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Myth Busted! Health Insurance for Differently-Abled

Published On Apr 15, 2019 5:30 AM By Chinansuka Agarwal

There is generally a debate on why insurance companies are hesitant on providing coverage for differently-abled people. They have a strong perception that a disabled person can’t buy health insurance. The application of a person with a disability is either rejected or loaded with a high premium. There are various myths about disabled people's insurance. But, it is not entirely true. Any person with a disability is eligible for health coverage, but many people are not aware of this fact.

Firstly, let’s understand the term specially-abled or differently-abled:

A person suffering from any of the anomalies mentioned below is considered to be specially-abled or differently-abled.

  1. Disabilities from birth: Congenital disabilities or disabilities from birth are the anomalies a person suffers from birth. To simply put, it is a disability that a person is born with. These include conditions related to heart, cerebral palsy, spina bifida, cystic fibrosis, etc.
  2. Disabilities due to accidents: A partial or total medical disability as a result of an accident is termed as an accidental disability. A person with fractured or impaired limbs falls under this category. Even someone with partial or complete blindness is considered under this category.
  3. Mental disability: Mental disability involves behavioral issues or psychiatric disorders. Individuals with mental illness or disease fall under this category. Just like congenital disabilities, individuals with mental disabilities are also considered high-risk cases. Hence, mental disability is also not fully covered under critical illness plans.

A person with a congenital or mental disability presents a higher risk to the insurance company. Thus, these individuals not considered eligible for complete coverage under a critical illness insurance policy. However, due to some unfortunate scenario, if you meet with an accident and sustain some form of disability. Then, you can purchase disabled people's health insurance. Accidentally disabled people are treated as normal people by health insurance companies. Insurance companies provide health coverage at no additional terms and conditions. This benefit can be opted as a standalone rider or as part of the policy.

Eligibility factors for getting health insurance for differently-abled:

1. Health state: This is the first eligibility criteria for getting health insurance for the disabled persons. Generally, the health status of the last two months is checked by the insurer. In case, an individual is suffering from any chronic illness, the chances of policy rejections remain high.
2. Earning of the family: This is the second important factor when determining the disabled person's eligibility for health insurance. Depending on the earnings of the family, the insurance policy is offered to an individual. The premium amount also depends on the family’s earning in many cases.
3. Capacity of premium paying: The insurer checks the premium paying capacity. Personally, your bank accounts, statements and documents, etc. are reviewed by the insurer. After checking, the insurer decides whether you are eligible for a health insurance policy or not.

There are some pointers based on which your proposal can be accepted or rejected. These are as follows:

1. Full disclosure of material facts: When buying a health insurance policy, full disclosure of material facts is mandatory. Many believe that they can get away with non-disclosure of facts, but it is not true. You have to give complete information about your disability. Whether you are suffering from a total or partial disability, you have to disclose it when buying a health insurance policy. Non-disclosure of facts is considered as fraud.

2. Restrictive clauses: Based on the scrutiny by the underwriters, the policy might be issued with some restrictive clauses. The restrictions are imposed on the scope of the coverage under the plan. These might also include the medical complications common with your disability.

3. Coverage for epilepsy: Epileptic patients can also get health insurance coverage. If you had no instances of an epilepsy attack in the last 10 years, you become eligible for coverage under health insurance. You should be on regular medications for epilepsy. You need to disclose your attack history and your current medications when applying for the health plan. Based on the information provided, the underwriters assess the medical risk and pass judgment.

Things to know about health insurance for a disabled person:

By now, you must have understood that even with a physical or medical disability, you still stand eligible for insurance coverage. The insurance companies allow health insurance for the disabled. You just need to disclose all the information to the insurer and then the proposal is accepted or rejected at the discretion of the underwriter. Depending on the disclosure of the facts, the insurers have full privileges to determine the premium amount. Just like any other insurer, an individual with either partial or complete disability can also avail tax deduction benefits with investment in health insurance plans.

There are various schemes and health insurance policy for differently-abled people offered by private insurers such as Bharti AXA. Not only are there private players, but also government-sponsored schemes such as Nirmalya and Swavlamban Health Insurance schemes are available. Check out the premium, and the amount of coverage offered and choose the plan that may help you deal with medical expenses and be financially rewarding.

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