Medical Insurance for Physically and Mentally Disabled People – How to Choose a Good Plan

Posted on: Sep 8, 2021 | | Written by:

Medical Insurance for Physically and Mentally Disabled People – How to Choose a Good Plan

Suffering from any kind of physical or mental disability can make everyday life challenging and create a financial strain as well. However, considering the increasing number of differently-abled people in India, the government has taken steps to ensure that they too can avail health insurance and stay covered. However, the health plans come with certain terms and conditions, such as they cover only basic medical treatments and certain expensive procedures may not be covered. Also, people with high-risk disability may not be eligible for complete health insurance coverage. So, here is everything you need to know before selecting a medical insurance policy for a disabled individual.

Who are considered differently-abled?

People suffering from one of the following disabilities are known as differently-abled:

1. Congenital disorder or disability:

This is a condition that is present from birth. It can be either hereditary or due to certain environmental factors. Some common congenial disabilities are heart conditions, down syndrome, spina bifida and cleft lip/ palate.

People with congenital disability fall under the high-risk category and insurers offer a partial coverage for it.

2. Mental disability:

People suffering from depression, bipolar disorder, anxiety, psychiatric disorders, schizophrenia, developmental disorders such as autism, and dementia come under this category.

Like congenial disability, even mental disability is a high-risk condition. Hence, individuals with any kind of mental disability will not be eligible for complete insurance coverage.

3. Accidental disability:

When a person meets with an accident and suffers a total, partial or temporary disability, it is called accidental disability. This may include broken arms or legs, complete or partial loss of eyesight, and more.

Health insurance companies cover those with accidental disabilities. They either cover it under a regular health plan or as a standalone rider benefit.

Factors that determine a disabled individual’s eligibility for health insurance

Current state of health:

This is one of the most important things that insurance companies consider. Most insurers check the previous two months’ health status of the applicant and take a decision accordingly. Those with chronic ailments and pre-existing complications may not be eligible for a medical insurance policy.

Family income:

Insurers consider this to decide the health plan cover and premium. They may check the bank account statements of the earning family members to get a rough idea about the family income.

Ability to pay premiums:

Insurance companies also check the bank account statement of the applicant to know if they can pay the premium to keep the plan active.

Things to consider when taking a disabled-friendly health plan

1. Submission of medical reports and other documents:

If you are suffering from a disability and applying for a medical insurance policy, you will be asked to submit the latest medical reports to the insurance company. You will need to get certain medical tests done at a government-authorised hospital and submit a medical report from a registered doctor. Based on these reports, the insurer will either accept or reject your insurance application.

2. Premium amount:

If your insurance application gets accepted, the insurer will decide the premium for your policy. The premium will depend on your age and location. Many renowned insurance companies also consider the current GST terms. Hence, as per the prevailing regulations, you may have to pay a GST of 18% on your health insurance premium.

3. Tax benefits:

As per Government regulations, differently-abled people taking health insurance can avail tax deduction benefits. This applies to both partially and severely disabled people. Section 80U of the Income Tax Act states that partially disabled people can avail tax benefits of up to INR 50000, while severely disabled individuals can enjoy tax deductions of up to INR 1 lakh.

Conclusion

If you or a loved one is differently abled, talk to reputed insurance companies in your region and check if you can take a health plan. The right medical insurance policy will keep you covered against health emergencies and save you from financial setbacks. You can also opt for the best treatment without worrying about the hospital bills. What’s more, if you are availing treatment at a network hospital, you won’t have to worry about filing a reimbursement claim either.

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

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