Support for Marginalized Individuals for Livelihood and Enterprise (SMILE): Composite Medical Health for Transgender Persons

Support for Marginalized Individuals for Livelihood and Enterprise (SMILE): Composite Medical Health for Transgender Persons is a central scheme run by the Ministry of Social Justice and Empowerment. It gives complete health cover to transgender people across India through the Ayushman Bharat TG Plus program. Every eligible person gets insurance cover of up to ₹5,00,000 per year, which takes care of medical treatment, hormone therapy and sex reassignment surgery in a fully cashless way.

The scheme is part of the bigger SMILE umbrella scheme and started on 12th February 2022. The government has kept it running and released revised scheme rules that are valid till 31st March 2028. Transgender persons who hold a valid certificate from the National Portal for Transgender Persons can use this cover at all empanelled government and private hospitals in India.

SMILE Composite Medical Health for Transgender Persons

This scheme bridges a big gap in healthcare by offering insurance through the well-known Ayushman Bharat network. It covers gender reaffirmation surgery, hormone therapy and the post-operative care that comes with it. Whether a person needs routine care or specialised transition-related treatment, the cover is designed to meet the medical needs with dignity and financial support.

The Government of India pays 100% of the approved medical expenses. There is no need to pay anything from pocket at the hospital, because the billing is handled directly between the empanelled facility and the National Health Authority. This makes quality care easy to access for transgender people who earlier had trouble getting proper treatment.

Key Information

Benefits

The scheme gives transgender people solid medical support through the points given below:

• Health insurance cover of up to ₹5,00,000 per year under the Ayushman Bharat TG Plus program, which is one of the main health cover schemes in the country.
• The package covers the full needs of gender transition, including hormone therapy, gender reaffirmation surgery and the follow-up care after surgery.
• All approved medical treatments are given on a cashless basis, so the person does not face any money problem at the time of treatment.
• The Government of India pays 100% of the approved medical expenses, so the beneficiary does not have to spend anything from own pocket.
• Benefits can be used at all empanelled government and private healthcare facilities spread across India.

Eligibility

To get benefit from this scheme, a person only needs to meet these simple conditions:

• The applicant should belong to the transgender community of India.
• The applicant should hold a valid Transgender Certificate issued through the National Portal for Transgender Persons.
• The applicant should not already be getting similar health or money benefits from any other central or state government insurance scheme.

Application Process

Getting the health benefit is simple. Follow these steps:

STEP 1 - First get the official Transgender Certificate and Identity Card through the National Portal for Transgender Persons. This certificate is the main document required for joining the scheme. A detailed guide on how to apply for the certificate is available on the Transgender ID Card Application Form page.

STEP 2 - After getting the certificate, visit an empanelled hospital or a Common Service Centre (CSC). These centres work through the existing Ayushman Bharat network to deliver the service.

STEP 3 - Show the Registration ID or the serial number from the Transgender Certificate to the help desk staff. They check the details in real-time through the official Beneficiary Identification System.

STEP 4 - Once the check is done, the person is issued an Ayushman Transgender Health Card. This card lets the beneficiary get medical services easily at any empanelled facility in the future.

Need Support?
For general queries, contact the support team at 011-20893988 or write to mahimanisd@gmail.com. For technical issues, call +91 79 23268279 or email tghelp@mail.inflibnet.ac.in. The help desk is open from 10:00 AM to 5:00 PM, Monday to Friday.

Documents

Keep the following documents ready to complete the process without any delay:

• Transgender Certificate And Identity Card: This is a required document issued by the National Portal for Transgender Persons.
• Registration or Certificate Serial Number: This number is needed so the staff can check the eligibility of the person on the system.

References

The official SMILE scheme guidelines published by the Ministry of Social Justice and Empowerment and the Composite Medical Health page on the official portal are helpful for more details on the scheme.

FAQ's

What official document do I get after verification?

After the check is done, the person is issued the specific Ayushman Transgender Health card to get the benefits.

Can I get this benefit if I already get other government benefits?

No. To keep it fair, the scheme is for people who are not already getting similar health or money cover from another government scheme.

Is the treatment at the hospital cashless?

Yes, the treatment is fully cashless. The hospital handles the billing directly with the National Health Authority on behalf of the beneficiary.

Are gender transition surgeries covered?

Yes. The Ayushman Bharat TG Plus package is made to cover gender reaffirmation surgery along with hormone therapy.

What if I do not have a Transgender Certificate yet?

Visit the National Portal for Transgender Persons to apply for one, as it is a required document for getting the scheme benefit.

What is the yearly coverage limit?

The beneficiary gets insurance cover of up to ₹5,00,000 per year under this scheme.

Does the government pay for everything?

Yes. The Government of India provides 100% funding for all approved medical expenses under the scheme.

Are regular check-ups and post-operation care included?

Yes, the package is complete and covers all needed parts of transition-related healthcare, including post-operation follow-up and consultations.

Where can I use this insurance?

The cover can be used at any empanelled private or government healthcare facility anywhere in India.

Is the certificate required for joining?

Yes, the Transgender Certificate from the National Portal is the main document required to join this health insurance scheme.