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Overview of Himachal Health Care Scheme

The Himachal Health Care Scheme or Himcare Scheme is a special medical insurance scheme introduced by the Himachal Pradesh government to ensure that most poor and needy people, who do not attain necessary medical treatment, can access quality medical facilities and timely cashless treatment of illness and diseases. 

Features of Himachal Health Care Scheme

  • Under Ayushman Bharat, families have been selected by the Government of India on the basis of SECC, 2011 and RSBY

  • It provides cashless treatment to the people of Himachal Pradesh who are needy and poor on a co-payment basis

  • It was implemented on 1st January 2019 by the Government of Himachal Pradesh.

Benefits of Himachal Health Care Scheme

  • Cashless treatment coverage of Rs. 5.00 lakh per year per family is provided under the scheme on a family floater basis subject to a maximum of five members per family unit.

  • In case family size exceeds five members, the remaining members can be enrolled as a separate unit subject to the capping of five members for each such additional unit.

  • Under the Himcare yojna, treatment will be provided on the basis of pre-defined package rates in the empanelled hospitals.

Who is Eligible for Himachal Health Care Scheme?

The following category of people are eligible for the Himcare health scheme.

  • BPL Category people

  • Registered Street Vendors

  • Ekal Naaris

  • More than 40% of disabled

  • Senior Citizens above the age of 70 years

  • Anganwari Workers/Helpers

  • ASHA workers

  • Mid-Day meal workers

  • Contractual Employees

  • Daily Wage Worker

  • Part-time Workers

  • Beneficiaries under HP Universal Health Protection Scheme

  • Beneficiaries not included in the above categories/non–government servants and their dependents 

Documents Required

The main documents required to avail of the Himcare scheme are an Aadhaar card, Ration Card, and Proof of Category as listed below:

 

  • For BPL Category - Copy of BPL certificate attested by the Panchayat Secretary in the last one month.

  • For Registered Street Vendors - Registration Certificate attested by the Executive Officer, MC/NP/NAC in the last one month.

  • For Ekal Naaris - Certificate to be issued by Child Development Program Officer (CDPO) of the concerned area and shall include Widows/Divorced/Legally Separated /Unmarried more than 40 years.

  • For More than 40% of disabled persons - Medical Disability Certificate showing permanent disability.

  • For Senior citizens aged 70 years and above - valid proof of age.

  • For Anganwari Workers and Helpers - Certificate from Child Development Program Officer (CDPO) of the concerned area.

  • For ASHA Workers - Certificate from Block Medical Officer (BMO) of the concerned area.

  • For Mid–Day Meal Workers -Certificate from Block Elementary Education Officer of the concerned area.

  • For Contractual Employees, Daily Wage Worker, Part Time Workers - Certification from the concerned Department. 

How to Apply for Himachal Health Care Scheme

To apply for the Himcare scheme online, applicants can go to the website and follow these quick and simple steps:

 

  1. Head to the official website of the Himcare scheme

  2. Click on ‘online Himcare enrolment’

  3. Next, you have to upload the proof of category mentioned above and upload the front and back sides of your ration card.

  4. Next, enter the dependent details.

  5. Enter the captcha and submit it.

  6. You will get a Unique Reference Number (URN) to track the status of the scheme.

  7. Once you receive the URN, the Applicant can make an online payment to complete the Himcare online registration

How to check the enrolment status

Once you have registered on the Himcare website, you can go back and check the enrolment status by following these steps:

  1. Head to the Himcare scheme website

  2. Click on ‘Himcare Enrollment’ and proceed to choose the option ‘Himcare Enrollment Status’

  3. Finally, enter your unique reference number (URN) or your ration card number to track the status of your enrollment. 

Himcare Health Card

  • Once the enrolment process is completed and verified by the back-end team, the applicant or the beneficiary will receive an SMS after which he/she will be able to download/generate the Himcare card under the scheme.

  • To download the Himcare health card, visit the website, click on ‘himcare enrolment’, and then choose the button ‘Get my Himcare health card’.

  • At this stage, you will need to enter the Unique Reference Number or the ration card number or the Aadhaar card number to download it.

  • There is also another way to generate and obtain the Himcare health card at the hospital level. 

Premium Details for Himachal Health Care Scheme

Based on the categories mentioned below, the premium amount will be collected from the applicant at the time of enrolment under the Himcare health scheme.

 

  • BPL Category people - 0

  • Registered Street Vendors - 0

  • Ekal Naaris - Rs 350 per year

  • More than 40% disabled - Rs 350 per year

  • Sr. Citizens above 70 years of age - Rs 350 per year

  • Anganwari Workers/Helpers - Rs 350 per year

  • ASHA workers - Rs 350 per year

  • Mid-Day meal workers - Rs 350 per year

  • Contractual Employees - Rs 350 per year

  • Daily Wage Worker - Rs 350 per year

  • Part-time Workers - Rs 350 per year

  • Beneficiaries under HP Universal Health Protection Scheme - Rs 1000 per year

  • Beneficiaries not included in the above categories/non–government servants and their dependents - Rs 1000 per year 

Fees to Pay while Enrolment

The Common Services Center (CSC)/ Lok Mitra Kendra (LMK) in Himachal Pradesh will collect Rs. 50/- per family from the beneficiaries for enrollment and uploading the documents under the scheme. After the approval message is received, the beneficiary can get his/her card printed from the concerned CSC/LMK within the user fee paid initially. 

How to Renew your Himachal Health Care Scheme?

The renewal process shall be initiated only for three months in a year to avoid any issues of adverse selection. Hence, from the months of January to March you can enrol for or renew your Himcare health card. The policy period for individual beneficiary households shall commence from the date of approval of enrollment/renewal till the expiry of twelve months.

 

15 days before the expiry of the policy period, the beneficiary will be informed through SMS on their registered mobile number along with the policy renewal link for easy renewal of the policy.

 

On receiving the link, follow these simple steps to renew your Himcare health card:

  • Head to the official website of the Himcare scheme

  • Navigate to the homepage and click on ‘Himcare enrolment’ and select ‘renewal of card’

  • Finally enter your Unique Reference Number (URN) or Himcare number to renew it 

Hospital List

To check the entire list of empanelled hospitals, follow these steps:

  1. Visit the Himcare scheme official website

  2. Click on ‘Search Hospital’

  3. Under that, enter District and Speciality to see the list of hospitals empanelled under the Himcare scheme.

  4. Now you can view all the hospitals under the Himcare health yojana near you

Conclusion

This sums up the key details of the Himcare scheme. If you know someone who is eligible for this initiative, do encourage them to enroll so they can take advantage of the benefits of health insurance and help themselves and their family members. 

FAQs on Himachal Health Care Scheme

  • ✔️When was the Himcare scheme launched?

    The Government of Himachal Pradesh launched the Himcare scheme on January 1st, 2019.

  • ✔️What if there is no network hospital in my vicinity?

    If there is no network hospital in your vicinity, don’t worry, get treatments at the hospital near you and pay all the medical bills at the time of discharge. And your insurer, later on, will reimburse the medical expenses incurred after making claim under the policy.

  • ✔️Does Himcare scheme provide cashless treatment?

    Yes, with the Himcare health card, you can avail of cashless treatment across a network of hospitals in the state of Himachal Pradesh

  • ✔️What are the required documents for the Himcare Health card?

    The main documents required to avail of the Himcare scheme are an Aadhaar card, Ration Card, and Proof of Category

  • ✔️Where can I view the Himcare scheme list of hospitals?

    You can view any of them by accessing the official website of the Himcare scheme and searching by the name of your district and speciality.