Health Insurance for the Differently-Abled in India

Posted on: Mar 25, 2022 | 3 Min | Written by: HDFC ERGO Team

Health Insurance for the Differently-Abled in India

While society is doing everything possible to promote an inclusive and accessible world for the differently-abled, we have a long way to go. Many people with disabilities continue to struggle to get decent jobs and be financially stable. Which means, emergencies, especially those that are medical in nature, often leave them destitute. But the good news is that buying a mediclaim policy can help in such situations. Read on to know more.

Who are Persons with Disabilities?

Any kind of disability - physical or mental – can make one’s daily life challenging. People with disabilities are those who suffer from physical, mental, sensory or intellectual impairment, due to which it is difficult for them to do certain activities and live a normal life. The disabilities hinder their full and effective interaction and participation in society. These disabilities are long-term as well.

Now, a disability can be present from birth, such as Down syndrome, or can be associated with developmental conditions which show up during childhood, such as autism, or accidental disability, such as brain injury, or a prolonged health condition like diabetes causing disability or nerve damage, loss of vision. Disability can also be progressive, such as muscular dystrophy, static, like loss of limb, or intermittent disability, like multiple sclerosis.

Which Disabilities are Covered by Health Insurance Plans in India?

All disabilities recognised under The Rights of Persons with Disability Act 2016 are covered by health insurance policies in India. These disabilities are divided into two categories, as explained below:

Category 1	Category 2
Intellectual disabilities	Muscular dystrophy
Certain learning disabilities	Multiple sclerosis
Mental disorders	Chronic neurological disorders
Low Vision	Cerebral Palsy
Hearing impairment issues	Sickle cell disorder
Disabilities with speech and language	Parkinson’s disease
Autism spectrum disorder	Thalassemia
People cured of leprosy	Other disabilities like deafness
Dwarfism	Disabilities with locomotor skills
Victims of acid attacks	Haemophilia
Blindness

Who Can Buy Health Insurance for Handicapped?

Health Insurance for disabled persons can be bought by:

• People with at least one disability from the list mentioned above.

• People with at least 40% of the disability mentioned under the Act for a policy with a sum insured of Rs. 4 or Rs. 5 lakhs.

• People with a valid certificate to prove their disability and become eligible for insurance benefits.

Inclusions of Health Insurance for Handicapped

Whether you buy individual health insurance plans or a family health insurance plan for disabled persons, it will provide coverage for the following:

• Medical expenses related to pre-hospitalisation

• In-patient hospitalisation

• Medical expenses related to post-hospitalisation

• Treatments for cataract

• Modern and Ayush treatments

• Day-care medical expenses

• In-patient dental treatments, provided the issue is due to an injury or illness

• Plastic surgeries, if done due to an injury or illness

• Ground ambulance charges in cases of emergencies

Exclusions of Health Insurance for Handicapped

Health insurance for disabled persons does not provide coverage for the following:

• Cosmetic or reconstructive surgeries

• Out-patient treatments and consultation

• Expenses on buying dietary supplements and other substances

• Stem cell storage

• Implantation of any device (internally or externally) or use of prosthetics

• Expenses for consumables

• Treatments not supported by any proof

• Rehabilitation expenses

• Expenses for treatments taken on foreign soil

Health Insurance – A Financial Safety Cushion for the Differently-Abled

The differently-abled are at risk of other health issues too. Which is why, with healthcare costs increasing by the day, a mediclaim policy can save them from financial strains. It is the financial safety net in case of a medical emergency. However, health plans have certain terms and conditions. All disabilities may not be covered, certain expensive treatments may not get coverage, and only basic medical treatments might be included. So, before selecting a mediclaim policy for a differently-abled person, it is necessary to check the coverage, benefits, exclusions and other terms and conditions.

After selecting the policy and submitting the relevant details, the plan will be issued based on the degree of disability.

Government Benefits for the Differently-abled

The central government runs welfare schemes that people with disabilities can benefit from. The two well-known schemes are:

Swavlamban Health Insurance Scheme:

It is a group health insurance or family floater policy. It covers the individual or family up to a sum of INR 2 lakhs for certain specified disabilities.

Niramaya Health Insurance Scheme:

It offers health insurance cover up to INR 1 lakh, helping people to get medical treatment without stressing over finances.

Also, Section 80u and Section 80dd of the Income Tax Act provide tax rebate to individuals if either they themselves or any of their family members suffer from certain disabilities, respectively. The tax benefits vary according to the severity of the disability.

Conclusion

Every day, technological advancements are helping people with disabilities to lead normal lives. Similarly, public places and workspaces are being designed keeping their accessibility factor in mind. However, a lot still needs to be done. It is a good idea to work towards that end by buying a mediclaim policy for someone who is differently abled but wishes to live a stress-free life.

FAQs

1. Is it possible for disabled persons to buy health insurance?

Yes, it is possible if disabled persons have a valid certificate to prove their condition. Their disability must belong to at least one of the categories listed under The Rights of Persons with Disabilities Act, 2016.

2. Does health insurance provide coverage for permanent disability?

Yes, coverage is available for permanent disability when you buy health insurance.

3. Can I get my disabled child covered under health insurance?

Yes, you can buy health insurance for your disabled child, provided your child’s disability is listed under The Rights of Persons with Disabilities Act, 2016.

4. Does health insurance cover pre-existing disabilities as well?

Health insurance plans for disabled people cover pre-existing disabilities after a 2-year waiting period.

5. Are there any co-payment terms associated with health insurance for disabled people?

Yes, a co-payment of 20% on all claims is mandatory when buying health insurance for disabled people.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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