The Meghalaya Health Insurance Scheme (MHIS) is a government-backed healthcare program aimed at providing financial protection to eligible families across Meghalaya. By offering cashless hospitalization and a wide network of empanelled hospitals, the Meghalaya Health Insurance Scheme ensures that residents can access quality medical treatment without facing heavy out-of-pocket expenses.
History and Evolution of MHIS
The Meghalaya Health Insurance Scheme was launched in 2012 to provide health insurance coverage to residents of Meghalaya. Initially, the scheme offered a coverage limit of ₹1.6 lakh per family, and over the years, it has expanded to provide up to ₹5.30 lakh per family on a floater basis. The scheme is now integrated with the Pradhan Mantri Jan Arogya Yojana (PMJAY), which allows beneficiaries to access treatment at empanelled hospitals across India. This evolution has strengthened health security and reduced financial burden for families throughout the state.
Eligibility Criteria for MHIS
Eligible beneficiaries of the Meghalaya Health Insurance Scheme must meet the following conditions:
- Permanent residents of Meghalaya
- Listed under government-approved databases or notified categories
- Possess valid identification such as Aadhaar, ration card, or other government ID
Exclusion: State and Central Government employees are generally not eligible, as they are covered under separate government employee health schemes or reimbursement policies (Official MHIS source).
Enrollment & Beneficiary Cards
Eligible residents are issued a MHIS or PMJAY beneficiary card after registration at:
- District Kiosk Centres
- State Kiosk Centres
- Empanelled hospital registration desks
Card Details & Use:
- Contains beneficiary name, age, gender, unique ID, and barcode
- Required for verification at empanelled hospitals
- Facilitates cashless treatment for covered medical procedures
- Can be reprinted if lost
- Digital verification is supported through the PMJAY platform if the physical card is unavailable
Step-by-Step: How to Use Your MHIS Card
- Present the card at the reception of an empanelled hospital
- Verify your identity with a government-issued ID
- Hospital staff checks entitlement in the Meghalaya Health Insurance Scheme system
- Cashless treatment is provided for eligible procedures
- After discharge, claim confirmation is completed electronically
Coverage and Benefits
The state’s health protection program provides comprehensive healthcare coverage, including:
Hospitalization Benefits
- Inpatient treatment expenses
- Room charges, nursing services, ICU, and operation theatre costs
Medical Procedures & Emergency Care
- Surgeries and approved day-care procedures
- Emergency treatments
- Newborn care and maternity services (as notified)
Diagnostic Tests
- Tests related to hospitalization such as X-rays, scans, and pathology
Coverage Limit
- Up to ₹5.30 lakh per family on a floater basis
- Coverage applies from day one, including pre-existing conditions
- Newborns are automatically included from birth
Empanelled Hospitals & Portability
Beneficiaries can access cashless treatment under the Meghalaya Health Insurance Scheme at:
- Government hospitals across Meghalaya
- Selected private hospitals in the state
- Hospitals across India under PMJAY network for specialized care
This ensures portability and access to treatment nationwide where empanelled facilities exist.
Claim Process
- Visit an empanelled hospital
- Present the MHIS/PMJAY card and a valid government ID
- Hospital verifies details in the Meghalaya Health Insurance Scheme system
- Cashless treatment is provided for eligible procedures
This hospital-driven process minimizes paperwork and ensures quick access to care.
Exclusions
- Outpatient treatment not requiring hospitalization
- Cosmetic or non-essential procedures
- Vaccinations or routine immunizations not part of inpatient packages
Tips for Beneficiaries
- Keep a photocopy of your MHIS/PMJAY card
- Carry a valid government ID along with the card
- Check the list of empanelled hospitals before admission
- In case of lost card, request reprinting at a kiosk centre
- Use toll-free number 1800-102-4762 for assistance
Why MHIS is Important
The Meghalaya Health Insurance Scheme helps families avoid financial hardship during medical emergencies, encourages timely treatment, and improves overall health outcomes. With a combination of beneficiary cards, cashless treatment, wide hospital networks, and nationwide portability, MHIS is a cornerstone of healthcare security in Meghalaya.
The Meghalaya Health Insurance Scheme is an essential and evergreen healthcare support system for residents of Meghalaya. Beneficiaries use MHIS/PMJAY cards for cashless treatment at empanelled hospitals, ensuring financial protection, access to quality healthcare, and nationwide portability. Staying informed about eligibility, registration, and card usage enables residents to fully utilize this vital government initiative.
For more information and updates, you can also check our internal guide: Meghalaya Health Insurance 2026
The Meghalaya Health Insurance Scheme is one of the key initiatives under the state’s welfare framework — learn more about it and other important Meghalaya government schemes here.
