A Guide to the State's Dual Health Insurance Schemes.
Welcome to the comprehensive guide for empanelled hospitals under Himachal Pradesh's dual health insurance schemes. The state provides a health safety net to its residents through two powerful programs: the central Ayushman Bharat (PMJAY) and the state's own universal scheme, HIMCARE. Together, they provide a cashless cover of up to ₹5 lakh per family per year, ensuring almost every family in districts like Shimla, Kangra, and Mandi is protected.
Click on your district from the list below to find all the empanelled government and private hospitals near you where you can use your Ayushman Card or HIMCARE Card for cashless treatment.
To achieve universal health coverage, Himachal Pradesh implements a two-pillar strategy. The Ayushman Bharat PMJAY, a central scheme, provides a completely free ₹5 lakh cover to families identified in the SECC 2011 census. To cover those left out, the state government launched the Himachal Pradesh Universal Health Protection Scheme (HIMCARE).
HIMCARE provides the same ₹5 lakh cashless cover to other resident families by charging a nominal, subsidized annual premium. For certain categories like BPL families (not under PMJAY) and registered street vendors, the premium is zero. For others, it's a small yearly amount (e.g., ₹365 or ₹1000 per family). This ensures nearly every family in the state has robust health protection. The information is managed by the State Health Assurance Society under the HP Health Department.
Both schemes share the same network of hospitals and offer over 1,947 treatment packages. This integrated approach is especially vital in a state with challenging terrain, ensuring quality care is accessible to all, from district hospitals to premier institutions like IGMC Shimla.
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Ayushman Bharat (PMJAY) is a central scheme that provides free coverage to families on the SECC 2011 list. HIMCARE is a state scheme that provides the same ₹5 lakh cover to families NOT on the PMJAY list, upon payment of a small annual premium. Together, they aim to cover everyone.
Yes. If you are a resident of Himachal Pradesh and not covered by PMJAY, you can enroll in the HIMCARE scheme. This will give you a HIMCARE card, which provides the same ₹5 lakh cashless benefit at the same network of hospitals.
The cost is a nominal annual premium per family, which varies by category. For BPL families, it's free. For others, it might be ₹365 or ₹1000 per year. This is highly subsidized by the government and far cheaper than any private insurance.
Yes, for all eligible Ayushman Card and HIMCARE card holders, treatment for any covered procedure at premier government institutions like IGMC Shimla and Dr. RPGMC Tanda (Kangra) is completely cashless.
The state government opens an enrollment window for HIMCARE for a specific period each year. During this time, you can apply online through the official HP health portal or visit a Lok Mitra Kendra (LMK) with your required documents to register your family.