Niramaya Insurance Scheme

What Is the Niramaya Scheme?

The Niramaya Health Insurance Scheme provides affordable health insurance to eligible people with disabilities covered under the National Trust Act. It is administered by the National Trust, a statutory body established to support the rights, welfare, and inclusion of people with autism, cerebral palsy, intellectual disabilities, and multiple disabilities.

The scheme aims to help eligible beneficiaries access healthcare and related services without having to bear all the expenses themselves. It provides coverage of up to ₹1 lakh, subject to the scheme’s benefit limits and conditions.

One important feature of Niramaya is that beneficiaries can seek treatment from healthcare providers across India, subject to the scheme’s requirements. The scheme does not require pre-insurance medical tests.

However, Niramaya is a reimbursement-based scheme. Families generally pay for eligible treatment first and then submit a claim with the required documents. It is important to understand the benefit limits and claim requirements before arranging treatment.

Benefits and Coverage Under the Niramaya Scheme

The Niramaya Health Insurance Scheme covers several types of eligible medical expenses. The overall coverage is up to ₹1 lakh per beneficiary, but individual services have separate limits.

The current published benefit chart includes the following categories:

• Hospitalisation and corrective surgery: Eligible hospitalisation and corrective surgeries for existing disabilities, including congenital disabilities, subject to the applicable limits.
• Outpatient treatment: Eligible medical consultations, medicines, pathology tests, and diagnostic investigations.
• Dental care: Certain preventive dental services.
• Ongoing therapies: Eligible therapies intended to reduce the impact of disability or related complications.
• Alternative medicine: Eligible treatment under recognised alternative systems covered by the scheme.
• Transportation: Eligible transportation expenses, within the prescribed limit.

The official benefit chart lists separate limits for these categories. These limits can change, so families should check the latest version before making financial decisions.

Niramaya does not mean that every medical expense will automatically be reimbursed. Treatment must fall within the scheme’s covered categories and comply with the applicable documentation and claim requirements.

Who Can Apply for the Niramaya Scheme?

• All persons with developmental disabilities are eligible and included. There is no ‘selection’ criteria.
• All the disabled persons who have at least one of the disabilities under the National Trust Act, 1999 with valid disability certificates.
• The Niramaya scheme is available in the entire country except J&K.

Whom Should You Approach?

National Trust of India

Enrolment to this insurance scheme can be made through registered organizations, as provided on the link: https://thenationaltrust.gov.in/content/registered_organization.php 

For more details, please visit the website – https://nationaltrust.nic.in/

How to Apply for the Niramaya Scheme

For first time applicants (fresh enrollment) for Niramaya Scheme, please follow these steps:

1. Step 1: A form is provided on the website : https://thenationaltrust.gov.in/auth/Niramaya/HTML/new4.php
2. Step 2: Filled details have to be submitted by eligible applicants to the nearest organization registered with the National Trust
3. Step 3: There will be a nominal processing fee as determined from time to time which shall be payable to the National Trust.
4. Step 4: On successful enrolment and approval, Health ID No. / card will be issued to each beneficiary and then can print Ecard through the website.
5. Step 5: Both the fresh enrolment and renewal will be from the enrolment date with the Insurance Company to the end of the financial year.
6. Step 6: Any beneficiary enrolled during any month of the financial year will be covered up to 31st March.
7. Step 7: The enrolment / renewal fee will be full and will be eligible to claim up to Rs.1 lakh. Fresh enrolment may be done throughout the year through our registered organizations.

Renewals

1. Step 1: The policy can be renewed online by logging on to the Niramaya website through providing below details: Policy Period, Beneficiary ID, UDID No/Enrollment no, Date of birth.
2. Step 2: Fee has to be paid as per the rate (fixed by National trust)

• Fee can be paid by by DD/ NEFT or cash only (not by Cheque) in National Trust (Niramaya) account either
• Fees can be paid at any Branch of Corporation Bank or State Bank of India.

1. Step 3: The details of banks are given on the website – https://thenationaltrust.gov.in/auth/Niramaya/HTML/pay2nt.php

Claims Process

1. Niramaya Insurance does not have a cashless policy
2. Claim Form for settlement has to be submitted in the Claim Form along with relevant vouchers / bills, etc. within 30 days of treatment or discharge from hospital.
3. The claim form can be downloaded from the website and sent to the Third Party Administrator, authorized by the Insurance Company.
4. In the claims form, all the fields must be filled and enclose the following documents :
   1. Copy of Niramaya card or mention Health ID No.
   2. Attested copy of Disability Certificate.
   3. All original prescription papers given by the doctor.
   4. All original bills of Hospital / Medicine / Doctor fee / Therapy fee / Conveyance etc., should be self-attested.
   5. All reports in Original.
   6. Complete bank details of Beneficiary :Account No. / Bank Name / Branch / IFSC Code / Name of Account Holder.

Important Tip : Please update your mobile number on the website of the National Trust by clicking on link Mobile No., to get updated information about NIRAMAYA on a regular basis.

The Insurance Company for the period 2015-16, is The Oriental Insurance Co. Ltd., DO -20, N-39, Bombay Life Building, Connaught Circle, New Delhi- 110001; and Third Party Administrator (TPA) is Raksha TPA Pvt. Ltd,

Claim Form may kindly be sent to the Regional Centres of Raksha TPA Pvt. Ltd. (as provided on the website- https://nationaltrust.nic.in/how-to-claim/ The Nirmaya Website provides contact details for the Third Party Administrator (TPA)- https://nationaltrust.nic.in/how-to-claim/ If you’re seeking more information and guidance on this topic and related areas, Nayi Disha’s Know Your Rights (KYR) Program is here to support you every step of the way. By joining, you’ll gain access to valuable resources on government schemes, benefits, financial support, legal rights, and more, all aimed at securing a brighter future for your child. To learn more, visit our chatbot by clicking this link: https://bit.ly/4dJVCP3, or simply type ‘KYR’ on our helpline number 844-844-8996.

If you have questions about Autism, Down Syndrome, ADHD, or other intellectual disabilities, or have concerns about developmental delays in a child, the Nayi Disha team is here to help. For any questions or queries, please contact our FREE Helpline at 844-844-8996. You can call or WhatsApp us. Our counsellors speak different languages, including English, Hindi, Malayalam, Gujarati, Marathi, Telugu, and Bengali.

Conclusion

The Niramaya Health Insurance Scheme can help eligible people with autism, cerebral palsy, intellectual disabilities, and multiple disabilities access financial support for certain healthcare expenses. Its coverage includes several types of treatment and services, up to the scheme’s overall limit of ₹1 lakh.

Families should confirm eligibility, keep disability and Health ID documents ready, understand the reimbursement process, and check current premium and renewal requirements before applying. For the most reliable information, refer to the official National Trust website or contact an authorised organisation for enrolment support.

Frequently Asked Questions

What is the Niramaya Health Insurance Scheme?

Niramaya is a health insurance scheme administered by the National Trust for eligible people with autism, cerebral palsy, intellectual disabilities, and multiple disabilities covered under the National Trust Act. It offers up to ₹1 lakh in coverage for eligible medical expenses, subject to the scheme’s benefit limits and conditions.

How can I claim Niramaya insurance?

Niramaya claims are processed through reimbursement. Keep the Health ID or card details, disability certificate, prescriptions, medical reports, original bills, and other required documents. Follow the current instructions on the National Trust’s official How to Claim page to submit or track a claim.

What is the premium for the Niramaya Health Insurance Scheme?

The scheme has an enrolment or renewal fee, but families should confirm the current amount through the National Trust or an authorised enrolment organisation. Older government documents contain historical fee tables that may not reflect the current applicable fee.

How can I check my Niramaya health insurance status?

For claim status, follow the tracking instructions on the National Trust’s official How to Claim page or contact MediAssist using the current listed contact details. For enrolment or renewal status, contact the organisation through which you applied or the National Trust’s Health Card support team.

Is Niramaya suitable for people with autism?

Yes. Eligible people with autism are among the intended beneficiaries of the Niramaya scheme. It may help with eligible medical consultations, diagnostic tests, therapies, hospitalisation, and other covered expenses. Benefits depend on enrolment eligibility, the benefit chart, and the current scheme conditions.