Nagaland government employee questions CMHIS-EP after newborn's NICU treatment leaves family with INR 5.15 lakh hospital bill burden
DIMAPUR — Questions have been raised over the implementation of Chief Minister's Health Insurance Scheme for Employees and Pensioners (CMHIS-EP) after a government employee alleged that a private hospital in Dimapur failed to provide cashless treatment for his newborn admitted to the Neonatal Intensive Care Unit (NICU).
The CMHIS-EP scheme provides health insurance coverage of up to INR 20 lakh per family per annum for state government employees, pensioners, and their dependants.
Addressing the media on Tuesday, the government employee expressed concern over the ‘exorbitant hospital bill’ despite being enrolled under CMHIS-EP and recounted the sequence of events: his wife was admitted to Eden Medical Centre in Dimapur on April 12, 2026, for delivery, and their child was born through a caesarean section on April 16.
While his wife was discharged on May 19, the newborn had to remain in the NICU due to complications. The child was eventually discharged on June 19 and was later shifted to Christian Institute of Health Sciences and Research (CIHSR) for surgery.
According to him, his wife's hospital bill of INR 48,000 was largely covered under CMHIS-EP, leaving him to pay INR 14,000. However, he claimed that the scheme offered little relief for his child's treatment.
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He alleged that the hospital informed him he would have to pay INR 5,15,704 out of a total bill of INR 6,79,679, with CMHIS-EP covering only INR 1,63,975. He said that the amount came as a shock and that he had not been informed about the limited coverage when he initially enquired about the scheme.
"I took my wife for treatment trusting this card. But I was told CMHIS would cover only INR 1,63,975 and I have to pay INR 5,15,704 for my child. I was shocked.
Where do I get that kind of money? I have small children at home. Every month INR 400 is deducted from my salary because we believed this card would help us in an emergency. But now it feels like there is no help," he said.
He alleged that the hospital had not informed him about the limited coverage. “They did not say it would not be covered. They said the card is active and there is no issue,” he added.
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When asked whether the hospital had explained the reason for the limited coverage, he said, "They told me that for babies, the package is different and limited. I could not understand this reasoning."
He further alleged that, before admitting his wife, he had specifically enquired whether the hospital accepted Ayushman Bharat or CMHIS-EP cards. According to him, he received a positive response and admitted his wife for delivery based on that assurance.
Asked about the pending dues to Eden Medical Centre, he said he had not yet settled the bill. "I am not in a position to pay such a huge bill. I have asked the hospital to give me some time so I can arrange a loan," he said.
Asked whether he had received any response from the authorities, he replied in the negative. "I met them once and requested them to consider it. But it feels like the card has no value," he lamented.
While the baby continues to receive treatment at CIHSR, he said he was disappointed that the scheme had failed to provide the support he had expected despite his monthly contributions.
“If a government scheme does not help poor people, what is the use? I trusted this card, but it did not help. It feels better not to use it at all,” he said.
He urged the state government to clarify the extent of CMHIS-EP coverage, particularly for neonatal intensive care and other critical care cases, so that beneficiaries are not left confused during medical emergencies.
Eastern Mirror reached out to Eden Medical Centre for its version. The hospital, however, said it would respond only after reviewing the news report.