Check How to Apply for Online HimCare Health Card Insurance – Himachal Pradesh

What is Him care Health Scheme?

Him Care Swasthya Bima Yojana & its Benefits

A new scheme has been launched by the Governor of Himachal Pradesh (HP) which will provide free cashless treatment to the people of Himachal Pradesh. This scheme is called as ‘The Himachal Health Care Scheme’ or HIM CARE, in short.

This scheme was commenced last year in December. This scheme is sure to benefit the residents of HP as it provides a beneficiary treatment program. Pradhan Mantri Arogya Mitra (PMAM) will work in coordination with HIMCARE Yojana and it’ll be designated as HIM CARE Sathi.

This is because HIMCARE shall have some similarities with the Ayushman Bharat Yojana because the same hospitals shall be responsible for the implementation of both Ayushman Bharat Yojana and HIM CARE.

Him care Yojana in Hindi : यहां क्लिक करे

Benefits of Him care Card Insurance

• A family floater basis treatment coverage package of Rs. 5 lakhs/year for every single family. A maximum of five members from every family can avail of this cashless treatment package.
• A family has more than five members who can enroll their remaining members in a separate unit with a maximum of five members for every additional unit.
• Inpatient or daycare treatment will be provided in all the enrolled hospitals on the basis of a pre-defined rate list of the particular hospitals.

How to Make Himcare Health Card

Various premium Amounts under the Him Care Scheme for all categories are mentioned below:

Documents Required for Him care Card Enrollment

There are three categories under which beneficiaries are listed who will have to pay the corresponding Premium Amount and attach the concerned documents as proof. The table given represents this:

How to do Online Registration for Him care Health Scheme?

• Using ecards, the HIM CARE scheme will be implemented. HP residents can enroll themselves by registering on the website www.hpsbys.in.
• This web interface will capture the Ration Card, Aadhar Card, Mobile Number, and proof of category.
• Beneficiaries can either apply directly via the online system or through the Lok Mitra Kendra (LMK)/Common Service Centres (CSC). Residents can pay for premium via online payment gateway.
• Beneficiaries will receive an SMS after their enrolment is approved from the back – end and he/she can then download their E-Card issued under HIM CARE.
• E-Cards downloading link will be available on the beneficiaries’ registered mobile number(s). these E-Cards can also be generated at the hospital level.
• Rs. 50 will have to be paid by every family for enrolment and uploading of the documents. The LMKs or CSCs will be collecting this fee from every enrolled family.
• Printing of the E-Card will be inclusive of this fee of Rs. 50. Beneficiaries can receive this printed card from the concerned CSC/LMK after receiving their enrollment approval message.

Important Note: HIMCARE Yojana shall include Mukhya Mantri State Health Care Scheme (MMSHCS) and Himachal Pradesh Universal Health Protection Scheme (HPUHPS). All the existing beneficiaries under these two schemes shall get all their data available on the new system with the same unique ID.

Before you fill the Himcare scheme Enrollment form, read out the following instructions carefully.

• Visit this link to Enroll under HimCare Scheme: Click Here
• You need to enter the Ration Card number without HP. Do cross-check that the Ration card number is the same as the scanned document which you upload.
• For example, if your Ration card number is HP4501424682, then you just have to enter this 4501424682 in the Registration box shown in the above link.
• Both front and backside of the Ration card need to be uploaded.
• The document which you upload should be clear and the scanned copy of the original Ration Card.
• Your application will be rejected in case there is any mismatch in the ration card number and it will not be possible to resubmit the application again.
• It will not be possible for you to submit the Application form under the HimCare scheme if your Ration card is already enrolled under Pradhan Mantri Jan Arogya Yojna i.e PMJAY.
• You have to register separately for each member in case there are more than five members in your Ration Card.
• You will register the first card by entering the Ration Card number (Without HP).
• And for each of the next cards, you have to enter an extra 0 after the Ration Card number.
• For example, the second card you will enter 45014246820, for the 3rd card will enter 450142468200 and so on.
• Your application will be rejected immediately if there is any mismatch in the Aadhaar Card number.
• Take care of the thing that, you should upload only the scanned copy of original documents, otherwise there are huge chances of getting your application rejected.
• It will not be possible for you to edit the Application after you confirm the Application. form.
• The Premium payment must be paid within 30 days, once you become eligible for the Premium Amount.
• A message will arrive at your registered mobile number when your application will be processed. Please follow all the steps carefully because your application will be rejected if you provide any wrong information.

How to check Him care Card Enrollment Status?

• Head to the official website Himachal Pradesh Swasthya Bima Yojana Society (HPSBYS).
• Click on the ‘HIM CARE Enrollment’ tab, a drop-down menu will appear.
• Click on ‘HIMCARE Enrollment Status’ from the drop-down that appears.
• A page asking your ‘Reference No/Ration Card Number’ will appear.
• Fill that in and press enter. Your enrollment status will be showcased.

How to Apply Online for Him Care Health Card Insurance

To apply online for Him care card click here

Download Himcare Health Card click here

How to Migrate Old Card to HIM CARE?

• Go to the home page of HPSBYS website.
• Click on the ‘HIMCARE Enrollment’ tab, a drop-down menu will appear.
• Click on the ‘Migrate Old Card To HIMCARE’ link.
• A page asking for your URN Number will appear, fill it up, and follow the instructions that appear next.

How to get HIM CARE Card?

To get your Himcare Card, follow the below steps: 1) visit the official site of Himcare: hpsbys.in 2) In the top menu you will see ‘HIMCARE ENROLLMENT’ 3) In the drop-down, select ‘Get My HIMCARE Card‘ 4) A window will appear as shown below:

5) Here you have to Enter your URN or Aadhhar no. or Ration card Number 6) After adding any of the above, click Search. 7) After Clicking the search, a list will appear. Here you can download you, Himcare Card,

How to add Family Member in Him care Card

Adding a family member to HIMCARE Card is very simple.

• Visit Himcare Enrollment
• Click Add Family Member – Himcare
• Enter URN
• Click Search

How to Renew HIM CARE Health Card?

The concerned beneficiary shall be informed via SMS on their registered mobile number about their policy renewal date. They will also get a policy renewal link for renewing their respective policy 15 days prior to it getting expired.

Follow the steps given below to know how to renew your HIM CARE Card:

• At the HPSBYS website, head straight to the ‘HIMCARE Enrollment’ tab.
• Click on the ‘Renewal of Card’ link.
• Enter your URN/Himcare Number and follow the instructions that’ll appear.

Important Note: HIMCARE Enrollment or Renewal shall be available only from January to March i.e. for 3 months every year. Policy period for every individual beneficiary shall start from the date the enrollment/renewal is approved until the next 12 months.

Is Him Care Card Valid in PGI?

Him care card is acceptable for treatment in PGI. The Card is completely valid in PGI and under the Him care scheme, patients will get the free treatment. Initially, the patient will have to pay the cost of registrations and treatment on their own.

But after this, the cost of their treatment will be reimbursed. There is a Goal market in PGI, where you have to visit both 24 of Rashtriya Swasthya Bima Yojana office. Here you will find full information about how to get reimbursement of the treatment.

What is RSBY, MMSHCS, HPUHPS?

RSBY stands for Rashtriya Swasthya Bima Yojna which is a health insurance scheme run by Himachal Pradesh Govt, for the BPL(Below Poverty Line) families of the state. The Himachal Pradesh Govt has listed the families and people who will be able to get the benefit of this health Insurance scheme and these are Rickshaw workers, Mine Workers, Auto & Taxi drivers, street Hawkers, domestic workers, etc.

What is the insurance coverage under these schemes?

A health insurance coverage of up to Rs. 30,000 will be provided to the families who are eligible for this insurance. The coverage will be provided per year. Additional coverage for 175000 will be given to the families for critical illnesses and serious diseases like Cancer, coverage of up to 2,25000 per year will be given.

What is not covered under these schemes?

One of the most important things to note about the Him Care scheme is that the expenses of OPD are not included in this scheme.

In addition to this, many other expenses which occur in hospitals are not covered in Him care scheme which is:-

Illness Due to Alcohol or Drug Consumption: If an accident happened due to Alcohol consumption and if the patient has any disease due to Alcohol, then the treatment will not be covered under the Him Care scheme.

Conditions in which there is no need for Hospitalization: If an illness or disease doesn’t require the need to be admitted in hospital and if the treatment is possible through medicines i.e through OPD procedures, then these types of treatment will not be covered under Him Care.

Also, treatments like a Root canal, Filling cavities, diagnostic like X-Ray, etc, and the costs of tonics and vitamin supplements during hospitalization are not covered under Him Care.

Congenital External malformations or diseases

Congenital diseases or birth defects are all those diseases that develop in a child during conception or during pregnancy. These kinds of external diseases are also not included in Him Care insurance coverage.

Operations related to Fertility and Sterilization

Any operations, surgeries, or procedures which are related to fertility and Sterility have been excluded from Him Care.

Sterilization and Fertility related procedures

Sterility, any fertility, sub-fertility or assisted. Procedures like Hormone replacement therapy, conception procedure, and Sex change also come into this category.

Vaccination

Expenses inured on any type of vaccination, cosmetic surgery, and plastic surgery.

Injuries due to War

Treatment of injuries which occurs directly or indirectly due to war or any type of nuclear attacks or weapons.

Suicide

Any kind of injury which occurs in the attempt of suicide.

Psychiatric problems

Any type of psychiatric and psychosomatic disorders have also been excluded.

Treatments other than Allopathy

Any type of treatment that is not through Allopathy is clearly excluded from the coverage benefits of the Him Care scheme. These type of treatments includes Homeopathy, Naturopathy, acupressure, acupuncture or any unproven procedures, etc.

Exclusions under the Maternity Benefit clause

The benefits of this scheme will not be provided in case of Maternity in the following case:

• Coverage for the expenses will not be provided in case of voluntary termination of pregnancy, except in case of some accident or the pregnancy is terminated to save the mother’s life.
• The hospitalization period in case of maternity is less than 48 hours from the time of delivery.
• The insurance benefits will not be provided to those who already have two or more children.
• Any expenses that incur Pre-natal. But if any complications occur before delivery and hospitalization is needed in that case, then it is covered in this scheme

Is OPD covered under these schemes?

As mentioned above, the Him Care scheme doesn’t provide coverage for expenses on OPD procedures. That means the expenses on tests and medicines will not be covered under Him Care. But coverage is available for some daycare procedures.

What is the concept of Hospitalization?

If a patient is admitted to the hospital for more than 24 hours, then it will be considered as Hospitalization. So coverage will be provided under the HimCare scheme under such circumstances.

But various daycare treatments will also be considered into this category and these treatments are Radiotherapy, Eye Surgery, Parenteral Chemotherapy, Haemo-Dialysis, kidney stone removal, Dental surgery due to accident, Prostrate Surgery, Nose Surgery, Throat Surgery, Urinary System surgery, Laparoscopic, Ear Surgery and some more.

Are maternity benefits covered under Him care?

Yes, maternity benefits are covered in the Him care scheme.

What is covered under maternity expenses?

All maternity expenses will be reimbursed through the Himcare scheme which is related to delivery in the hospital.

What types of deliveries are covered?

Reimbursement will be given for normal as well as cesarean deliveries. The benefit of Rs. 2500 and Rs. 4500 will be given for normal and cesarean deliveries respectively.

Is there any provision to take care of the new-born?

Himcare scheme provides the provision of automatically covering the newborn baby under this scheme.

Will the new-born baby be covered if there are already five members of the family covered

The newborn will be covered under Himcare, even if there are already five members enrolled.

Are Transportation charges covered under Him care?

Yes, the Himcare scheme provides coverage for transportation charges. Maximum of Rs. 1000 transportation charges will be paid and for cases of hospitalization, Rs. 100 will be paid per case. If hospitalization is done in case of critical care, the Rs. 300 will be paid.

Is any proof required to claim transportation charges?

No proof is needed to claim the benefits of transportation charges.

At what time the transportation charges will be paid?

The transportation charges will be paid at the time of discharge.

Who will pay Transportation charges?

The beneficiary can get these transportation charges from the hospital after discharge from where they took the treatment.

Will the coverage amount be reduced, if there are less than five people?

The coverage amount is on a floater basis. Therefore, the total amount will remain the same even if the family consists of only one member.

Is the coverage of Rs. 30,000/- (or 1, 75,000 or 2, 25,000) for single-family member or for entire family?

The HimCare insurance scheme provides coverage on a floater basis, so that means the coverage amount of Rs. 30,000/- (or 1, 75,000 or 2, 25,000) is for the entire family and is not given individually.

What is the meaning of a Floater basis?

The meaning of the Floater basis in the case of the HimCare scheme is that, the total coverage amount i.e Rs. 30,000/- (or 1, 75,000 or 2, 25,000) can be used by a single person of the family or by all members of the family jointly.

What is a pre-existing disease?

Pre-existing disease refers to a disease of which the insured person is not aware of or the disease which exists before the time of getting insured under the HimCare scheme.

Is coverage available in HimCare for pre-existing diseases?

Yes, the Himcare scheme provides the coverage for pre-existing diseases.

Is there any age limit to get enrolled under these schemes?

There is no age for the enrollment in the HimCare scheme.

What is Call Center Service for the HimCare scheme?

The Call Center service for Himcare means that the insurance company should provide help to beneficiaries through Phone calls so that the beneficiaries can contact the company anytime if they have any confusion or problem regarding the Himcare scheme.

Him Care Helpline Number

For technical support/issues on HIMCARE Card, please contact on 8091773886 (avaliable on all working days from 10 AM 1:30 PM and 2:30 PM to 5 PM) or mail us on [email protected]

Himcare Health Card Hospital List and Contact Number