is called the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana. This
initiative is part of the Government’s vision to ensure that its citizens – especially the poor and vulnerable
groups have universal access to good quality hospital services without anyone having to face financial
hardship as a consequence of using health services.

3. Who are entitled to the scheme?

All the citizens of the state of Meghalaya (BPL and APL Category) are entitled, excluding State and Central
Government employees who are entitles to the State/Central re-imbursement policy.

4. How many members per family are entitled for the scheme?
There is no restriction on family size under the scheme

5. How much does the MHIS beneficiary have to pay to avail the scheme?
MHIS beneficiary will have to pay only Rs. 30 for every individual card at the time of registration.

6. Who pays the premium to the insurance company?

The premium will be paid by the Government and not the beneficiary.

7. What is the source for the data of beneficiary list?

The data has been compiled by using the SECC data (2011) and the Electoral list of 2016.

8. What is the insurance cover for the scheme?

The Scheme provides insurance cover of up to Rs 5,00,000 per family on a floater basis.

9. What is meant by floater basis?

Floater basis means that the total amount can be used by one person or jointly with other members of the
family.

10. What is the Registration Process under AB-PMJAY and MHIS?

A beneficiary can walk into any PMJAY/MHIS Registration Centre or Kiosk to register themselves under the
scheme. They must provide a valid government issued Photo Identity Card for personal registration. To add
members under the family, the beneficiary must provide supporting documents as proof of relation between
members of the family such as Marriage Certificate, Birth Certificate, Ration Card or Declaration from
headman listing all members of the family.
Upon completion of registration, the beneficiary will be handed an individual PMJAY/MHIS card for a fee of
Rs 30 per beneficiary.

11. What are the documents required in order to register with MHIS?
Any one of the documents in each section are required during the Registration Drive:

Personal Details Family Details Add Member (If Required)

1. Voter Id 1. Ration Card 1. Adoption Certificate

2. Aadhaar Card 2. RSBY/MHIS Card for 2. Birth Certificate
3. Birth Certificate RSBY/MHIS category 3. Marriage Certificate
 4. MGNREGA Job Card
5. Ration Card
6. Other Government
ID/Certificate with Photo
3. PM’s Letter for SECC 4. Ration Card
Beneficiary Category (once 5. Headman’s declaration
received)
4. Other Government
Documents which lists all
members of Family
5. Headman’s declaration

12. What must a beneficiary do if their name is not included in the data?
All efforts were made to include all eligible beneficiaries in the data. If any one of the family members are in
the database, they can add themselves under the identified member of family by providing necessary proof
of relationship. However, if none of the family members are included in the data, they are requested to
contact the MHIS Helpdesk or Tollfree number. Alternatively, they can walk into to the state and district
offices of MHIS along with the Photocopy of their Epic card and the Old MHIS/RSBY card if available.

13. What are package rates?

Packages Rates are pre-approved rates that are available for specified surgical and medical procedures. The
same can be view at www.mhis.org.in

14. What about procedures not specified in the package rates?

For unspecified procedures, the concerned hospitals will need to seek approval from the insurance
company.

15. What is excluded under the scheme?

There are certain common exclusions under the scheme, which are as follows -
a. Conditions that do not require hospitalization
b. Congenital external diseases
c. Drug and Alcohol Induced illness
d. Sterilization and Fertility related procedures
e. Vaccination
f. War, Nuclear invasion
g. Suicide
h. Naturopathy, Unani, Siddha, Ayurveda

16. Which hospitals are empanelled under the scheme?

All public hospitals and health centres of the state are empanelled under MHIS. The list of hospital is
available in the website.

17. Is the scheme entitled only for admission to General Ward?

Under MHIS, the beneficiary can be admitted to General Ward, Private Ward or ICU. In case of
hospitalization in Private Ward, patients will have to pay the excess amount out of their own pockets.

18. What is the toll-free number for MHIS?

1800-102-4762

19. What is the MHIS helpdesk number?

0364-250 7477

20. Is there any age limit under MHIS?

There is no age limit under MHIS. Anybody can enrol under the scheme.

21. Mention the Grievance Redressal method in MHIS?

 Grievances can be lodged through the Tollfree No, MHIS Helpdesk, Letters, MHIS website, PMJAY Website,
walk ins and the Grievance Redressal Committees.

22. Does MHIS cover for OPD care?

Certain packages – ANC/OPD Diagnostic such as MRI Scan and CT scan, Child health care, Diabetes and
Cardiac Care are covered under the scheme (subject to applicable caps and coverage limits).

23. Who is the Insurance Company for MHIS – Phase IV?

Reliance General Insurance Company LTD

24. What is a MHIS/PMJAY card?

After registration a paper ID card will be issued to all beneficiaries. The card will include the individual’s
details such as photo, name, age, gender, address, bar code and the unique PMJAY/MHIS ID number.

25. What happens if the beneficiary loses the card?

Beneficiaries will have to visit any of the identified District Kiosks to get a new card printed. Alternatively in
case of hospitalization, hospital authorities will ask for the personal mobile number submitted at the time of
registration so he/she can avail the benefits in any empanelled facility.

26. Is there any provision to take care of new-born?

A new-born is covered under MHIS since birth automatically for the remaining period of the health insurance
policy.

27. How is the balance amount ascertained in the smart card?

Beneficiaries will receive a SMS on their registered mobile number post the time of hospitalization stating
the amount deducted from the card and the balance.

28. Does the beneficiary need to take any document to hospital other than the PMJAY/MHIS card?
The beneficiary needs to take the PMJAY/MHIS card issued to them after registration along with any other
Govt issued Identity Card.

29. How does a beneficiary use the MHIS card in empanelled hospitals?
The PMJAY/MHIS card needs to be handed over to the Arogya Mitra (MHIS Operator) in the MHIS counter
present at the hospital on the day of admission.

30. How much is the transportation allowance and economic compensation under MHIS-IV?
There is no transportation allowance and economic compensation under MHIS-IV.