All That You Should Know About Health Insurance for Disabled People
Published On Apr 01, 2019 5:30 AM By Prashant Srivastava
A few private insurance companies, as well as government-owned, have launched many health insurance products for the differently-abled.
After all, a large chunk of people in India is from differently-abled segments.
If we go by the Census report of 2011, out of 121 crore population, 26.8 million individuals are disabled.
Among the disabled people, 1.5 Cr (56%) are males and 1.18 Cr (44%) are females.
However, much to their relief there are a few insurance companies in India that provide health plans to the “Person with Disabilities” (PwDs).
For example, Jeevan Bharati-I plan of LIC provides a rider for congenital disability for the lives of women. On the other hand, Niramaya Health Insurance is a plan for people with mental disabilities.
Currently, only a few insurers offer critical illness insurance coverage to differently-abled individuals. However, not every health policy provides complete benefits to the policyholder.
That’s why getting the best health care facilities is a grueling task for the disabled, especially when hospitals impose heavy medical bills on patients.
In a nutshell, handicaps can get only a few benefits from the health plans provided by both the private and public health insurance companies. Here is a wealth of information about different disability health insurance schemes. Continue reading to know them.
Who are Actually Differently-Abled Persons?
Differently-abled people are the ones suffering from any of the following disabilities:
Congenital disability: This is a kind of disability that is present right from birth. Cerebral palsy, Down syndrome, cleft palate or lip, and spina bifida are some of the common examples of congenital disability. Most of the health insurance companies don’t provide coverage for congenital disability. However, LIC offers a congenital disability rider under LIC’s Jeevan Bharati-I plan exclusively for the females.
Accidental disability: In this disability, a person becomes disabled owing to an accident. For example, a person who has lost his or her legs in an accident is called permanently totally disabled. Those with impaired or broken limbs are also covered under accidental disability. Even an individual with partial or complete vision loss caused due to an accident is covered. Most of the health insurance companies treat accidentally disabled individuals as normal applicants. They do not impose extra charges and has no restrictive clauses for providing coverage.
Mental disability: Mental disability is referred to as a mental illness or disorder. It means the impairment of the individual’s thoughts, behavior, speech, or functioning. Example of mental disability includes autism, schizophrenia, and Asperger’s syndrome.
It’s important to note that a person with a mental disability and congenital disability falls under the high-risk category. Therefore, these people are not eligible for complete coverage under critical health insurance coverage. A person with an accidental disability can gain benefits as part of the policy or as a standalone rider benefit.
Information to Provide
There is certain information that determines the eligibility for health insurance for a disabled person. So, you need to declare your disability in detail while filling out the proposal form. Many insurers may even ask for the doctor’s report in order to assess the disability level that might hinder the day-to-day activities of a person. They may also seek information on any of the tests or doctor’s visits made recently. So, it’s advisable to declare everything correctly.
What determines the eligibility for the policy?
Usually, there are three factors that can determine your eligibility to avail a health policy for the disabled.
Family Earnings: Family earnings are among the most crucial factors that not only affect the eligibility of a differently-abled person to avail of health insurance but also affect the premium of the policy. Depending on the overall income of the family, insurers offer an appropriate policy.
Current Health State: Current health state is another factor that an insurance company can check before offering the coverage to disabled. In general, an insurance company checks the last two months of health status to reduce any risks. If the individual is suffering from any chronic diseases or ailments at the time of policy issuance, then the chances of the eligibility of the person decrease.
Premium Paying Capacity: Every health insurance policy comes with its own premium share. The policy providers usually check the bank accounts and statements of the individual and determine whether the person is eligible for the coverage or not.
These are the three crucial factors that determine the eligibility of availing a health insurance plan for the disabled.
Government-Sponsored Health Policies for Disabled:
While there is no specific health policy for critical illness or disability, the government provides some insurance options to handicaps. These policies bring some relief to them. The government-sponsored policies are:
1. Niramaya Health Insurance
2. Swavalamban Health Insurance
Niramaya Health Insurance: This policy is an appropriate alternative for those suffering from mental disabilities. Under this plan, the insured can avail of coverage of up to Rs. 1 lakh. The coverage amount is available for both pre and post hospitalization expenses incurred in medical treatment.
The premium paid against this policy varies. For a family with an income of less than Rs. 15,000 is entitled to pay only Rs. 250 as the fixed premium payout. In addition, for the family whose monthly income is over Rs 15,000, then the premium is Rs 500.
Swavlamban Health Insurance: Swavlamban Health insurance is another health policy for disabled people sponsored by the government. This plan is customized especially for the PwDs in a low-income group and provides them with a much needed affordable yet comprehensive cover.
The people with an annual family income of Rs. 30,000 or below can avail this policy.
- The policy has a uniform premium of Rs. 357.
- The policy is available for people between 0 to 65 years of age.
- There is no pre-requisite of medical tests.
- The scheme covers up to three family members.
- Both the expenses of pre and post hospitalization are covered under the scheme.
Swavlamban Health insurance schemes have been designed in a way that the insured can provide a single premium on-one go and reap coverage benefits.
Things to Know:
Apart from the above-mentioned information, here are a few things to be kept in mind.
Medical Report: Whether you want to buy a health insurance plan from a private insurance company or you want to go for a government-sponsored plan, your present medical report will be required. Based on this report, the insurance companies approve a policy request and decide the coverage.
You can either visit a government hospital or consult a registered doctor for the issuance of a medical report.
Tax Benefits: Investment in health insurance entitles you to enjoy tax benefits. Every disabled individual gets tax deduction benefits for up to Rs 50,000 under Section 80U.
According to the government norm, an individual with a partial or severe disability can enjoy tax benefits. If you are severely disabled, then you can avail maximum tax deductions of up to Rs 1 lakh.
It’s worth noting that insurance companies in India have the right to decide the premium amount. The premium may vary depending upon various factors such as GST terms, the age of the disabled person, and location.
A health insurance plan for differently-abled people is of great benefit. Though only a few policies are available in the market, you should do thorough research, find the best company and then apply for the right policy. You can purchase a policy in case you’re suffering from disorders that don’t affect your mobility. It’s also advisable to crosscheck the premium and the coverage the insurance company is providing to you before you shop for a health plan.