Kalyani Life Institute

কল্যাণী লাইফ ইনস্টিটিউট

Opposite to B-3 Playground,Near 3No Bazar, Kalyani, West Bengal

Niramaya

Niramaya Health Insurance Scheme

The Niramaya Health Insurance Scheme is an initiative by the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice & Empowerment, Government of India, designed to provide affordable health insurance to persons with disabilities (PwDs). The scheme is aimed at ensuring comprehensive health coverage with a uniform premium across age groups, providing the same level of coverage regardless of the type of disability. Its accessible nationwide and covers a wide array of medical expenses to support the well-being of PwDs.

Key Features of the Niramaya Health Insurance Scheme

  • Affordable Health Coverage: Health insurance coverage of up to ₹1,00,000/- annually.

  • OPD Treatment: Includes medicines, pathology, and diagnostic tests for non-hospitalized treatments.

  • Regular Medical Checkups: Available for non-ailing individuals with disabilities.

  • Dental Care: Covers preventive dentistry.

  • Surgical and Non-Surgical Care: Includes corrective surgeries for existing and congenital disabilities, as well as hospitalization expenses for non-surgical treatments.

  • Ongoing Therapies: Coverage for therapies aimed at reducing the impact of disabilities.

  • Alternative Medicine: Coverage for AYUSH and other alternative treatments.

  • Transportation Costs: Reimbursement for medical-related travel.

  • No Pre-Insurance Medical Tests: Accessible to all eligible individuals without the need for prior medical examinations.

Scheme Description and Eligibility

The Niramaya Health Insurance Scheme is open to all individuals with disabilities covered under the National Trust Act. Eligible individuals must possess a valid Disability Certificate and either a UDID card or a UDID enrollment number (with PwD certificate).

  • Nationwide Access: Scheme is available across all states in India.

  • Dedicated Helpline: A dedicated claims helpline is available at 040-68178569 or 71326135.

Note:

  • For claims involving imaging tests (like MRI, X-ray, Ultrasound), original reports and films are required.

  • For ongoing therapies, a doctors prescription, updated every six months, must specify the type and duration of therapy. Bills from rehabilitation professionals will be accepted with this prescription.

Disclaimer: The benefits and sub-allocations may be revised annually based on agreements between the National Trust and the Insurance Provider, and updates will be notified on the official website.

Application and Renewal Process

New Enrollment Process:

  1. Visit Nearest Registered Organization (RO): The guardian or parent of the PwD should visit the nearest Registered Organization with the required documents.

  2. Application Submission: RO completes the online Niramaya application, uploading scanned copies of documents.

  3. Health ID Card Issuance: Upon approval, a Health ID No./Card is issued and can be downloaded online.

Renewal Process:

  1. Online Renewal: The guardian or parent of the beneficiary can log on to the Niramaya website with details such as Policy Period, Beneficiary ID, UDID No., and Date of Birth.

  2. Document Verification: RO verifies the validity of documents.

  3. Fee Payment: Renewal fees are paid online, and notification is sent upon successful renewal.

Claim Process

  1. Claim Form Download: Beneficiaries can download the claim form from Raksha TPA under the “Downloads” section.

  2. Submission of Documents: Completed claim forms, along with medical bills, prescription, discharge summary, and bank details, should be submitted to the insurance providers regional centers.

  3. Claim Settlement: The insurance provider verifies and transfers the approved amount to the beneficiarys bank account as per IRDA guidelines.

Required Claim Documents:

  • Copy of Niramaya Card/Health ID Card.

  • Self-attested Disability Certificate.

  • Original medical prescriptions, bills, discharge summary, and reports.

  • Bank details including Name of Account Holder, Account No., Bank Name, Branch, and IFSC Code.

For more details, please visit the official Niramaya Scheme website or contact the helpline.