AI SummaryMadhya Pradesh government is preparing a new cashless health insurance scheme for state employees, pensioners and their families. The latest proposal promises treatment cover up to ₹20 lakh for employees and up to ₹5 lakh for pensioners.
Scheme is tentatively called CM Ayushman Health Insurance Scheme. Departments also refer to it as CM Care Yojana. A committee of senior secretaries led by the Chief Secretary has already cleared the draft, and it now waits for cabinet approval.
MP CM Ayushman Health Insurance Scheme Details
Health insurance for state staff is not a new idea. It was first approved in 2019 by former Chief Minister Kamal Nath, with a plan to start it from 1 April 2020. The plan went on hold after the government changed. Present government studied the employee health insurance models of states like Haryana and Rajasthan and prepared a fresh draft.
Right now, employees and pensioners pay for treatment first and later claim reimbursement as per CGHS rates. This often leads to partial payment. A liver transplant that costs ₹20 lakh may get only around ₹4 lakh as reimbursement, and the patient has to arrange the rest. New scheme is meant to end this problem with card based cashless treatment at empanelled hospitals.
Who Will Get Benefit
Proposal covers state officers, regular employees, teachers and pensioners along with their dependent family members. Government has also proposed to bring several other working groups into the scheme.
- Contractual and temporary staff, officers of autonomous institutions and employees of boards are proposed to be included in the scheme.
- Anganwadi workers, ASHA and Usha workers, home guards, Panchayat level functionaries and Kotwars are also planned to be covered.
- Families of retired employees are part of the plan, including the spouse of a pensioner.
What Employees and Pensioners Will Get
Draft benefits are higher than the cover available under the existing employee health scheme. Cashless treatment will be available at empanelled government and private hospitals, both inside Madhya Pradesh and outside the state, so that specialised care is not blocked by location.
- Employees and their families get cashless treatment up to ₹20 lakh a year, as per the current proposal.
- Pensioners get cashless treatment cover up to ₹5 lakh.
- Each eligible employee and pensioner will get a photo based digital health card, on the lines of the Ayushman card, to use at network hospitals.
- OPD treatment, medicines and required medical equipment support up to ₹20,000 a year is also part of the proposal.
- If an emergency forces treatment at a hospital that is not empanelled, the bill can be claimed as reimbursement under a set process.
Monthly Contribution From Employees and Pensioners
Scheme runs on a shared contribution model. As per the draft, employees will pay around 1 percent of basic salary every month and pensioners will pay around 4 percent of basic pension every month. State government will bear the remaining premium cost. Earlier reports had pegged the monthly deduction between ₹250 and ₹1,000, depending on salary and pension.
| Detail | Information |
|---|---|
| Scheme Name | CM Ayushman Health Insurance Scheme (also called CM Care Yojana) |
| Launched By | Madhya Pradesh Government |
| People Covered | State officers, employees, teachers, pensioners and their families (over 11 lakh people) |
| Benefit Amount | Up to ₹20 lakh cashless treatment for employees, up to ₹5 lakh for pensioners |
| Employee Contribution | Around 1% of basic salary every month |
| Pensioner Contribution | Around 4% of basic pension every month |
| Application Mode | Through department records and digital health card issued to eligible people |
| Official Website | Not announced yet |
Family Members Covered Under the Scheme
Health cover will not be limited to the employee alone. Husband or wife, parents, two dependent children, adopted children and a divorced daughter are part of the plan. For pensioners, both husband and wife stay covered.
How the Scheme Will Be Run
State Health Agency, which already runs Ayushman Bharat Yojana in the state, has prepared the draft for this scheme. The agency will manage the rollout with experts from health, insurance and legal fields. A special task force is also planned for monitoring and policy decisions.
Timeline and Next Steps
Cabinet approval is the last step before rollout, and the launch date is not confirmed. Once approved, employees and pensioners will have to get their family details updated in department records so that health cards can be issued without delay.
Till the new scheme starts, Mukhyamantri Karamchari Swasthya Bima Yojana continues for state employees, teachers and pensioners. That scheme gives up to ₹5 lakh a year for general treatment, up to ₹10 lakh for serious illness and ₹10,000 OPD support every year. Poor families in the state get separate cover under MP Ayushman Bharat Niramayam Yojana.
For a wider view of state welfare programs, check the Madhya Pradesh government schemes list.
FAQ's
Is CM Ayushman Health Insurance Scheme launched for employees?
Not yet. The draft has cleared the committee of senior secretaries and is waiting for cabinet approval. Launch date is not confirmed.
How much cashless treatment cover will employees get?
As per the current proposal, employees and their families get cover up to ₹20 lakh a year. Pensioners get cover up to ₹5 lakh.
Do employees have to pay anything for this scheme?
Yes. Employees will contribute around 1 percent of basic salary every month and pensioners around 4 percent of basic pension. Government will pay the remaining premium.
What health cover do employees get right now?
Mukhyamantri Karamchari Swasthya Bima Yojana gives each employee family up to ₹5 lakh a year for general treatment, up to ₹10 lakh for serious illness and ₹10,000 OPD support every year.