Nirmaya Health Insurance Scheme PDF

The Nirmaya Health Insurance Scheme plays a vital role in providing health services to persons with disabilities, enabling them to live independently and fully. Through this health insurance scheme, architects of care aim to make essential health products available for people with disabilities. The Nirmaya scheme aims to achieve several key objectives:

• To provide affordable Health Insurance to persons with Autism, Cerebral Palsy, Mental Retardation & Multiple Disabilities.
• To encourage health services seeking behaviour among persons with disabilities.
• To improve the general health condition & quality of life of persons with disabilities.
• Implementation
• The entire scheme will be implemented through an Insurance company & monitored by the National Trust.

Scheme & Its Coverage

The Nirmaya scheme aims to deliver comprehensive health insurance coverage for beneficiaries, which includes:

• A single premium across all age groups.
• Equal coverage regardless of the type of disability under the National Trust Act.
• Insurance coverage up to Rs. 1.0 lakh per beneficiary.
• All persons with developmental disabilities covered under the National Trust Act are eligible, with no ‘selection’ process.
• The scheme is available nationwide, excluding Jammu & Kashmir.
• Key features of the scheme include:
• No exclusion of pre-existing conditions.
• Coverage is the same as for other individuals.
• Services range from regular medical check-ups to hospitalization, therapy, corrective surgery, and transportation.
• Conditions requiring repeated medical interventions as in-patient.
• Pre & post-hospitalization expenses, subject to limits.
• No pre-insurance medical tests are required.
• Reimbursement of claims for OPD services from any qualified medical practitioner; for IPD treatment, patients can go to any hospital across the country.

Enrollment for Beneficiaries

To enroll in the Nirmaya Health Insurance Scheme, eligible individuals should apply through the nearest organization registered with the National Trust or designated agencies. Registered organizations must submit Enrollment Form/Applications online via our MIS at www.niramayascheme.com. Upon successful enrollment and approval, individuals will be covered under the insurance policy. Applications submitted from 1st September to 28th February will be effective from April, while those from 1st March to 31st August will be effective from October.

You can download the Nirmaya Health Insurance Scheme in PDF format using the link given below.