Swavlamban Health Insurance Scheme

The Swavlamban Health Insurance Scheme is a healthcare coverage initiative designed to address the unique requirements of individuals with disabilities. Administered by the New India Assurance Company Limited under the auspices of the Ministry of Social Justice and Empowerment and the Department of Empowerment of Persons with Disabilities, it was inaugurated on October 2, 2016. Tailored exclusively for Persons with Disabilities (PwD), the scheme's objective is to enhance the overall health of PwD, thereby enhancing their quality of life.

Swavlamban Health Insurance Scheme: An overview

Objectives of Swavlamban Scheme

Given below are the key objectives basis which the scheme was initiated:

• To provide affordable medical Insurance to persons with blindness, low vision, leprosy-cured, hearing impairment, loco motor disability, mental retardation and mental illness.
• To improve the general health condition and quality of life of persons with disabilities.

Features and benefits of Swavlamban Insurance Scheme

Discussed below are the key features and benefits of Swavlamban Health Insurance Scheme:

• Uniform premium rate applicable across all age groups.
• Coverage extends to the family members of Persons with Disabilities.
• Health insurance provides coverage of up to Rs. 2 lakh per annum on a family floater basis.
• Outpatient department (OPD) coverage for corrective therapy is available up to Rs. 10,000 per annum for Persons with Disabilities, whereas for Persons with Mental Retardation and Mental Illness, OPD coverage is limited to Rs. 3,000 per annum.
• Pre-existing conditions are not excluded. However, corrective surgery for existing impairments requires prior consent from the Insurer/Third Party Administrator (TPA).
• Pre- and post-hospitalisation expenses covered, subject to predefined limits.
• No pre-insurance medical check-ups or conditions required.
• All other terms and conditions of the scheme are governed by the standard group health insurance policy.

Also check: BMI Calculator

Eligibility criteria for Swavlamban scheme

Below are the eligibility details for the Swavlamban Health Insurance Scheme:

• Age: 18 to 65 years
• Persons with blindness, low vision, leprosy-cured, hearing impairment, loco motor disability, mental retardation and mental illness, and their families.
• Families with annual income less that Rs. 3 lakh.
• Person with multiple disabilities is not eligible for this scheme.

Read more: PMJAY Registration Process Online

Application process for Swalamban Scheme

There are various means through which you can enroll for the Swavlamban Health Insurance Scheme:

• The Department of Empowerment of Persons with Disabilities will furnish the camp calendar for camps conducted by National Institutes and CRCs.
• Individuals with disabilities connected with Artificial Limbs Manufacturing Corporation (ALIMCO) & National Handicapped Finance and Development Corporation (NHFDC).
• Dissemination of publicity materials at National Institutes & CRCs and dissemination of information on the websites of the Department of Empowerment of Persons with Disabilities and affiliated institutions.

Documents required for enrolment process

To enroll, beneficiaries are required to provide the following documentation:

• Completely filled proposal form.
• Payment of premium (10% of the fixed premium).
• Self-attested income certificate.
• Any government-issued identification proof, such as Aadhar card, voter ID, driving license, etc., accompanied by one passport-size photograph.

Also read: Gram Suvidha

Claim process for Swavlamban Health Insurance Scheme

New India Assurance provides a network of hospitals offering cashless treatment for insured individuals. However, if the insured seeks treatment at a non-network hospital, approval from the Third Party Administrator (TPA) is necessary, except in cases of emergency hospitalisation where approval may be waived.

Pre-existing conditions of the insured are covered under the scheme. Similarly, if treatment is needed at a non-network hospital for such conditions, approval from the TPA is required. During the claim process, the ‘Person with Disability’ Certificate, issued in accordance with the Persons with Disability Act, 1995, must be submitted along with the claim to the TPA.

Securing health insurance for disabled individuals in India can pose significant challenges, particularly for those with multiple disabilities or severe impairments affecting extensive areas of the body.

Nevertheless, as mentioned, government schemes and numerous individual plans from insurance providers like ours are available to address the ongoing expenses arising from medical treatments for your disabilities.