Sikkim Mukhya Mantri Swasthya Bima Yojana
State-notified public health assurance program providing cashless medical treatment across Sikkim.
Sum Insured / Cover
₹5 Lakh per family
Annual Premium
100% Free / Subsidized by State
Claim Settlement
98.2% (Direct Cashless)
Network / Scope
1,200 Empaneled
✦ Key Benefits & Policy Coverage
Universal health coverage for Sikkim certificate of identification (COI) holders and non-SECC rural households.
What is Missing: Critical Policy Exclusions & Limitations
Eligo disclosure: Private insurance agents and official ads rarely mention these limitations. Verify before relying on this coverage.
Super-specialty care in Siliguri/Kolkata requires referral from STNM Hospital Gangtok.
✦ Eligibility Requirements
Permanent residents of Sikkim holding Certificate of Identification.
✦ Application, Enrollment & Claims Process
1. Verify family eligibility on state food security or health portal.
2. Obtain state health smart card or link Aadhaar at local CSC.
3. Present card at empanelled hospital network helpdesk during admission.Official Portal
Official Government / PSU Portal
Apply or verify on the official administrative domain
✦ Documents Checklist
Aadhaar Card, State Ration Card / Jan Aadhaar / Parivar Pehchan Patra, Domicile certificate, Mobile number.
✦ Life Situations Where This Scheme Helps
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Having a Baby & Early Childhood
Government financial assistance, healthcare, nutritional support, and savings schemes for expecting mothers, newborns, and infants.
Health Emergency & Medical Care
Cashless hospital treatment up to ₹5 Lakh, free essential medicines, diagnostic services, and critical illness financial support.
Senior Citizens & Retirement Care
Guaranteed pension schemes, free assisted living devices, subsidized healthcare, and geriatric welfare for elderly citizens.
Underwriting Entity & Public Grievance Contact
Administering Body:
Government of India