Chief Minister Arogya Arunachal Yojana Guide

Overview

Chief Minister Arogya Arunachal Yojana (CMAAY) is a state-funded health insurance scheme providing cashless hospitalization coverage of up to ₹5 lakh annually at empaneled hospitals within and outside Arunachal Pradesh.

Key Benefits

Coverage Limit: The scheme offers ₹1 lakh for secondary care and ₹4 lakh for tertiary care. These limits cannot be combined.
Hospitalization Expenses: It covers 3 days of pre-hospitalization and 10 days of post-hospitalization expenses for the illness.
Pre-Existing Diseases: Pre-existing diseases are covered from enrollment.

Eligibility

APST Families: APST members and families are eligible.
Non-APST Residents: Permanent residents of Changlang, Lohit, and Namsai holding a resident certificate are eligible.
Government Employees: State employees, pensioners, dependents, and accredited journalists are eligible.
Exclusions: Central government and public sector undertaking employees are excluded.

Required Documents

Documents: Aadhaar, eligibility proof, and a family tree certificate or ration card.

How to Enroll?

Enrollment: Visit kiosks, the portal, or the Arogya Arunachal app.

A sudden hospitalization can leave a family scrambling to arrange lakhs of rupees at short notice. For eligible families in Arunachal Pradesh, this financial pressure can be reduced through the Chief Minister Arogya Arunachal Yojana (CMAAY).

CMAAY provides cashless hospitalization coverage at empaneled hospitals, helping eligible beneficiaries access treatment without paying approved expenses upfront. However, eligibility rules, coverage limits, and enrollment requirements determine how these benefits can be used.

This guide covers CMAAY’s eligibility, benefits, enrollment, cashless treatment, and whether you still need private health insurance.

What Is the Chief Minister Arogya Arunachal Yojana?

The Chief Minister Arogya Arunachal Yojana (CMAAY) is a flagship health insurance scheme launched by the Department of Health and Family Welfare, Government of Arunachal Pradesh, on August 15, 2018. The scheme aims to improve access to quality cashless healthcare for eligible beneficiaries while reducing out-of-pocket expenses during hospitalization at a network hospital and under the approved package list.

CMAAY covers eligible treatments under secondary and tertiary healthcare packages, helping bridge healthcare gaps and support the state's goal of universal healthcare.

Enrollment under the scheme is also free of cost for all eligible beneficiaries.

The scheme also seeks to strengthen the state's public health system by supporting government hospitals through reimbursement of claims, thereby making healthcare delivery more efficient and self-reliant.

Eligibility Criteria for the Chief Minister Arogya Arunachal Yojana

You can be eligible for the Chief Minister Arogya Arunachal Yojana (CMAAY) if you belong to any of the following categories:

Members of the Arunachal Pradesh Scheduled Tribe (APST).
Regular Arunachal Pradesh state government employees and pensioners, along with their eligible dependent family members.
Permanent non-APST residents of Changlang, Lohit, or Namsai districts holding a valid Resident Certificate (RC) issued by the Government of Arunachal Pradesh.
State-accredited working journalists registered with the Arunachal Pradesh Union of Working Journalists (APUWJ) and the Arunachal Press Club (APC).

The following individuals are not eligible for CMAAY:

Central Government and Public Sector Undertaking (PSU) employees.
Families already covered as beneficiaries under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).

Coverage and Benefits Under the Chief Minister Arogya Arunachal Yojana

Benefit	Coverage
Annual Health Cover	Up to ₹5 lakh per eligible family per year on a family floater basis.
Coverage Breakdown	Includes ₹1 lakh for secondary-care treatments and ₹4 lakh for high-cost tertiary-care treatments.
Pre-Existing Diseases	Covered under the scheme from the date of enrollment, without any waiting period.
Pre- and Post-Hospitalization Expenses	Covers eligible expenses incurred up to 3 days before hospitalization and 10 days after discharge for the same illness or surgery.
Age and Gender	No age or gender restrictions for eligible beneficiaries.
Family Size	No restriction on the number of family members covered.
Hospitalization Expenses	Covers general ward charges, medical and surgical expenses, medicines, diagnostic tests, implants, and other treatment-related costs.

How Does the ₹5 Lakh Family Floater Work?

The ₹5 lakh annual cover is shared among all eligible family members and is restricted to the breakdown of the coverage. For example, if your family's secondary care hospitalization costs ₹1.6 lakh, the scheme pays only up to the ₹1 lakh secondary care limit, and you must pay the remaining ₹60,000, even if the ₹4 lakh tertiary care amount is completely unused.

Conditions and Treatments Not Covered Under CMAAY

Conditions that do not require hospitalization.
Hospitalization primarily for evaluation, investigation, or diagnostic purposes.
Cosmetic, corrective, or aesthetic dental treatments, including fillings and root canals, unless required due to a disease, illness, or injury requiring hospitalization.
Congenital external diseases.
Fertility-related procedures.
Illnesses caused by drug or alcohol consumption.
Transport and ambulance expenses.
Vaccination expenses.
Treatment related to suicide or self-inflicted injuries.
Persistent vegetative state.

How to Register for CMAAY and What Documents Are Required?

CMAAY Enrollment Process

Beneficiaries can enroll for CMAAY through the following methods:

In-Person Enrollment: Visit a CMAAY kiosk at an empaneled hospital or the designated enrollment kiosk in your district.
Online Registration: Apply through the official CMAAY website or the Arogya Arunachal app, available on the Google Play Store and Apple App Store.
Common Service Centers (CSCs): Complete registration at designated CSCs across Arunachal Pradesh.

Steps to Apply Online for CMAAY

Visit the official CMAAY portal.
Scroll to the bottom of the homepage and select Apply Online under the Enrollment section.
Complete the enrollment form, upload the required documents, and submit the application.
After successful enrollment, download the CMAAY e-card.

Documents Required for CMAAY Enrollment

For Arunachal Pradesh Scheduled Tribe (APST) Members:

Tribe certificate issued by the Government of Arunachal Pradesh.
Aadhaar card.
Family details through a family tree certificate or ration card.

For State Government Employees and Pensioners:

Government employee ID card or Pension Payment Order (PPO) for pensioners.
Aadhaar card.
Family details through a family tree certificate or ration card.

For Non-APST Permanent Residents of Changlang, Lohit, and Namsai Districts:

Resident certificate issued by the Government of Arunachal Pradesh.
Aadhaar card.
Family details through a family tree certificate or ration card.

For State-Accredited Working Journalists:

Accreditation certificate issued by the Arunachal Pradesh Union of Working Journalists (APUWJ) or Arunachal Press Club (APC).
Aadhaar card.
Family details through a family tree certificate or ration card.

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Empaneled Hospitals and How to Get Cashless Treatment Under CMAAY

Empaneled Hospital Network

CMAAY treatment is delivered through a network of empaneled hospitals. As per the latest data on the official CMAAY portal, the scheme has 86 empaneled hospitals across 47 cities, and this network is expanded in a phased manner.

Categories of Empaneled Hospitals:

Government hospitals within Arunachal Pradesh.
Government hospitals outside Arunachal Pradesh.
Private hospitals within Arunachal Pradesh.
Private hospitals outside Arunachal Pradesh.

Note: Empaneled hospitals outside Arunachal Pradesh, including government and private hospitals, can treat CMAAY beneficiaries only with a referral from a government hospital in the state through the District CMAAY Referral Board. Referrals to CMC Vellore and other notified hospitals are processed through the Program Management Unit (PMU).

State government employees posted outside Arunachal Pradesh and eligible students studying outside the state can approach these hospitals directly. In genuine emergencies, prior referral is not required, and the hospital's Arogyamitra can obtain emergency pre-authorization from the PMU while the referral request is processed.

Beneficiaries can find the complete list of empaneled hospitals, along with their addresses, on the official CMAAY website under the Hospitals section on the homepage, which is organized by these same four categories.

How to Get Cashless Treatment

You must be enrolled in CMAAY and have an active e-card before receiving cashless treatment.

Visit an Empaneled Hospital: Go to a CMAAY-empaneled hospital. Treatment outside Arunachal Pradesh requires a government-hospital referral, except for emergencies, eligible students studying outside the state, and state government employees posted outside the state.
Complete Verification: Show your CMAAY e-card or Aadhaar card. The hospital’s Arogyamitra will verify your eligibility and register the case.
Get Pre-Authorization: The hospital will submit a pre-authorization request to CMAAY. Treatment can begin after approval, except during emergencies.
Receive Cashless Treatment: CMAAY pays the hospital directly for approved expenses covered under the applicable treatment package and available limit.
Complete Discharge: You do not need to pay for approved expenses. However, you must pay for excluded costs or expenses exceeding the scheme limit.

Note: If you need help, email support@cmaay.com or call 1800 233 5558 or 08956048405. You can also raise a new complaint or track an existing complaint through the CMAAY complaint portal.

CMAAY vs. Private Health Insurance: Do You Still Need Cover?

CMAAY provides meaningful financial protection against hospitalization at no cost to eligible families. However, depending on your healthcare needs, a private health insurance policy can still offer additional benefits.

Additional Financial Protection: CMAAY works within predefined treatment packages and annual coverage limits. If your medical expenses exceed this limit or involve treatments outside the approved packages, a private health insurance policy can help bridge the gap.
Greater Choice and Convenience: A private health insurance policy gives you greater flexibility in choosing hospitals, room categories, and treatment options, subject to the insurer's network and policy terms. This can be particularly useful if your preferred hospital is not empaneled under CMAAY or does not offer the required treatment package.
Coverage Beyond Hospitalization: CMAAY covers a short window before and after hospitalization (up to 3 days prior and 10 days after), but most other healthcare expenses, such as routine doctor consultations, diagnostic tests, and ongoing follow-up care, fall outside its scope. Some private health insurance plans offer these as optional benefits, along with features like restoration of the sum insured, cumulative bonus, and wellness benefits.
Cover Amount vs. Medical Inflation: CMAAY provides a fixed cover of ₹5 lakh per family per year. This amount has not been revised since 2018, even as healthcare costs continue to rise due to medical inflation, reducing the purchasing power of this fixed sum over time.

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Conclusion

The Chief Minister Arogya Arunachal Yojana helps eligible residents of Arunachal Pradesh reduce hospitalization expenses by providing up to ₹5 lakh of coverage per family each year at no cost. While it can substantially reduce out-of-pocket medical expenses, it's important to understand its eligibility rules, treatment packages, and hospital network before relying on it for planned care.

If your healthcare needs extend beyond what the scheme provides, or you want greater flexibility in choosing hospitals and coverage, it's worth comparing some of the best health insurance plans in India to find a policy that fills the gap.

Frequently Asked Questions

Is Chief Minister Arogya Arunachal Yojana enough cover for a family in Arunachal Pradesh?

CMAAY provides up to ₹5 lakh of hospitalization cover per eligible family for a year. However, it works within fixed treatment packages and a limited hospital network, and does not cover routine outpatient care. For families who want more flexibility in hospital choice or protection against costs exceeding the scheme's limits, a private health insurance policy can serve as a useful addition.

Can a non-APST resident of Arunachal Pradesh apply for CMAAY?

Yes, but only if they are permanent residents of Changlang, Lohit, or Namsai districts and hold a valid Resident Certificate issued by the Government of Arunachal Pradesh. Non-APST residents from other districts of the state do not qualify under this category, though they may still be eligible through other routes, such as being a state government employee or an accredited journalist.

Are retired Arunachal Pradesh government pensioners covered under CMAAY?

Yes. State government pensioners, along with their eligible dependent family members, are covered under CMAAY. They can enroll using their Pension Payment Order along with Aadhaar and family details, similar to the process followed by serving government employees.

Can I use CMAAY at a hospital outside Arunachal Pradesh?

Yes, but generally only with a referral from an empaneled hospital within the state, through the District CMAAY Referral Board. This referral requirement does not apply to state government employees posted outside Arunachal Pradesh or eligible students studying outside the state, who can approach empaneled hospitals directly for treatment.

Can I be enrolled in both CMAAY and Ayushman Bharat PM-JAY?

No. Families already covered as beneficiaries under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana are not eligible for CMAAY, since the two schemes are meant to complement rather than duplicate each other. Beneficiaries must avail benefits under whichever scheme they are entitled to, not both.

How do I check my CMAAY application status?

You can check your enrollment or application status on the official CMAAY website by selecting your district and entering your Unique Registration Number or Aadhaar number in the status check section. This lets you confirm whether your enrollment has been verified and your e-card is ready.

Does CMAAY cover pre-hospitalization and post-hospitalization expenses?

Yes. CMAAY covers eligible expenses incurred up to 3 days before hospitalization and up to 10 days after discharge, for the same illness or surgery. This includes related consultations, diagnostic tests, and discharge medicines, provided they fall within the approved treatment package for that hospitalization.

Can I claim reimbursement under CMAAY if I pay for treatment myself?

No. CMAAY operates on a cashless basis. If you receive treatment at a non-empaneled hospital or undergo treatment without the required pre-authorization or referral, you cannot claim reimbursement later. In such cases, the treatment cost must be borne by the beneficiary.

Do I need to enroll again if I already had a CMUHIS SMART card?

Yes. All eligible beneficiaries must enroll under CMAAY, even if they previously held a Chief Minister’s Universal Health Insurance Scheme (CMUHIS) SMART card. Cards issued under the earlier CMUHIS scheme are no longer valid after the introduction of CMAAY.

Last updated on: 7 Aug, 2026