Home Government Schemes or Yojana Niramaya Health Insurance Scheme

Niramaya Health Insurance Scheme

Niramaya Health Insurance Scheme was launched by the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice & Empowerment. Government of India. The objective of the scheme is to provide affordable Health Insurance to persons with Autism, Cerebral Palsy, Mental disability, and Multiple Disabilities. The scheme provides insurance coverage of up to ₹1,00,000/-, which must be renewed annually after the financial year.

Benefits of Niramaya Health Insurance Scheme

  • Health insurance coverage: Up to ₹1,00,000/- for various expenses.
  • Outpatient department (OPD) treatment: Covers medicines, pathology, diagnostic tests, etc.
  • Regular medical checkups: For non-ailing individuals with disabilities.
  • Dental care: Preventive dentistry services.
  • Surgery: To prevent further disability worsening or for existing disabilities (including congenital).
  • Non-surgical/hospitalization: Coverage for non-surgical treatments and related stays.
  • Ongoing therapies: For managing disability and related complications.
  • Alternative medicine: Coverage for alternative treatment options.

Health insurance coverage

Up to ₹1,00,000/- bifurcation for various expenses.

  • Section I: Hospitalization: The overall limit for hospitalization expenses is ₹55,000/-. This includes:
    • Corrective Surgeries for existing Disability, including congenital disability (Under SECI(A)a maximum capping of ₹15,000/- For other than the corrective surgeries for Existing Disabilities, which is included in the overall limit of ₹40,000/- of Sec I(A))
    • Non-surgical or hospitalization costs are covered up to ₹15,000/-.
  • Section II: Outpatient Department (OPD): The overall OPD treatment limit is ₹19,000/-, broken down as:
    • OPD treatment, including medicines, pathology, diagnostic tests, etc., is covered up to ₹15,000/-.
    • Dental preventive dentistry is covered up to ₹4,000/-.
  • Section III: Ongoing Therapies
    • A total of ₹20,000/- is allocated for ongoing therapies aimed at reducing the impact of disability.
  • Section IV: Alternative Medicine (AYUSH)
    • Treatment under AYUSH systems of medicine is reimbursable up to ₹4,000/-.
  • Section V: Transportation
    • Transportation costs related to medical treatment are covered up to ₹2,000/-.

Eligibility

  • All disabled persons who have at least one of the disabilities under the National Trust Act, 1999, with a valid disability certificate.