Just like you and everybody else, there are some people with a disability or let's say different abilities who also need health care access when needed. Being totally fit and healthy we have made health insurance a necessity so there is no denial that disabled people need more health coverage than any other.
But unfortunately, not each and every health insurance company has designed specific health insurance for such people so that they can stay active, hopeful and most importantly feel like part of the society. Unlike normal people, they have limited access to money and future stability thus, access to health care in an emergency would be more challenging for differently abled people.
As per the 2011 Census reports, there are more than 26.8 million people who are differently abled and struggling with different challenges and there are only a few companies in India coming in the front to support these individuals. In order to support people with disabilities, India Govt. has launched several policies but they only cover basic treatment and issues. If you are one of the differently abled or a friend or family member of yours is in need, then you need to know everything about a health plan for such people.
Who Are Differently Abled?
As per the medical definitions people struggling from the following physical or health condition are considered under disabled people:
Mental disability just like its name means to a person having a mental illness or disorder. It refers to the illness of the person's thoughtfulness, actions, speech, or behavior. People suffering from mental diseases like schizophrenia, autism, and Asperger’s syndrome are included under mentally disabled individuals.
People with such issues are included under the high-risk category so they are not considered eligible for a complete health plan which is an unfortunate thing for the society.
This is a set of disabilities present with the patient from birth. Probes such as Down syndrome, cleft palate or lip, Cerebral palsy, and spina bifida are among the types of congenital disability which are commonly known around the world. Most of the health insurance policies in India have excluded congenital disability from their health coverage plans.
Just like the name refers these conditions have occurred when a person becomes paralyzed or incapable due to an accident. For instance, a person lost his or her hands or legs in an accident is called permanently totally disabled. People with damaged or broken parts are also included under accidental disability. Most of the health insurance companies have made it easy for such people to get insurance like other normal applicants. But there a few companies who still demand an extra fee to avail good coverage.
While there are some companies offering support with health insurance plans for disabled people. The government also offers a few health plans for handicaps which is a big relief to them. Let's start with the
Government Health Insurance Policies for Disabled
Niramaya Health Insurance - To provide affordable Health Insurance and encourage people with disabilities such as Autism, Cerebral Palsy, Mental Retardation & Multiple Disabilities, Niramaya Health Insurance offers health care facilities to differently abled individuals in India.
Under this policy, a policyholder can avail coverage of up to Rs. 1 lakh with the benefit of both pre and post hospitalization expenses acquired in the medical treatment.
The premium paid upon this policy changes. If a family earns less than Rs. 15,000n then they are qualified to pay only Rs. 250 as the set premium payout. Or if the family's monthly income is above Rs 15,000, then the premium would be Rs 500.
Swavlamban Health Insurance - Swavlamban Health insurance the second health policy for disabled people ruled by the Indian government. This health plan is designed especially for the PwDs in a low-income group and gives them a comprehensive health plan with amazing health benefits. To avail, the policy benefits the family income of the person should be Rs. 30000 or below.
Remarkable Features of Swavlamban Health Insurance Plan are
- A premium of Rs. 357 is to be provided by the disabled person.
- The plan is prepared for PwDs from 0 to 65 years of age.
- Yearly protection of Rs. 2,00,000 will be given to the insured person.
- The scheme will be a family floater type. (Parents and siblings cannot be covered).
- If the insured with a disability is a minor, her or his parents or legal guardian are also covered under the plan.
- No medical tests are required and pre-existing disease is not excluded.
- For corrective treatment, OPD up to Rs. 10,000 will be covered.
- For mental disability, OPD costs up to Rs. 3000 per year will be included.
- Pre-existing medical conditions are not excluded.
- People with multiple disabilities are not covered under this scheme. As they are included with the Niramaya Health Insurance Scheme already.
LIC’s Jeevan Bharati-I – This an exclusively designed plan special for the women. It also provides protection for accidental injuries, Critical Illness, and Congenital Disability Benefit as optional Riders 1.
- The policyholder can avail the survival benefit any time on or after its due date.
- The mode of premium pay is only annually under this plan. However, the policyholder can easily spend the following yearly premium in advance in installments.
- The policyholder has the option to get the maturity returns in the form of an annuity.
- After two years of the premiums paid, whenever a premium payment is stopped, the life protection for full sum assured will proceed for 3 years from the scheduled date of first due premium.
- Death benefit after deducting outstanding premiums, with interest is payable
NOTE: There are many private health insurance companies in India who cover personal accident and physical disabilities with a personal accident cover plan or riders on basic health plans. But they may not cover mental or congenital illnesses.
Eligibility Factors Of Health Insurance for Differently Abled
1) Financial Status and Background - Another major point that affects the eligibility of a policy is the financial status of the family of the insured. The overall income of the family should be covering the criteria so that the company can issue the health plan.
The insurance company gives an appropriate plan for a person based on family income. In addition to this, the premium is chosen on the basis of earning in many cases.
2) Health Status: This is the primary element an insurance company will take into account while offering a health insurance plan to a person with disabilities or special abilities. There is a two month time period decided to evaluate the risks related to the health and the eligibility is largely affected by the criticality of the illness and health reports.
3) Source of Income/ Income - No insurance policy can be assigned without getting the premium amount before the due date especially for private insurance companies. The insurer will evaluate the bank statements and account to understand whether the applicant can pay the premiums on time or not. However, the premiums of Govt. health plans for disabled people are designed with a very low premium so that each of them can enjoy health coverage when needed.
Things to keep in mind
While buying a health insurance plan for differently abled people, it is important to keep a few things in mind for an appropriate purchase.
Tax Benefits - Under section 80U and 80DD of the income tax act 1961, persons with disabilities are covered for tax benefits on the health insurance plans. A person with 40% to 79% disability will be eligible for a tax deduction of RS. 50000 and a person above that limit would be allowed a tax deduction of RS. 100000. Under section 80D all the family members of the disabled person can also claim a tax deduction only when the dependent's disability is 40% to 79%, the supporting family member will get tax deductions of Rs 50,000 on the health insurance covering the disabled. For disabilities greater than 80%, deductions of Rs 1,00,000 is available.
Documents Required - Whether for private health insurance companies or governmental health policies for disabled, you will be required to submit documents to complete the process and verify that the information you have provided is true. Though the documents vary from company to company the most common documents are:
- Doctor's report regarding your disability and its percentage
- Present medical report
- Income proof
On the security of your medical documents, the insurer will confirm or reject your application for insurance coverage.
High-Risk Covers - Like every other normal candidate, the disabled person also needs to present the grounds for opting a high-risk health cover plan. The main reason for anyone preferring a high-risk health cover plan is to guarantee the safety of their dependent members in case of an unfortunate occurrence. If the reason is found valid you may get the benefits of a high-risk health plan for disabled individuals.
Leave Your Health Policy When You Reach Retirement Age
If you are 65 or more than that, there's no point in spending on disability health insurance. For instance, if your doctor diagnoses you as disabled at age 67, you will be viewed retired and the coverage will not be paid by the insurance company. So, you reach the retirement age, it is better to leave the policy and go to an alternative option.
Compare - Though disabled people in India do not have as many options for health policies as in the other countries still, you can use the comparison platforms to make the right decision. Ask the agent whether there is any specific insurance policy that would be helpful for you and your family.
Now that you know how to find the right health insurance for a differently abled person, you can choose any of the private or governmental plans. However, more insurance companies should come to support the disabled people and treat them like the normal policy seekers looking for financial stability especially when they need it more than anyone else.