| QUICK GIST |
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| HIMCARE, or the Mukhya Mantri Himachal Health Care Scheme, is Himachal Pradesh’s health scheme for families not covered under Ayushman Bharat PM-JAY. It has run since 1 January 2019 through the HP Swasthya Bima Yojana Society. It gives cashless treatment of up to ₹5 lakh per family per year on a floater basis at empanelled hospitals. Unlike most state schemes, HIMCARE charges a small annual premium that depends on your category. Groups such as BPL families, registered street vendors, eligible MNREGA workers, senior citizens above 70 and children in orphanages pay nothing. Other categories pay ₹365 or ₹1,000 a year. Government employees, pensioners and their dependants are not eligible. You can enrol and renew online at hpsbys.in or at a Lok Mitra Kendra or Common Service Centre. Hospitals empanelled under Ayushman Bharat in the state also accept HIMCARE. |
HIMCARE Explained: Himachal’s ₹5 Lakh Health Card for the Families Ayushman Bharat Missed
Built for the families in between
Ayushman Bharat covers families picked from national surveys. Government employees have their own medical reimbursement. But in the hills, plenty of families fit neither box: the orchard owner in Kinnaur, the homestay family in Kasol, the shopkeeper in Mandi.
Himachal Pradesh noticed that gap early. On 1 January 2019, it launched HIMCARE to cover exactly those left-out families, with the same ₹5 lakh cover as Ayushman Bharat.
There’s one twist. HIMCARE isn’t always free. Depending on your category, you pay ₹0, ₹365 or ₹1,000 a year. That’s a small price for a big cushion, but it means you need to renew on time.
Here’s how it works, who qualifies, and how to plan beyond it.
| Working in Chandigarh while your parents run the apple orchard back home? Long-distance insurance planning is harder than it looks. Book a call with us and we’ll help you map the family’s cover. Faster than the Shimla traffic jam on a long weekend. |
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What HIMCARE actually gives you
HIMCARE is run by the Health and Family Welfare Department through the HP Swasthya Bima Yojana Society. It mirrors Ayushman Bharat in how it works, but it’s aimed at families Ayushman Bharat doesn’t cover.
The essentials:
- Up to ₹5 lakh per family per year, on a family floater basis.
- Cashless treatment at empanelled hospitals, paid on predefined package rates, the same approach as Ayushman Bharat.
- Ayushman Bharat hospitals in Himachal also accept HIMCARE, so the network is shared.
- Five members per unit. If your family has more than five members, the extra members are enrolled as a separate unit, again capped at five.
- E-cards. Once enrolled, you download or generate your card online.
| Have a private policy as well? Know Your Policy translates its fine print into plain language: benefits, limits, waiting periods and exclusions. Then you’ll see where it adds to HIMCARE and where they overlap. |
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Enrolling in HIMCARE, step by step
- Check that Ayushman Bharat doesn’t already cover you. HIMCARE is for left-out families.
- Find your category. Your category decides your premium. Pick carefully, because the premium isn’t refunded if you choose the wrong one.
- Keep documents ready. Aadhaar, ration card, mobile number and proof of your category.
- Apply online or with help. Enrol at hpsbys.in yourself, or visit a Lok Mitra Kendra or Common Service Centre.
- Pay the premium online, if applicable. After back-end approval, you’ll get an SMS.
- Download your e-card. Generate it from the portal and keep a copy on your phone.
- Use it at an empanelled hospital. Show the card at admission. Covered packages are cashless.
- Renew every year. HIMCARE cover runs year to year. Set a reminder.
| Ready to enrol or renew? Head to the official HIMCARE portal for categories, enrolment, renewal and hospital lists. It’s the only place where the category rules are final. |
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| Family split between Himachal, Punjab and Haryana? The CoverSure State Health Scheme Calculator lines up every state’s scheme side by side. Easier than explaining three different health cards at Diwali. |
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Before you count on HIMCARE
A lapsed renewal means a lapsed card. Because HIMCARE runs year to year, missing renewal can leave you uncovered exactly when you need it.
The wrong category costs money. If you pick a subsidised category you don’t qualify for, the premium won’t be refunded. Check the definitions on the portal first.
Big families need more than one unit. Each unit covers up to five members. A joint family of eight is two units, each with its own enrolment.
It works within the state’s network. Treatment generally happens at empanelled hospitals in Himachal Pradesh. Plan separately for family members who live elsewhere.
Packages, not bills. HIMCARE pays package rates for defined treatments, like Ayushman Bharat.
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| HIMCARE renews yearly. So does your car insurance. And your term plan. And your parents’ policy. Add your state scheme to your CoverSure insurance portfolio and get renewal reminders for all of them in one place. Turn on Family Share so someone at home can find the e-card when the road to the hospital is long. |
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HIMCARE vs a private health plan
HIMCARE gives left-out families Ayushman-style cover for the price of a few cups of chai a month. A private plan costs more, but gives you more choice.
What HIMCARE does well
- ₹5 lakh family cover for ₹0, ₹365 or ₹1,000 a year.
- Fills a real gap for families outside Ayushman Bharat and government reimbursement.
- Shares Ayushman Bharat’s hospital network within the state.
- Easy online enrolment and e-cards.
Where a private plan usually adds more
- No category rules. Eligibility depends on the insurer’s health and age criteria.
- Hospitals across India, which matters in a state where many people work in Chandigarh, Delhi or beyond.
- Actual bills paid, subject to policy terms, instead of fixed packages.
- Room choice, restoration, cumulative bonus and optional add-ons.
- Tax benefit on premiums under Section 80D in the old tax regime (please verify current limits).
For eligible families, HIMCARE is an excellent base at a tiny cost. A private plan or super top-up adds reach and flexibility.
Is ₹5 lakh enough in the hills?
In Himachal, the bill is only part of the story. Serious treatment can mean a long trip to a bigger hospital, sometimes out of state.
Meet the Thakurs (a hypothetical family; numbers are illustrative). They live near Kullu, with seven members, enrolled as two HIMCARE units.
| Event in the year (hypothetical) | Unit | Used from that unit’s ₹5 lakh |
|---|---|---|
| Grandfather’s cardiac procedure | Unit 1 | ₹2.8 lakh |
| Mother’s hysterectomy | Unit 1 | ₹1 lakh |
| Son’s fracture surgery after a trekking fall | Unit 2 | ₹1.2 lakh |
| Remaining | Unit 1: ₹1.2 lakh; Unit 2: ₹3.8 lakh |
The two-unit setup helps a big family. The gaps that remain usually look like this:
- Travel and stay for treatment far from home, which isn’t a hospital bill.
- Hospitals outside the network, including many outside Himachal.
- Renewal slips, which can leave a unit uncovered.
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Who is eligible for HIMCARE?
You can enrol if you’re a permanent resident of Himachal Pradesh and your family isn’t covered under Ayushman Bharat PM-JAY or government medical reimbursement. Your premium depends on your category:
| Premium | Who pays it |
|---|---|
| ₹0 (proof of category required) | BPL families, registered street vendors, MNREGA workers not covered under Ayushman Bharat, senior citizens above 70, and children living in orphanages |
| ₹365 a year | A middle category defined on the HIMCARE portal; check the current list before choosing |
| ₹1,000 a year | All other eligible families not covered under PM-JAY or medical reimbursement |
Not eligible: government servants, pensioners and their dependent family members.
Documents: Aadhaar, ration card, mobile number and proof of your category.
HIMCARE at a glance
| Detail | HIMCARE (Himachal Pradesh) |
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| Full name | Mukhya Mantri Himachal Health Care Scheme |
| Run by | HP Swasthya Bima Yojana Society, Health and Family Welfare Department |
| Started | 1 January 2019 |
| Cover | Up to ₹5 lakh per family per year, floater |
| Family unit | Up to five members per unit; larger families enrol extra units |
| Premium | ₹0, ₹365 or ₹1,000 a year, by category |
| Who qualifies | Himachal residents not covered by Ayushman Bharat or government reimbursement |
| Not eligible | Government servants, pensioners and their dependants |
| Hospitals | Ayushman Bharat empanelled hospitals in the state also serve HIMCARE |
| Card | E-card, generated online after approval |
| Renewal | Yearly |
| Main limitations | Annual renewal, category rules, package rates, state network |
| Official website | hpsbys.in |
| Rather swipe than scroll? Totally valid. HIMCARE’s categories, premium and steps, packed into a few LinkedIn slides. Swipe through it on CoverSure’s LinkedIn and share it with the cousin who still hasn’t renewed this year. |
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Quick answers (FAQs)
- What is HIMCARE? Himachal Pradesh’s health scheme for families not covered by Ayushman Bharat, offering up to ₹5 lakh cashless cover per family per year.
- How much is the HIMCARE premium? ₹0, ₹365 or ₹1,000 a year, depending on your category.
- Who gets HIMCARE free? BPL families, registered street vendors, eligible MNREGA workers, senior citizens above 70 and children in orphanages, with proof.
- Can government employees get HIMCARE? No. Government servants, pensioners and their dependants aren’t eligible.
- How do I apply for HIMCARE? Online at hpsbys.in, or through a Lok Mitra Kendra or Common Service Centre.
- What if my family has more than five members? Extra members are enrolled as a separate unit, with up to five per unit.
- Do I need to renew HIMCARE? Yes, every year.
- “Hey Google, which hospitals accept HIMCARE?” Ayushman Bharat empanelled hospitals in Himachal Pradesh also accept HIMCARE.
| HIMCARE covers the hospital. CoverSure covers the reminders, records and emergencies. Download the CoverSure app to track every policy and renewal in one place, and set up SOS so family gets alerted in one tap. |
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