The Niramaya Health Insurance Scheme is an initiative by the Government of India that provides affordable and comprehensive health insurance coverage to individuals with disabilities. This government scheme ensures that people with disabilities can access essential medical care and financial support for their healthcare needs.
Overview
The following table showcases the key highlights of the Niramaya Health Insurance Scheme:
| Scheme | Key Highlights |
|---|
| Scheme Name | Niramaya Health Insurance Scheme |
| Launched By | Government of India |
| Established Under | National Trust Act of 1999 |
| Objective | Provide affordable and comprehensive health insurance coverage for individuals with disabilities |
| Coverage Amount | Up to ₹1 lakh per annum |
| Premium | Government-subsidised, requiring beneficiaries to pay only a nominal amount |
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What Is The Niramaya Health Insurance Scheme?
Niramaya Health Insurance Scheme is a government-planned social security health insurance scheme to pay the medical expenses of disabled persons (PwD). Established under the National Trust Act of 1999 its intended purpose is to safeguard the interest of disabled persons, autistic, those with cerebral palsy and other forms of mental retardation.
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Features
The insured targeted under the Niramaya Health Insurance Scheme is aimed to educate people having a specific disability so that they can get affordable and required healthcare services without any financial burden on them and their families.
The following are the key details of the Niramaya Health Insurance Scheme:
- The Major Causes of Understanding Insurance
The existing level of insurance for the Niramaya scheme is up to ₹1 lakh per annum (floater and may vary from year to year). In this category, you have the cost of treatment in hospitalisation, therapy, rehabilitation, and pre-existing illnesses. As an important side, the specific range of services and the scope of the benefits may also differ from insurance company to insurance company.
- Subsidised Premium and Enrollment Process
The government subsidises the premium for the Niramaya scheme details, requiring beneficiaries to pay only a nominal amount as their share. To enrol in the scheme, individuals must submit relevant documents, including a disability certificate and proof of age, to the insurance provider.
- Network of Empanelled Hospitals
Beneficiaries of the Niramaya scheme online can access a network of empanelled hospitals and healthcare providers throughout India. This allows them to receive cashless treatment at these facilities for covered medical expenses, simplifying the payment process during treatment.
- Annual Renewal Requirement
In the case of the Niramaya Health Insurance Scheme, it is mandatory for the beneficiaries to come and renew their insurance every year. Annual renewal of this scheme helps to receive all the benefits of its functioning. Further, timely renewal is crucial to maintain the receipt of the scheme.
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Benefits
The Niramaya scheme details provide nearly all sorts of needful things to guarantee that persons with disabilities require medical treatment. Below are some of the primary advantages:
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Health Insurance Coverage: A maximum of ₹1,00,000 for various medical bills.
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Outpatient Treatment: Forces expenses for medicines, pathology and diagnostics including costs of laboratory and imaging investigations.
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Regular Check-ups: Under it, there are provisions for ordinary checkups on people with disability who are not sick.
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Dental Care: Dental services are exhibited as preventive care services.
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Surgical Coverage: Includes operations to reverse a disability’s progression or correct a pre-existing condition.
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Non-Surgical Treatments: Can support non-surgical procedures and hospitalisation.
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Ongoing Therapies: Supports therapies for disability and its complications Fund therapies for persons with disabilities and other related issues.
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Alternative Medicine: Provisions for the use of other forms of treatment.
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Transportation Costs: Transportation that has a relation to medical care but not for medical necessity.
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Eligibility Criteria
In the case of the Niramaya scheme and the Nirmaya Health card, eligibility is centred on the holder of a disability certificate who is disabled. The criteria include:
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Should be a disabled person having at least one of the disabilities enumerated in the National Trust Act, of 1999.
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Be a holder of a valid disability certificate.
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Application Process
This scheme like all the modern ones is also implemented online and the process of its application is easy as well. Here’s how parents or guardians can apply for the Niramaya Scheme:
Step 1: Visit a Registered Organisation (RO): The parent of the PwD should visit the nearest Registered Organisation for enrollment.
Step 2: Fill out the Application Form: The RO will fill out an online form Niramaya and forward copies of the documents after confirming the originals.
Step 3: Receive Health ID: To avail of the benefits, the beneficiary will enrol and receive a Niramaya Health ID number or card, which will also be issued or can be downloaded.
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Claim Settlement Process
To avail of benefits under the Niramaya scheme one has to fill up a claim form and attach necessary copy documents to the insurance company. The process of the Niramaya Claim Settlement Process is as follows:
Step 1: Download the Claim Form: Download the claim form from the Niramaya website.
Step 2: Fill and Attach Documents: Fill out the form and you may have to include additional documents such as hospital bills and receipts of your prescription.
Step 3: Submit for Approval: This is useful since the insurance provider will require the claim form to be sent to the regional centres within 30 days of treatment or discharge from the hospital.
Documents Required
The following table showcases detailed information about the documents required for all the scenarios under the Niramaya Health Insurance Scheme:-
| Purpose | Category | Documents Required | Fee |
|---|
| Enrolment | BPL Applicants | Disability certificate (self-attested) from the District Hospital, BPL card, Address proof and Proof of payment. | ₹250 |
| APL Applicants (Income ≤ ₹15,000) | Disability certificate (self-attested), Address proof, Proof of payment and Income certificate (self-attested). | ₹250 |
| APL Applicants (Income > ₹15,000) | Disability certificate (self-attested), Address proof and Proof of payment. | ₹550 |
| Renewal | BPL | BPL card and Address proof (if changed) | - |
| APL (Income ≤ ₹15,000) | Address proof (if changed), Income certificate (self-attested) and Proof of payment. | ₹250 |
| APL (Income > ₹15,000) | Proof of payment and Address proof (if changed). | ₹500 |
| Claim Process | | Copy of Niramaya card or Health ID number, Self-attested Disability Certificate, Original prescription documents, All original bills related to medical expenses, Original reports and Complete bank details of the beneficiary (account holder name, account number, bank name, branch, and IFSC code). | - |
Renewal Process
The main steps to be followed by the applicants for the renewal process of the Niramaya Health insurance scheme are as follows:-
- Step 1: Log into the Niramaya Website: The parent/guardian can renew the govt scheme through the Internet by submitting some information like Policy Period and Beneficiary ID among others.
- Step 2: Verification: The RO confirms the authenticity of documents.
- Step 3: Payment: Projects: Electronics-Based Design Pay the application fees online.
- Step 4: Notification: This will be done through the Website in which the RO/beneficiary will receive a renewal notification.
Niramaya Health Card
The Niramaya Health Card is a health insurance card which has been specifically launched to give the healthcare needs of autistic, cerebral palsy, mental retardation and multiple disability patients.
Niramaya Health Card covers many forms of disability and makes it possible for those afflicted to get admission to healthcare centres where they require medical help The health card assists in smoothing the cost incurred on the families of affected individuals.
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Conclusion
Coming to the Niramaya Health Insurance Scheme is deemed an essential reform by the Gujarat Government that offers needed cash support to disabled patients to avail of essential healthcare facilities. The govt scheme includes several incentives designed to raise the standard of living of PwDs in India and a simple procedure for its implementation.
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Government Sources
Official Website
Enrollment Form
Claim Form
Renewal Form For Individuals
