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Health Insurance Plan for Disabled People

22 June 2022, 8:37 AM

A health insurance policy is your ticket to financial security in times of medical emergencies. Additionally, the rising cost of healthcare facilities is alarming and utilizing savings can cause a massive hole as all the savings shall sooner or later drain out. Financial reserves are the need of the hour. Therefore, it is very important to have a health insurance plan so that your savings remain intact even in the event of a medical emergency.

Health Insurance for the Disabled

However, medical emergencies are constantly faced by disabled people. People with Disabilities are in constant need of medical attention. The constant visits to doctors and healthcare institutions for treatment makes them more entitled to insurance coverage. 

Earlier there was not much financial infrastructure available for disabled people as very limited insurance cover options were available for differently-abled people. However, with changing times and increase of private players in the insurance market opened doorways for various options, thereby making health insurance coverage available for disabled people. Insurance companies now have understood the importance of adequate health insurance cover for disabled people. 

Here is a simple guide related to the health insurance plan for disabled people.

Types of Possible Disabilities

One of the important things to know before understanding the health insurance plans for disabled people is the types of disabilities and their categorization. As per 2018 reports of the National Statistics Office, 2.2% of the Indian population is suffering from some type of disability. The following are the types of disabilities and their categorization. 

  1. Congenital Disability
    Congenital Disabilities refer to birth defects, congenital anomalies or functional disorders that occurred right from birth. These abnormalities are caused due to genetic factors, while some can be detected during pregnancy.  However, in many cases, they are detected in the later stage of pregnancy. Some common examples are People with down syndrome, cerebral palsy, spina bifida, etc.
     
  2. Accidental Disability
    As the name suggests this disability is caused due to an accident. Under health insurance plans available in India, any disability total, partial or temporary if caused due to an accident are covered. 
     
  3. Mental Disability
    Mental disability is difficult to ascertain i.e. the degree of mental disorder therefore most of the time the health insurance coverage and pricing is determined on a case to case basis. Most of the health insurance plans offering cover for mental disability provide coverage for in-patient hospitalization, outpatient hospitalization, therapy and counselling sessions etc. 
    Mental disabilities include anxiety disorder, depression, schizophrenia, etc.

How is the Eligibility of Disable People Determined?

Above we have stated the categories of disability but deciding a health insurance cover is a tedious task as a congenital disability or mental disability cannot be ascertained. Therefore, the insurance companies have formulated the factors determining the eligibility based on the following factors.

  • State of Health
    One of the primary checkpoints before offering health insurance coverage is to understand the current state of health of the disabled person. Before insuring a disabled person, the insurance company checks the health condition of previous months in order to determine the extent and degree of disability and risk. 
     
  • The family’s earning Capacity:
    Premium is the fundamental aspect of a health insurance policy. An insurance provider considers the family’s earning capacity from which the dependent disabled insured belongs.

Insurance Schemes for Disabled People

  1. Nirmalya Health Insurance Scheme: Nirmalya Health Insurance Scheme is a comprehensive health insurance cover launched by National Trust. This health insurance covers disabled people suffering from cerebral palsy, autism, mental retardation and people with multiple disabilities. Disabled people need to register with the National Trust for availing this insurance coverage.

The key highlights of this plan are as under:

EligibilityThere is no age limit however enrolment with national trust and valid disability certificate is mandatory
CoverINR 1 Lakh
Expense Limit

Hospitalization Expenses INR 70,000

OPD Expenses Limit INR 14,500

Ongoing Therapy Complication INR 10,000

Alternate Therapy Expense INR 4,500

Transportation Expense INR 1,000

Premium

INR 250 for a family whose income is less than INR 15,000

INR 500 for a family whose income is more than INR 15,000

  1. Swavalamban Health Insurance Scheme: 
    Swavalamban Health Insurance scheme is launched by the government of India in order to provide comprehensive cover to the disabled people. This plan offers health coverage to disabled people suffering from blindness, hearing disability, people with low vision, loco-motor disability, mentally retarded, people cured of leprosy, and mental illness.

The key highlights of this plan are as under:

EligibilityAge at entry: Minimum 18 years; Maximum 65 years, and valid disability certificate is mandatory
CoverINR 2 Lakh
Family IncomeFamilies with earning less than INR 3 lakhs can avail this policy
PremiumINR 3,100 PA – only 10% to be collected from the insured
CoverageCoverage is offered to disabled person, spouse and 2 children
  1. Health Insurance offered by Private Health Insurance Providers: 
    There are some private insurance providers that offer health coverage to disabled people. It is important to scrutinize and understand their terms and conditions in detail as terms and conditions differ from one insurance provider to another.

Things to know before buying health insurance plan for disabled people

  • Documentation:
    Documentation is an important aspect while purchasing a health insurance plan for disable people. Documentation is a must because in case of people with disabilities the insurance provider needs to understand their current health of state. Disabled people or their family members need to submit latest medical reports, disability certificate, documents pertaining to earnings of the family, etc in order to avail health insurance plan either from government institutions or from private health insurance providers.

     
  • Tax Benefit: 
    Family members of disabled person can file tax benefits. For an individual suffering 40% to 79% disability can avail INR 75,000 tax deduction per year. While an individual suffering more than 80% of disability can avail INR 1,25,000 tax deduction.

Conclusion

Even today we are in a nascent stage but we are making progress as many companies are coming up with health insurance plans for disabled people. The health insurance cover can help them to cover their medical expenses to a certain extent

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