What is a disability?
A physical or mental defect that limits one’s capacity to carry out daily chores is referred to as a disability. According to the People with Disabilities Act of 1955, a person is deemed disabled if they have a physical impairment that is at least 40% severe. Nonetheless, a person is deemed severely impaired if they exhibit multiple disabilities or have 80% physical impairment.
Disability classifications in health insurance
Disabilities in India are often categorised into the following three groups under health insurance for the disabled.
- Congenital impairment
This kind of impairment is present at birth and is typically inherited or brought on by external stimuli. Congenital impairments include things like spina bifida, cleft lip, and cleft palate. Congenital conditions were initially thought to be a universal health insurance exclusion. Nevertheless, only exterior congenital anomalies are excluded under the laws that the Insurance Regulatory and Development Authority of India (IRDAI) modified in 2016. #
- Accidental impairment
Accidental impairments are those that develop as a result of accidents. They are divided into three categories based on the impact: total, partial, and temporary incapacity. Accidental impairments include the loss of limbs, hearing, eyesight, whole or partial paralysis, etc. *
- Mental illness
This category of disabilities covers mental illnesses that have an impact on a person’s thinking, emotions, and behaviour. These conditions include, for instance, autism, schizophrenia, depression, etc. Over 14% of adult Indians, according to the National Mental Health Survey from 2016, require mental health therapies. *
What are the requirements for PwDs to be eligible for health insurance?
These are the standards that insurers typically use to decide whether you qualify for health insurance coverage.
- Size of the impairment
When approving health insurance for people with disabilities, health insurers typically consider the severity of your disability. This is done to estimate the risk that results from your handicap and establish its extent.
- Current state of health
While purchasing health insurance as a PWD, your present state of health is typically taken into consideration.
A health insurance premium calculator is a tool you may use online to determine the amount of coverage required based on your needs.
The Indian Government presents two health insurance policies exclusively for disabled persons.
- Niramaya Health Insurance
This government introduced a health insurance programme that covers people with disabilities. In particular, it offers a sum of Rs. 1 lakh for the treatment of mental impairments such autism, retardation, and cerebral palsy. There are no medical examinations necessary while purchasing Niramaya Health Insurance.
|Age criteria||No age limit|
|Documents required for enrolling||Disability certificate|
|Sum insured||Rs. 1,00,000|
|Premium payable||Family income < Rs. 15,000: Rs. 250, Family income > Rs. 15,000: Rs. 500|
|Coverage limits||Ongoing therapy: Rs. 10,000, Hospitalisation: Rs. 70,000, Transportation expenses: Rs. 1,000, Alternative medicines: Rs. 4,500, Outpatient department(OPD): Rs. 14,500|
- Swavlamban Health Insurance
This is a family floater/group health insurance plan that provides coverage for both people with disabilities and their families. It provides coverage for illnesses like mental illness, loco-motor handicap, blindness, and hearing loss, among others. Even this health insurance policy does not demand any pre-purchase medical examinations. Pre-existing conditions are not excluded either.
|Age criteria||18 to 65 years|
|Family income criteria||Family income < Rs. 3 lakh per annum|
|Sum insured||Rs. 2,00,000|
|Individuals covered||The disabled person, his/her spouse and up to two children|
|Premium payable||Rs. 3,100 (only 10% has to be paid from your pocket, the rest will be funded by the Government)|
|Documents required for enrolling||Identity proof, Proposal form, Income certificate, Premium payment receipt|
Make sure you compare health insurance plans before buying one.
* Standard T&C Apply
# Visit the official website of IRDAI for further details.
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.