On WeCapable, we have been highlighting the dismal state of health and life insurance for the persons with disabilities in India. On 02 October 2015, Government of India had launched the Swavlamban Health Insurance Scheme to provide the much-needed affordable health insurance for the persons with disabilities. However, so far the government has not release any funds for the implementation of this scheme.
The scheme was to be implemented in collaboration with the New India Assurance Company Limited. But because of the lack of support from the government, the insurance company has now stopped collecting premium from beneficiaries.
Although this scheme still remains on papers, we are presenting the the benefits of this scheme — in hope that it will be implemented soon in the future.
Features of Swavlamban Health Insurance Scheme
This scheme is designed to be an affordable and yet comprehensive health insurance cover for the persons with disabilities. Salient features of Swavlamban Health Insurance Scheme are:
- A uniform premium of Rs. 357 is to be contributed by the disabled person.
- Swavlamban Health Insurance Scheme is available only to those disabled people whose annual family income is Rs. 3,00,000 or below.
- The scheme is available for PwDs from 0 to 65 years of age.
- An annual cover of Rs. 2,00,000 will be provided to the insured person.
- The scheme will be a family floater type. This means the family members of the insured disabled person could also be covered. Please note that here family means only spouse and children. Parents and siblings can not be covered.
- Family Floater: Primary insured person will be the person with disability. She and up to three family members can be covered under the scheme.
- If the person with disability is a minor, her parents or legal guardian could also be covered.
- No medical tests will be done before taking this health insurance policy.
- For corrective therapy, OPD costs up to Rs. 10,000 per year will be covered.
- For mental illness, OPD costs up to Rs. 3000 per year will be covered.
- Pre-existing medical conditions are not excluded.
- Corrective surgeries for the existing condition can be covered with the consent of the insurer company.
- Persons with multiple disabilities, Cerebral Palsy & autism are not covered under this scheme. This could be because these people are covered by the Niramaya Health Insurance Scheme provided by the National Trust.
Premium Amount of Swavlamban Health Insurance Scheme
New India Assurance Company Limited has come up with the following premium structure:
A premium of Rs. 3,100 per year will be charged for OPD and hospitalization cover of the person with disability, spouse and up to two children.
|SUM INSURED||PERSONS COVERED||PLAN||PREMIUM|
|Rs. 2,00,000||PwD, Spouse & up to two Children||Hospitalisation and OPD||Rs. 3,100 + taxes|
Please note that Person with Disability will be charged only 10% of the premium. Rest of the amount will be provided by the government. So, effectively, person with disability will have to pay just around Rs. 357 per year.
We really hope that the Indian government begin to implement the Swavlamban Health Insurance Scheme. It is much needed and will be of great help for persons with disabilities in the low income groups.
See the full details PDF for Swavlamban Health Insurance Scheme as provided by the NIEPMD.
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