Tamil Nadu Government Extends New Health Insurance: In a significant move to ensure continued healthcare protection for its workforce, the Tamil Nadu government has extended the New Health Insurance Scheme (NHIS), 2021 by another year. Initially set to expire on June 30, 2025, the scheme will now remain in force till June 30, 2026, offering crucial health insurance coverage to lakhs of government employees and their families. The extension, effective from July 1, 2025, maintains the existing partnership with United India Insurance Company Limited, and retains the same terms and conditions.
Under this extension, the health insurance scheme continues to offer a financial assistance cap of ₹5 lakh per family, and an additional ₹5 lakh for specified critical illnesses, thus ensuring comprehensive healthcare support. However, employee associations have raised concerns about clarity regarding whether the additional ₹5 lakh benefit is valid if the initial ₹5 lakh coverage has already been exhausted during the four-year block period. P. Frederic Engels, the State Coordinator of the CPS Abolition Movement, has pointed out ambiguities in the Government Order (G.O.) issued by the Finance (Health Insurance) department.
Further, Engels noted that while the scheme is meant to function on a cashless treatment model, most employees are forced to pay out-of-pocket expenses due to the non-availability of real-time cashless transactions at many hospitals. This has led to questions about the real benefits of the scheme, particularly if the same terms continue without addressing past inefficiencies. Stakeholders are urging the government to clarify the benefits and streamline the implementation to ensure employees can truly benefit from the extended coverage.
Who Can Apply?
The New Health Insurance Scheme (NHIS), 2021, extended until 2026, is applicable to:
- All Tamil Nadu government employees under regular employment
- Employees covered under Contributory Pension Scheme (CPS)
- Family members of insured employees including spouses, dependent children, and dependent parents
It is important to note that contractual workers and part-time employees are not eligible unless otherwise specified.
Also read: Health Insurance in India Must Be Inclusive: Bridging Gaps in Premiums, Claims, and Accessibility
Insurance Fees
The premium for the scheme is shared between the employee and the government:
| Contributor | Contribution |
|---|---|
| Government | 75% of premium |
| Employee | 25% of premium (deducted monthly from salary) |
The current annual premium per family is ₹7,800 approximately, subject to changes in upcoming financial years.
How to Use the Health Insurance Scheme
To avail of benefits under the NHIS:
- Register with the HRMS portal using your employee credentials.
- Download your E-card, which acts as a proof of insurance.
- Choose a network hospital listed under United India Insurance Company’s tie-up for cashless treatment.
- Produce the E-card and Employee ID at the time of admission for cashless service.
- In case of emergency treatments, reimbursement claims can be filed with appropriate documentation.
Benefits of the NHIS 2021 Extension
The extended scheme continues to provide:
- ₹5 lakh base cover per family for hospitalisation and approved treatments
- Additional ₹5 lakh for specified critical illnesses such as cancer, heart surgeries, organ transplants, etc.
- Cashless treatment model in approved network hospitals
- Coverage for pre-existing diseases
- No medical check-up required for enrollment
However, clarity is awaited on whether the additional ₹5 lakh is reset or applicable if already used during the earlier policy term.
How to Apply
Employees already enrolled under the scheme need not re-apply. However, new employees or those yet to enroll can follow these steps:
- Visit https://www.tn.gov.in/
- Navigate to the Health Insurance section under Finance Department
- Download the NHIS application form
- Fill in your personal and employment details
- Submit through your respective DDO (Drawing and Disbursing Officer)
- Upon processing, your E-card will be generated and available for download
Important Dates
| Event | Date |
|---|---|
| Scheme Expiry (Old Term) | June 30, 2025 |
| Scheme Extended From | July 1, 2025 |
| New Expiry Date | June 30, 2026 |
| Enrollment for New Employees | Ongoing |
| Deadline for Clarification on ₹5L Add-On | Awaited by Govt |
Disclaimer
This article is intended for informational purposes only and does not represent the official stance of the Tamil Nadu government. Employees are advised to refer to the official Government Order and contact their department head or DDO for personalized assistance and clarification. Changes in premium, coverage terms, and hospital networks are subject to revision without prior notice.
Tamil Nadu Government Extends New Health Insurance Conclusion
The extension of the NHIS 2021 scheme by the Tamil Nadu government is a welcome move aimed at ensuring continuity of healthcare access for lakhs of government employees and their families. However, ambiguous wording in the extension order has raised questions about the real-world applicability of critical benefits, particularly the additional ₹5 lakh support for serious illnesses. If not properly clarified and implemented, employees may find themselves paying premiums for coverage they can’t fully use.
To maintain trust and transparency, it is crucial that the Finance (Health Insurance) Department urgently releases a detailed FAQ or addendum clarifying eligibility for the additional cover and addressing the current shortcomings in cashless service accessibility. With proper guidance, the scheme has the potential to provide financial security and timely healthcare for the state’s workforce.
The government must also take feedback from employees’ unions seriously to enhance service delivery. Improving the digital experience, streamlining the claim process, and ensuring better hospital onboarding will go a long way in reviving confidence in the scheme.
Ultimately, health insurance is not just a policy—it is a lifeline for thousands of families. Ensuring its effectiveness must be a top priority for the government in the coming year.
Tamil Nadu Government Extends New Health Insurance FAQs
1. What is the New Health Insurance Scheme (NHIS), 2021 for Tamil Nadu Government Employees?
The NHIS is a health insurance plan introduced by the Tamil Nadu government in partnership with United India Insurance Company Limited. It provides ₹5 lakh coverage per family annually, with an additional ₹5 lakh for specific critical illnesses. It operates under a cashless treatment model in approved hospitals across the state.
2. Can employees still avail of the additional ₹5 lakh benefit under the extended term?
As per current reports, the Government Order only mentions continuation under “existing terms and conditions.” This has led to confusion. It is unclear whether employees who have already used the original ₹5 lakh coverage during the 4-year block period are eligible for a fresh ₹5 lakh under the one-year extension. Official clarification is awaited.
3. Is cashless treatment truly available under this scheme?
The scheme is intended to be cashless, but many employees have reported that they had to pay expenses upfront and apply for reimbursement later. This gap exists due to hospitals not following the cashless protocol strictly or delays in approvals. The government is being urged to fix this issue for smoother implementation.
4. How can new government employees enroll in the scheme?
Newly appointed employees can apply by:
- Downloading and filling the NHIS application form
- Submitting it via their department’s Drawing and Disbursing Officer (DDO)
Once processed, an E-card is generated, which can be used for availing cashless treatment.
5. What happens if I change departments or get promoted—will I need to re-enroll?
No, once enrolled, your insurance continues as long as you remain within the TN government system. However, inform your DDO or HR section in case of transfer, promotion, or change of designation so that your insurance details and deductions remain updated.
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