Health Insurance for Differently-Abled : Types, Factors and Schemes
It’s inspiring to hear stories of differently-abled people beating all the odds and finding their way to success. Their perspective towards life and the will to scale new heights is something we all should aim for.
People with disabilities need quality healthcare, maybe more than anyone else. Recognising the challenges differently-abled people face, insurance policy providers have come up with comprehensive insurance plans that cover any kind of expenses that may arise from medical treatment.
Types of Disability Considered in Health Insurance Policies
Generally, individuals suffering from the following conditions are considered to be specially abled:
1. Congenital Disability
A person is born with this type of disability. Some of the congenital disorders include cystic fibrosis, cerebral palsy, heart conditions, and more.
2. Accidental Disability
This condition arises due to an accident. Individuals with impaired or broken limbs fall under the accidental disability. Furthermore, partial or complete blindness caused due to an accident also falls under this disability.
3. Mental Disability
Disabilities related to mental disorders or illnesses are referred to as mental disabilities. For instance, people with behavioural distress, psychiatric disorder, or mental impairment are covered under this category.
Note that congenital and mental disabilities fall under the high-risk category. Therefore, individuals with these conditions are not eligible for complete coverage under a critical illness insurance policy.
Nevertheless, one with an accidental disability can get coverage under health insurance plans. Policyholders can get this benefit either as a part of their policy or as a standalone rider*.
Note: A rider is an insurance policy provision that amends or adds features to the terms and conditions of a base insurance policy.
Factors Determining Disability Health Insurance Policy Eligibility
Here are some of the factors that determine the eligibility requirement for a disabled person’s health insurance plan.
1. Current Health Condition
Insurance providers will check the health status of a specially-abled person for the last two months before offering him or her coverage benefits. In case an individual is suffering from chronic illness at the time of policy issuance, the chances are that an insurer might reject the application for the same.
2. Family Income
Based on the household’s entire income, an insurer will issue an appropriate plan to an individual. Moreover, a policyholder’s family income also determines the eligible premium amount.
3. Premium Paying Capacity
To determine the premium paying capacity, an insurer will check the interested individual’s bank account statement details.
Disability Health Insurance Schemes in India
Take a look at the health insurance schemes for specially-abled individuals in India.
| Health schemes | Features |
| Navi Health Insurance | Offers insurance cover ranging from Rs. 2 lakh to Rs. 1 crore. Covers more than 20 health benefits. Provides affordable EMI option, starting from Rs. 240 per month. 100% paperless and hassle-free process. Cashless claims in 20 minutes. |
| Niramaya Health Insurance Scheme | Offers an insured sum of Rs. 1 lakh to individuals with a disability. Comes with a flexible coverage period.A processing fee of Rs. 250 for disabled persons below the poverty line and Rs. 500 for other individuals with a disability. This scheme offers coverage for multiple disabilities, cerebral palsy, autism, and mental retardation. |
| Swavalamban Health Insurance Scheme | It provides a high insured sum of Rs. 2 lakh to a specially-abled individual whose family income is less than Rs. 3 lakh per year.90% subsidised premium available. Offers coverage for AYUSH care, Siddha, Unani, and Ayurveda. |
Things to Consider While Buying Disability Health Insurance Policy
While settling for a health insurance policy, a specially-abled individual must consider the following factors:
1. Documentation
Whether a disabled individual buys a government-sponsored health scheme or a health insurance policy from a private insurer, presenting a medical report is mandatory.
He/she needs to get valid medical tests from an authorised hospital and collect medical reports after consultation with a registered doctor to furnish this document. Depending on the medical report, an insurer will approve or reject the insurance coverage plea.
2. Tax Benefits
Under the Income Tax Act, one can avail of tax deductions on a health insurance scheme. A partially or severely disabled person is eligible to receive tax benefits on his or her disability health insurance policy.
Under Section 80U, a partially disabled individual can avail of tax deductions up to Rs. 75,000. In contrast, a severely disabled person can qualify for a maximum of Rs. 1.25 lakh tax deduction.
3. Premium Pay-out
Before opting for a health insurance policy, a specially-abled person can select the amount of premium he wants to pay. Insurance providers across India charge a premium amount based on GST terms, age of a disabled individual, and location. As per the GST regime, there is 18% GST on health insurance policies.
For a comprehensive health insurance policy, you can download the Navi app and get cashless claims from over 10,000 network hospitals across 400+ locations in India. With Navi, you can get a Claim Settlement Ratio of 97% for cashless claims.
Final Word
Insurers tend to offer customised options and a huge sum of insured amounts to make the premium more manageable. However, disability cover may vary from plan to plan and will also depend on the nature of the disability. It is always safe to disclose these conditions to the insurance company and let them decide. In most cases, they would cover.
In addition, one can avail of tax benefits on their disability insurance plan. Nevertheless, skimming through the aforementioned guide aids in choosing an appropriate health insurance policy for disabled individuals.
FAQs
Ans: Individuals with a congenital disability can opt for high-risk covers after providing sufficient reasons for choosing such a plan.
Ans: The eligible age for purchasing a health insurance policy for specially-abled individuals varies across insurance providers in India. For instance, Navi insurance provider offers health insurance schemes to individuals between the age of 25 and 40 years.
Ans: Yes, disabled policyholders can purchase add-ons on their existing health policy by paying an additional amount on top of the premium.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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