Niramaya Health Insurance Scheme

Scheme Introduction: A Brief Overview

The Niramaya Health Insurance Scheme is a Central Government health insurance scheme designed to provide affordable healthcare support to eligible persons with disabilities. Implemented by The National Trust under the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment, the scheme provides health insurance coverage of up to ₹1 lakh per person per year. It is specifically available to persons with Autism, Cerebral Palsy, Intellectual Disability and Multiple Disabilities covered under the National Trust Act.

Niramaya is intended to reduce the financial burden of healthcare expenses by covering a range of medical needs rather than focusing only on hospitalisation. The current scheme provides coverage for hospitalisation, corrective surgeries, OPD treatment, medicines, pathology and diagnostic tests, preventive dental care, ongoing therapies, AYUSH treatment and transportation costs. The overall cover is available on a reimbursement basis only, subject to the applicable limits and terms of the scheme.

One of the important features of the Niramaya Health Insurance Scheme is that no pre-insurance medical test is required. The scheme also has no age bar, allowing eligible children as well as adults to enrol. Treatment can be taken from hospitals subject to the applicable scheme conditions, while the benefit structure is divided into different coverage heads within the overall ₹1 lakh annual limit.

To be eligible, a person must fall under one of the four disability categories covered by the National Trust and have the required disability documentation and UDID details. The current enrolment system also provides an online route for applicants, while assistance can be obtained through National Trust Registered Organisations, National Institutes and Composite Regional Centres. Eligible beneficiaries are required to complete enrolment and pay the applicable fee, where required, before the Niramaya Health Card is issued.

The scheme also provides a low-cost route for continued coverage through its annual enrolment and renewal structure. The applicable fee depends on the beneficiary category, while specified beneficiaries, including eligible persons with legal guardians other than natural parents and beneficiaries from North-Eastern States, can receive the benefit without paying the enrolment or renewal fee as per the applicable rules.

After receiving the Niramaya Health Card, beneficiaries can claim eligible medical expenses by submitting the required documents for reimbursement. Since the scheme follows a reimbursement model, keeping original medical bills, prescriptions, diagnostic reports and other supporting documents is important. Claims also need to be submitted within the prescribed time limit to avoid rejection on account of delay.

For assistance related to Niramaya enrolment, Health Card or other scheme-related matters, beneficiaries can contact the National Trust through its official support channels. The National Trust currently provides a dedicated Niramaya/Health Card support contact along with a separate helpline for claim-related assistance.

Readers looking for additional health insurance support can also explore the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (PM-JAY), a Central Government health scheme that provides eligible beneficiaries with health coverage of up to ₹5 lakh.

Scheme Benefits

The Niramaya Health Insurance Scheme helps eligible persons with disabilities manage the cost of healthcare through an annual insurance cover of up to ₹1 lakh. The scheme covers several medical expenses, including treatment, therapies and related healthcare costs, subject to the prescribed limits.

• Provides health insurance coverage of up to ₹1 lakh per beneficiary per year on a reimbursement basis.
• Covers hospitalisation and corrective surgery up to ₹55,000, OPD treatment and preventive dental care up to ₹19,000, ongoing therapies up to ₹20,000, AYUSH treatment up to ₹4,000, and transportation expenses up to ₹2,000.
• Eligible beneficiaries can enrol without a pre-insurance medical test, and the scheme has no age bar.

The coverage is divided into specific benefit categories, so reimbursement for a particular treatment is subject to the limit applicable to that category. Beneficiaries must also submit the required medical records, prescriptions, bills and other supporting documents while making a claim.

Coverage and Financial Assistance

Under the Niramaya Health Insurance Scheme, eligible beneficiaries can receive health insurance coverage of up to ₹1 lakh in a policy year. The coverage is distributed across different healthcare expenses, and each category has its own prescribed limit.

Note: The limits shown above are part of the overall ₹1 lakh annual coverage and are not separate additional payments. For example, the ₹40,000 available for corrective surgery falls within the ₹55,000 hospitalisation limit, while the ₹4,000 preventive dental limit forms part of the ₹19,000 OPD limit. Reimbursement is subject to the terms, conditions and applicable limits of the Niramaya policy.

Eligibility Requirements

The Niramaya Health Insurance Scheme is available to persons with specific disabilities covered under the National Trust Act. Applicants must meet the prescribed disability and documentation requirements before enrolment.

• The applicant must have Autism, Cerebral Palsy, Intellectual Disability or Multiple Disabilities covered under the National Trust Act.
• The applicant must have a valid disability certificate issued by the competent authority and the required UDID details.
• A UDID Card is required for enrolment. For children below 7 years, a UDID Enrolment Number along with a valid disability certificate can be used as prescribed under the scheme.
• There is no age bar for enrolment, so eligible children and adults can apply.
• There is no general income ceiling for enrolment. However, the applicable enrolment or renewal fee depends on the beneficiary category.
• Beneficiaries can enrol through eligible National Trust Registered Organisations, National Institutes and Composite Regional Centres, or use the online application facility provided by the National Trust.

Applicants should ensure that their disability and identification documents are valid and that the details entered during enrolment match the official records. The current online application process also requires UDID data-sharing consent for verification.

Required Documents

Applicants need to keep the required identification, disability and banking documents ready while applying for the Niramaya Health Insurance Scheme. The documents may vary depending on the beneficiary category and the method of application.

• Valid disability certificate issued by the competent authority.
• UDID Card or, for children below 7 years, UDID Enrolment Number along with the disability certificate, as applicable.
• BPL card or other prescribed proof of BPL status, if applying under the BPL category.
• Address proof, such as Aadhaar Card, ration card or another accepted document.
• Recent passport-size photograph of the beneficiary.
• Income certificate, wherever required for determining the applicable beneficiary category.
• Legal Guardian Certificate issued by the Local Level Committee, where the beneficiary has a legal guardian other than the natural parents.
• Bank account details, including account number and IFSC code, for receiving claim reimbursement.
• Copy of the bank passbook or cancelled cheque, as required during the application process.
• Active mobile number and email address for communication and verification.

Applicants should provide clear and valid documents and ensure that their personal, disability and bank details are correctly entered in the application. Additional documents may be requested during verification or claim processing, depending on the case.

Steps to Apply

Eligible beneficiaries can choose any of the following three routes to enrol in the Niramaya Health Insurance Scheme, depending on the support they need.

1. Through the National Trust Website

Beneficiaries who want to apply online can use the Niramaya enrolment facility provided by the National Trust. Complete the UDID consent first and then proceed with the Niramaya application.

• Open the UDID Portal and log in using the beneficiary's UDID or Enrolment Number and Date of Birth.
• After logging in, open the Give/Withdraw Consent under DPDP Act 2023 option from the account menu.
• Select Give Consent and allow the beneficiary's UDID details to be shared with the concerned government departments for the stated purpose.
• Click Submit to confirm the consent. Wait for the confirmation message showing that the consent has been updated successfully.
• Once the consent is updated, open the Niramaya Enrolment Form on the National Trust website.
• Enter the beneficiary's UDID Number and Date of Birth in the application and use the available verification option to validate the details.
• Check the beneficiary's information and complete the remaining fields in the application, including correspondence details, mobile number and bank account information.
• Provide the required supporting documents and review the application carefully. Make sure the beneficiary's personal, disability and bank details are correct before submitting the form.
• Submit the completed application and pay the applicable Niramaya enrolment fee through the available payment option.
• After submitting the application, save the Application ID or acknowledgement details. Keep these details safely, as you may need them later to check the application or access the Niramaya health e-card.

Note: For children below 7 years, the Niramaya policy allows the UDID Enrolment Number along with a Disability Certificate issued by the competent authority instead of a UDID Card.

2. Through National Institutes or Composite Regional Centres (CRCs)

If you prefer to apply with assistance, you can approach a National Institute or Composite Regional Centre (CRC) under the Department of Empowerment of Persons with Disabilities (DEPwD). These centres are located in different parts of the country and provide services to persons with disabilities.

• Visit the official list of National Institutes and CRCs maintained by DEPwD.
• Find the National Institute or CRC located nearest to you and note its address and contact number.
• Contact the centre before visiting and ask whether it provides assistance with Niramaya enrolment.
• Visit the concerned centre with the beneficiary's UDID details, disability certificate and other required documents.
• Complete the Niramaya enrolment formalities with the help of the concerned centre and pay the applicable fee.
• Keep the application or acknowledgement details provided after submission for future reference.

DEPwD currently lists National Institutes and 25 Composite Regional Centres across different states and Union Territories. The official directory provides the available address, telephone number and website details for these centres.

3. Through a National Trust Registered Organisation (RO)

• Find a suitable National Trust Registered Organisation.
• Contact the organisation and ask for Niramaya enrolment assistance.
• Carry the beneficiary's UDID details, disability certificate and other required documents.
• Provide the required information to the organisation for completing the Niramaya application.
• Check the application details before submission and pay the applicable enrolment fee.
• Keep the Application ID or acknowledgement details provided after submission.

How to Download Niramaya Health E-Card

Once the Niramaya enrolment has been completed, beneficiaries can obtain their health e-card through the National Trust's online facility. The process is simple and requires the Niramaya Application ID.

• Open the Niramaya E-Card page on the National Trust website.
• Enter the Niramaya Application ID in the field provided on the page.
• Click on the option to generate the e-card.
• After the details are verified, the Niramaya health e-card can be accessed for use and record-keeping.

Keep the Application ID safely after completing enrolment, as it is required to access the e-card through the online facility. Beneficiaries can also use the National Trust's online services to access other Niramaya-related facilities.

Niramaya Premium / Renewal Fee

Niramaya has a low annual fee structure, with different charges for fresh enrolment and renewal. The amount payable depends on the beneficiary category, while certain eligible categories are exempt from the fee.

The applicable fee is paid during the Niramaya enrolment or renewal process. Beneficiaries should check the payment category shown in the National Trust application system before making the payment, as the amount is determined according to the applicable category.

Niramaya provides coverage for a policy period subject to the scheme's applicable rules. Beneficiaries who want uninterrupted coverage should complete the renewal within the prescribed period and retain their payment details for future reference.

Note: Niramaya enrolment and renewal fees may be updated by the National Trust. Check the fee amount shown in the current Niramaya Enrolment Form before making payment.

Relevant Links

• The National Trust – Ministry of Social Justice and Empowerment
• Niramaya Health Insurance Scheme – Official Scheme Details
• Niramaya Online Enrolment / Application Form
• Niramaya Health E-Card
• Niramaya Claim Process and Claim Form Information
• Niramaya Scheme – National Trust
• Term & Conditions for Niramaya Health Insurance Scheme

Contact Information

Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment, Government of India

• Niramaya / Health Card Support Phone: 01165216007
• Claims Helpline 04068178569
• Email: [email protected]
• Address: National Trust, Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment, Government of India
• National Trust Contact Details and Helplines