Benefits of Niramaya Health Insurance for Persons with Disabilities

In India, caring for a child or family member with a disability brings unique challenges emotionally, physically, and financially. And as women, whether as mothers, sisters, or caregivers, we often shoulder a large part of this responsibility.

But here’s the good news: help is available. The Niramaya Health Insurance Scheme, launched by the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice & Empowerment. It is designed to ease the financial burden on families of persons with disabilities. It’s more than just insurance, it’s a support system.

And while you’re caring for your loved ones, don’t forget to care for your own financial well-being too. You can start small and invest money online to build a secure future for yourself and your family.

Let’s break down the Nirmaya Scheme benefits in a way that’s easy to understand and highlights the real benefits for women navigating this journey.

What is Niramaya Health Insurance?

Niramaya is a government-sponsored health insurance scheme that provides affordable and accessible healthcare to Persons with Disabilities (PwDs). Its primary goal is to ensure that individuals with disabilities receive the financial support they need to access essential medical care and therapies, helping families feel more secure and supported.

And while you focus on creating a safety net for your loved ones, don’t forget to build one for your future too. You can invest in SIP to grow your money steadily and prepare for life’s unexpected turns.

Let’s break down the Niramaya Scheme benefits in a way that’s easy to understand and highlights the real value for women navigating this journey.

It covers conditions under the National Trust Act, like:

• Autism
• Cerebral Palsy
• Mental Retardation (Intellectual Disabilities)
• Multiple Disabilities

What are the Niramaya Scheme Benefits & Features?

Here’s why this scheme is a true blessing, especially for mothers and caregivers:

1. Annual Coverage Up to ₹1 Lakh

• Covers OPD, hospitalization, therapies, and special education.
• No pre-insurance medical tests required.

2. Affordable Enrollment Fees:

Particulars	Enrollment Fees
Persons with disabilities below the poverty line (BPL)	₹250 per year
Persons with disabilities above the poverty line (APL) (If family income is up to ₹ 15,000/- Per Month)	₹250 per year
Persons with disabilities above the poverty line (APL)(If family income is above ₹ 15,000/- Per Month)	₹550 per year

3. Annual Renewal: 

The insurance coverage needs to be renewed every financial year to continue availing benefits.

• ₹250 per year for PwD below the poverty line
• ₹500 per year for PwD above the poverty line

4. Covers Ongoing Therapies and Alternative Medicines

Ongoing Therapies to reduce the impact of disability and disability related complications, and alternative medicine are covered such as speech therapy.

5. Extensive Coverage:

Medical Services Covered by the Niramaya Health Insurance Scheme

• Regular health check-ups for non-ailing persons with disabilities
• Outpatient Department (OPD) treatments
• Preventive dentistry services
• Non-surgical hospitalisation like therapies for managing disability, rehabilitation, and other non-surgical medical interventions.
• Surgeries aimed at preventing the worsening of disabilities
• Treatment for congenital disabilities (are health conditions or differences that a person is born with)
• Ongoing therapies such as physiotherapy, speech therapy, and occupational therapy
• Coverage of alternative medicine treatments (e.g., Ayurveda, Homeopathy)

Niramaya Health Insurance Scheme Benefit Chart (On Reimbursement Basis only)

Section	Sub-Section	Detail	Sub Limit	Overall Limit of Section
I	Overall Limit of Hospitalization			55,000/-
	A	Corrective Surgeries for existing Disability including congenital disability(Under SECI(A)a maximum capping of Rs.15000/-For other than the corrective surgeries for Existing Disabilities, which is include in the overall limit of Rs.40,000/- of Sec I(A))	40,000/-
	B	Non-Surgical / Hospitalisation	15,000/-
*II	Overall Limit for Out Patient Department (OPD)			19,000/-
	A	OPD treatment including the medicines, pathology, diagnostic tests, etc.	15,000/-
	B	Dental Preventive Dentistry	4,000/-
**III	Ongoing Therapies to reduce impact of disability…			20,000/-
IV	Alternative Medicine-AYUSH			4,000/-
V	Transportation costs			2,000/-
OVERALL LIMIT OF THE COVERAGE FOR A PERSON: Rs. 1,00,000/-

What is the Eligibility for Niramaya Health Insurance?

All persons with disabilities under the National Trust Act with a valid disability certificate, having a UDID (Unique Disability ID) Card or UDID enrollment number (with PwD certificate) will be eligible and included.

What are the Documents required for Niramaya Health Insurance?

The required documents generally include proof of disability, age verification, identity proof, and an income certificate for families below the poverty line (BPL). 

What is the Enrollment Process for Niramaya Health Insurance?

Visit Registered Organization (RO):

A registered organisation is an entity that has been officially recognized by the National Trust to facilitate enrollment and provide support to beneficiaries with disabilities.

Parents or guardians of the person with disability (PwD) visit the nearest Registered Organization with the required documents.

Application Form Submission:

The RO fills the Niramaya application form online and uploads scanned documents after verifying the originals.

Issuance of Health ID:

Upon successful enrolment and approval, a Health ID number/card is issued to the beneficiary. This can be downloaded online or obtained through the RO.

What is the Scheme Renewal Process?

1. Online Renewal:
   Parent/guardian logs into the Niramaya website to renew the scheme by providing:
   • Policy Period
   • Beneficiary ID
   • UDID No/Enrollment number
   • Date of birth
2. Document Verification:
   The RO verifies the validity of the submitted documents.
3. Payment of Renewal Fees:
   Renewal application fees are paid online.
4. Renewal Confirmation:
   After payment, the RO and beneficiary receives notification of successful renewal for another year via the website.

What is the Scheme Claim Process?

1. Download Claim Form:
   Beneficiaries download the claim form under the “Downloads” menu.
2. Submit Claim Form with Documents:
   Submit the filled claim form along with all supporting documents (medical bills, prescriptions, hospitalization reports, discharge cards, etc.) to the regional centres of the insurance provider. Preferably within 30 days of treatment or hospital discharge.
3. Verification and Payment:
   The insurance provider verifies the submitted documents and transfers the approved claim amount to the beneficiary’s bank account following IRDA guidelines.

Important Notes:

• The scheme is valid until March 31st of the financial year in which enrolment is done. For example: This means that if a person enrolls in the scheme during the financial year 2025-26 (April 1, 2025 – March 31, 2026), their coverage will be valid until March 31, 2026
• Beneficiaries should renew the scheme at least three months before expiry to continue benefits.
• For the Above Poverty Line category (family income above ₹15,000/month), renewal can be done online through the Niramaya website.

Imagine this: you’re a mother of a 6-year-old with cerebral palsy. Your days are filled with therapy sessions, doctor visits, and emotional ups and downs. The last thing you want to worry about is the cost of another MRI or the speech therapy fee.

With Niramaya Insurance, these worries ease. The scheme allows you to focus on care, not costs. And when your child shows progress, says a new word, walks a few steps, it’s not just a milestone, it’s a celebration of resilience, backed by support that’s both emotional and financial.

Bookmark this blog for your future reference.

Comment “Very Helpful” if you find it informative and helpful at the same time.

FAQs:

Further read:

• Understanding the Difference Between Mediclaim and Health Insurance
• 10 Top Benefits of Health Insurance
• Demystifying Health Insurance vs. Accident Insurance: Choosing the Right Shield for You