Tamil Nadu government has rolled out a revamped New Health Insurance Scheme, 2026 for pensioners and family pensioners, with cashless cover going up to ₹7.5 lakh and the programme running for the next five years from 1 July 2026. Enrollment is open and the scheme stays in force till 30 June 2031.
Finance (Health Insurance) Department notified the scheme through a Government Order. United India Insurance Company will run it again after winning the bid, so the public sector insurer keeps its long link with the programme. A monthly amount of ₹644 will be cut from the pension starting July 2026.
New Health Insurance Scheme 2026 for Tamil Nadu Pensioners
This is the pensioner version of Tamil Nadu's New Health Insurance Scheme. It covers retired state government employees, their spouse, and family pensioners. The cover works on a five-year block, not on a yearly reset. So the limit applies across the whole 2026 to 2031 period.
Cashless treatment is available up to ₹7.5 lakh for the block. For certain listed critical illnesses, the cover goes higher, up to ₹12 lakh. The total help under the family floater model is also capped at ₹12 lakh for the block period. In simple words, the whole family unit shares one pool of cover.
Who is covered and what you pay
Enrollment is required for pensioners, including those under the Tamil Nadu Assured Pension Scheme (TAPS) and the Contributory Pension Scheme. The annual premium is fixed at ₹7,728 per beneficiary. From July 2026, ₹644 a month gets recovered from the pension, family pension, or interim payout.
Whatever premium is left after the pensioner's share is paid by the state for government pensioners. For pensioners from local bodies, PSUs, statutory boards, and universities, the respective organization pays the balance. Pensioners under the Special Time Scale, like sanitary workers, Anganwadi workers, noon meal workers, and village assistants, will keep getting cover under the Chief Minister's Comprehensive Health Insurance Scheme instead.
| Detail | Information |
|---|---|
| Scheme Name | New Health Insurance Scheme (NHIS), 2026 for Pensioners |
| Launched By | Tamil Nadu Government, Finance (Health Insurance) Department |
| Beneficiaries | Pensioners (including spouse) and family pensioners |
| Block Period | 1 July 2026 to 30 June 2031 (five years) |
| Cashless Cover | Up to ₹7.5 lakh; up to ₹12 lakh for specified critical illnesses |
| Family Floater Cap | ₹12 lakh for the block period |
| Annual Premium | ₹7,728 per beneficiary (₹644 per month) |
| Insurance Company | United India Insurance Company |
| Administrator | Commissioner of Treasuries and Accounts |
| Official Website | tn-nhis.com / tn.gov.in/karuvoolam |
Treatments and hospitals covered
The scheme covers 2,992 approved treatments and surgeries. Out of these, 46 are specified procedures with the higher cover. You can get treated at 1,535 empanelled private hospitals, along with government hospitals brought into the network.
If you go to a non-network hospital for non-emergency care, you can still claim reimbursement. But it is subject to the fixed ceiling, so it will not match full cashless rates. For planned treatments, sticking to network hospitals is the safer choice.
How the scheme works for pensioners
The process is built around the pension office and the empanelled hospital.
STEP 1 - Enrollment happens automatically for eligible pensioners since it is required, and the ₹644 monthly amount starts getting cut from your pension from July 2026.
STEP 2 - When treatment is needed, go to any empanelled hospital from the network list and inform them you are an NHIS pensioner beneficiary.
STEP 3 - The hospital sends a pre-authorisation request to United India Insurance Company or its Third Party Administrator for approval before the treatment.
STEP 4 - Once approved, you get cashless treatment up to the package rate, within your block cover limit. For non-network non-emergency care, pay first and then claim reimbursement within the ceiling.
Pensioner Enrollment Form
Where to check official details
The full list of approved treatments, empanelled hospitals, and scheme rules is available on the official portals. For the scheme portal and hospital network, the main site is tn-nhis.com.
Pensioners can also check the Nalam Kakkum Stalin Scheme for general health camps in their area.
Pensioner Helpline: 1800-233-5544
FAQ's
What is the cover under NHIS 2026 for pensioners?
Cashless treatment up to ₹7.5 lakh for the five-year block, and up to ₹12 lakh for specified critical illnesses. The family floater cap is ₹12 lakh for the block.
How much premium does a pensioner pay?
The annual premium is ₹7,728 per beneficiary. From July 2026, ₹644 per month is cut from the pension or family pension.
How long will the new scheme run?
It runs for five years, from 1 July 2026 to 30 June 2031.
Is enrollment required or can pensioners skip it?
Enrollment is required for pensioners, including those under TAPS and the Contributory Pension Scheme. It is not optional.
How many hospitals and treatments are covered?
The scheme covers 2,992 approved treatments and surgeries, including 46 specified procedures, at 1,535 empanelled private hospitals plus government hospitals.
Which company is running the scheme?
United India Insurance Company is running it after winning the bid. The Commissioner of Treasuries and Accounts is the administrator.