NIRAMAYA MSJE
Niramaya’s Health Insurance Scheme Revised Benefit Chart (on Reimbursement Basis only w.e.f.April, 2015)
Renewal and Enrollment of beneficiaries under Niramaya is open throughout the year. Kindly
contact us
About the Scheme
- Affordable Health Insurance to PwDs.
- Health insurance cover of up to Rs. 1.0 lakh.
- Facility for OPD treatment including the medicines, pathology, diagnostic tests, etc, Regular Medical checkup for non-ailing disabled, Dental Preventive Dentistry, Surgery to prevent further aggravation of disability, Non- Surgical/ Hospitalization, Corrective Surgeries for existing Disability including congenital disability, Ongoing Therapies to reduce impact of disability and disability related complications, Alternative Medicine.
- Transportation costs.
- No pre-insurance medical tests required.
- The scheme will be available in the entire country except J&K.
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 valid disability certificate will be eligible and included.
- No pre-insurance medical tests
- Treatment can be taken from any hospital.
Niramaya' Health Insurance Scheme Revised Benefit Chart |
On Reimbursement Basis only (w.e.f. April, 2015) |
Section |
Sub- Section |
Detail |
Sub Limit |
Over all Limit of Section |
I |
Over all Limit of Hospitalization |
70,000/- |
|
A |
Corrective Surgeries for existing Disability including congenital disability |
40,000/- |
|
|
B |
Non- Surgical/ Hospitalization |
15,000/- |
|
|
C |
Surgery to prevent further aggravation of disability |
15,000/- |
|
II |
Overall Limit for Out Patient Department (OPD) |
14,500/- |
|
A |
OPDtreatment including the medicines, pathology, diagnostic tests, etc. |
8,000/- |
|
|
B |
Regular Medical checkup for non-ailing disabled |
4,000/- |
|
|
C |
Dental Preventive Dentistry |
2,500/- |
|
III |
Ongoing Therapiesto reduce impact of disability and disability related complications |
10,000/- |
IV |
Alternative Medicine |
4,500/- |
V |
Transportationcosts |
1,000/- |
OVERALL LIMIT OF THE COVERAGE FOR A PERSON: Rs.1,00,000/- |
The sub-allocation outlined above may undergo an annual alteration based on the agreement between the National Trust and the Insurance Provider and will be notified on the website.
Guidelines for Enrolment
Enrolment is being done online by all Registered Organisations. List of Registered Organisations is available on the website.
The applicant is required to submit the duly filled in enrolment form to the registered NGO, along with the following documents :
- Disability certificate issued from the District Hospital or appropriate Government authority.
- Address Proof.
- One Passport size photograph of the Special Need person.
- BPL card, if applicable.
- Income certificate (Latest IT return, or Income certificate from Tehsildar).
- Proof of payment of applicable fee (Bank receipt).
- Bank details for settlement of claims.
PwD Category |
Enrolment Fee (In Rs) |
Required Documents |
Below Poverty Line(BPL) |
Rs. 250/- |
-
Disability certificate (self attested) issued from the District Hospital or appropriate Government authority
-
BPL card
-
Address Proof
|
Non BPL |
Rs. 500/- |
-
Disability certificate issued from the District Hospital or appropriate Government authority (self attested)
-
Address Proof
-
Income certificate of (self attested) the parent/guardian competent authority as issued by the State
|
PwD with Legal Gurdian (Other than natural parents) |
Free |
-
Disability certificate(self attested) issued from the District Hospital or appropriate Goverment authority.
-
Legal Guardian Certificate issued from the Local Level Committee constituted under section 13 of The National Trust Act, 1999
-
Address Proof
|