NIRAMAYA (Health Insurance Scheme)

About the Scheme

1. Affordable Health Insurance to PwDs.
2. Health insurance cover of up to Rs. 1.0 lakh.
3. Facility for OPD treatment including the medicines, pathology, diagnostic tests, etc, Regular Medical checkup for non-ailing disabled, Dental Preventive Dentistry, surgeries other than the Corrective Surgeries for Existing Disabilities , Non- Surgical/ Hospitalization, Corrective Surgeries for existing Disability including congenital disability, Ongoing Therapies to reduce impact of disability and disability related complications, Alternative Medicine.
4. Transportation costs.
5. No pre-insurance medical tests required.
6. The scheme will be available in the entire country.  

Scheme Description

The scheme envisages delivering comprehensive cover which will

• Have a single premium across age band
• Provide same coverage irrespective of the type of disability covered under the National Trust Act
• Insurance cover upto Rs.1.0 lakh , on reimbursement basis only.
• All persons with disabilities under the National Trust Act with UDID Card or UDID Enrol No. (with valid disability certificate issued from Competent Authority) will be
  eligible and included.
• No pre-insurance medical tests
• Treatment can be taken from any hospital.

Niramaya’s Health Insurance Scheme Revised Benefit Chart (on Reimbursement Basis only)

Niramaya' Health Insurance Scheme Revised Benefit Chart
On Reimbursement Basis only
Section	Sub- Section	Detail	Sub Limit	Over all Limit of Section
I	Over all Limit of Hospitalization			55,000/-
	A	Corrective Surgeries for existing Disability including congenital disability    (Under SEC I (A) a maximum capping of rs. 15,000/-For surgeries other than the Corrective Surgeries for Exitsting Disabilities, which is inculuded in the overall limit of Rs.40,000/- of SEC I(A)..)	40,000/-
	B	Non- Surgical/ Hospitalization	15,000/-
II	Overall Limit for Out Patient Department (OPD)			19,000/-
	A	OPDtreatment including the medicines, pathology, diagnostic tests, etc.	15,000/-
	B	Dental Preventive Dentistry	4,000/-
III	Ongoing Therapiesto reduce impact of disability and disability related complications			20,000/-
IV	Alternative Medicine-AYUSH			4,000/-
V	Transportationcosts			2,000/-
OVERALL LIMIT OF THE COVERAGE FOR A PERSON: Rs.1,00,000/-

** Need for ORIGINAL REPORTS / FILMS LIKE MRI, X-RAY, ULTRASOUNDS ETC. – Original documents are required including the film for settling of Claims.

Prescription for Ongoing Therapies- Doctor’s prescription at least once in Six months is essential in which the category of therapy and duration of therapy should be clearly mentioned. Thereafter other documents from Rehabilitation Professional for therapy, and related bills will be acceptable. Doctor who prescribes the prescription should be a valid medical Practitioner with valid license/degree as per Medical council rules.

Beneficiary:

person with disabilitiy

Benefits:

Health Benefit for PwDs