On June 15, I wrote about the insurance scheme Niramaya for disabled people. In this article, we will cover the scheme in some detail.

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Niramaya is an insurance scheme specifically designed for the special-needs people suffering from autism, cerebral palsy, mental retardation, multiple disabilities (sclerosis) and other similar diseases.

Around 85,000 people have been registered under this scheme so far. The number is very small considering the number of people who need to benefit, and this is due to low awareness about this scheme.

Benefits galore  This scheme covers existing disease without any medical check-up, and no premedical check up is required for enrolling. The scheme is unique in the sense that there is no upper or lower age limit for enrolment. Another unique feature of the scheme is that the premium charged is uniform across all ages.

The scheme covers overall medical expenses up to Rs 1 lakh within separate sub-limits, besides many other expenses which are not normally covered under regular health insurance plans like OPD treatment, regular medical check-up, corrective surgery for existing disability, etc, in addition to the regular expenses on hospitalisation. The scheme also covers expenses incurred for transportation of the patient as well as cost of alternative medicines.How to enrollNiramaya is administered by the National Trust (www.thenationaltrust.in) in collaboration with ICICI Lombard General Insurance. Applications for the scheme are accepted through registered organisations which are primarily trusts and NGOs. (The area-wise list of registered organisations and the enrolment forms are available on the   website of the National Trust). The applicant is required to submit a filled enrolment form to the trust along with proof of payment of applicable fee. Below poverty line (BPL) families are not required to pay the fee, but need to submit a copy of their BPL card. Otherwise, a copy of an income certificate from an authority competent to issue the BPL card will also do.

Enrolment can be done throughout the year, but the process of covering the patients under this scheme has two cut-off periods. People enrolled from September 1 to February 28 are covered from April 2, while those enrolled from March 1 to August 31 are covered from October 2.

The registered organisation furnishes the details to The National Trust. Details received from the NGOs are forwarded to ICICI Lombard, which in turn issues the health card, which is forwarded to the organisation through which the application had been made.

The application for renewal should be done well in advance, accompanied with payment of proof of appropriate fee. The fee is required to be directly deposited into the account of The National Trust.

Medical screening is not insisted for enrolment under the scheme. Every beneficiary is issued a smartcard once he/ she is covered, which enables him to access services in empanelled hospitals.

Premium charges  A family whose total income is less than Rs 15,000 per month needs to make a payment of Rs250 annually to cover the person inflicted.

Families having income of more than Rs15,000 per month are also eligible, but the insurance premium payable would be Rs500. For BPL families, this scheme is provided free of cost as the cost is borne by the government.

Earlier, Niramaya, like other regular health insurance plans, used to offer cashless facilities. This has been discontinued from March 11, 2010, and now only offers reimbursement facilities for expenses incurred. The cashless facility will be resumed once the deficit is covered.The writer is CFO, Apnapaisa.com, a price comparison engine for loans, insurance and investments. He can be reached at balwant.jain@apnapaisa.com