HIMCARE CARD

HIM Card provides health insurance coverage up to Rs. 5,00,000/- per year on a family of a maximum of five members. For the treatment of critical illnesses, an additional benefit of Rs 1,75,000/- is also provided. For cancer, the limit has been increased annually. For more than five members, the additional members have to enroll separately.

Transportation charges are covered under HIM Card Scheme. For every case of hospitalization, the beneficiary is paid Rs. 100/- per hospitalization as the transportation charge (maximum Rs. 1000) during the policy period under the scheme. For hospitalization under critical care, the beneficiary is paid Rs. 1000 per hospitalization as the transportation charge subject to a maximum of Rs. 3000.

Enrolment teams are sent to every village in Himachal Pradesh. Each enrolment team in the villages is accompanied by a Field Key Officer (FKO) who identifies the beneficiaries at the time of enrollment. The job of the officer is to identify the beneficiary and authenticate their card with his own FKO card and fingerprint. Without the field officer’s authentication, the HIM card with the beneficiary will not work. The details of each family which are authenticated by the FKO also get copied into the FKO card and the insurance company/support agency is paid based on the number of beneficiaries obtained from the FKO card.

Pre-hospitalization expenses are such expenses which are incurred by the hospitals before taking a view concerning hospitalization. Any expenditure incurred by the beneficiary on diagnostic tests/medicines which lead to hospitalization is also covered for reimbursement. Proofs like medical bills of these medications/tests will be required before reimbursement. The hospital will also provide medicines and other assistance which are needed for patients till five days after discharge from the hospital. For a critical care patient, medicines will be provided till 60 days from the discharge from the hospital.