Access to quality healthcare is essential for everyone, but for individuals with disabilities, it becomes even more important. Health insurance for handicapped individuals in India is designed to cover medical expenses related to disabilities, ensuring financial support for treatments, hospital stays, and rehabilitation. However, finding the right insurance plan can be challenging, as many policies offer limited coverage or exclude pre-existing conditions.
Despite these numbers, access to healthcare remains a major challenge. Many insurance policies in India provide only partial coverage for disabilities, often excluding essential treatments or long-term rehabilitation. This leaves individuals and families with significant out-of-pocket expenses, making it harder to afford the necessary medical care.
In this article, we’ll explore some of the best health insurance plans available in India for individuals with disabilities. Let’s get started.
Divyangjan Health Insurance Schemes Launched by the Indian Government
| Features | Niramaya Health Insurance Scheme | Swavlamban Health Insurance Scheme |
|---|---|---|
| Eligibility | Mandatory enrollment with The National Trust | Family income has to be less than INR 3 Lakhs/annum. |
| Mandatory Documents Required | Disability certificate, identity proof, and recent photograph | Disability certificate, identity proof, and recent photograph |
| Number of Disabilities Covered | Autism, Cerebral Palsy, Mental Retardation, and Multiple Disabilities | All disabilities as defined under the Persons with Disabilities Act, 1995 |
| Coverage Scope | Comprehensive coverage including hospitalization, therapy, corrective surgeries, and transportation | Hospitalization expenses, including pre and post-hospitalization |
| Instant Cover | Coverage begins from the policy start date; no pre-insurance medical tests required | Coverage begins after a 30-day waiting period from policy inception |
| Coverage for Complications | Includes coverage for conditions requiring repetitive medical intervention | Covers complications arising from pre-existing conditions after a waiting period |
| Cashless Facility/Network Hospitals | Treatment can be availed at any hospital with no mandatory pre-insurance medical tests | Cashless treatment available at empaneled hospitals |
| Pre/Post Hospitalization | Covered, subject to policy limits | Pre-hospitalization: 30 days; Post-hospitalization: 60 days |
| Premium Range | Nominal fee of ₹250 for the person with a disability in the BPL (Below Poverty Line) category and ₹500 for people in the non-BPL category |
Rs. 3,100 p.a (only 10% will be collected from the insured & 90% by the Indian government) |
| Coverage for OPD/Medication |
Hospitalization expenses limit: Rs. 70,000 OPD expenses limit: 14,500 Ongoing therapy complications: Rs. 10.000 Alternative Medicine Limit: Rs. 4,500 Transportation costs: Rs. 1,000 |
OPD cover of Rs. 3000 will be provided as part of the health insurance for the mentally disabled. Coverage is available for the disabled person, spouse, and two children. |
| Inclusions | Hospitalization, therapies, corrective surgeries, transportation, pre-existing conditions | Hospitalization expenses, pre and post-hospitalization, pre-existing conditions after waiting period |
| Exclusions | Cosmetic surgeries, injuries due to hazardous activities, alternative treatments | Cosmetic treatments, non-allopathic treatments, injuries due to self-harm |
| Waiting Period | No waiting period for policy coverage | 30-day initial waiting period; specific waiting periods for pre-existing conditions |
| Pre-existing Diseases Coverage | Covered from day one without any waiting period | Covered after a specified waiting period |
| Unique Benefits | No pre-insurance medical tests; same premium across all ages; coverage for a wide range of therapies and interventions | Provides coverage for Siddha, Ayurveda, AYUSH (homeopathy) care, and Unan |
| Sum Insured (in ₹) | Up to ₹1 lakh per beneficiary | Up to ₹2 lakh for the beneficiary and family members |
| Entry Age | No age limits; All ages eligible | 18 - 65 years |
| Policy Type | Individual | Family floater, covering PwD, spouse, and up to two children |
| Policy Tenure | Period of coverage is provided till the end of the financial year, i.e. till March 31st. | Period of coverage is provided for 12 months from the issue date of the policy |
Top Health Insurance for Handicapped in India by Insurance Companies
| Features | HDFC ERGO EquiCover Health Plan | SBI Divyanga Suraksha | Special Care Gold by Star Health And Allied Insurance |
|---|---|---|---|
| Claim Settlement % |
98.5%* Claims Settled FY 23-24 |
98%* Claims Settled FY 23-24 |
Not specified |
| Eligibility | Covering Persons with Disability as per The Rights of Persons with Disabilities Act, 2016 and The Mental Healthcare Act,2017. Or Individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. | Persons who have at least one of the disabilities as defined under Specified Disability under The Rights of Persons with Disabilities Act, 2016 with valid disability certificate are eligible to buy this policy. |
person with 40% or more of a specified disability as per, The Rights of Persons with Disabilities Act, 2016 Or / and for individuals with HIV/AIDS as defined under the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017. |
| Mandatory Documents Required | Disability certificate issued by a competent authority. | Disability certificate issued by a competent authority. | |
| Number of Disabilities Covered | 21 specified disabilities. | 21 specified disabilities. | 21 specified disabilities. |
| Coverage Scope | In-Patient Care, Pre and Post-Hospitalization, AYUSH Treatment, Ambulance Charges. | In-Patient Care, Pre and Post-Hospitalization, AYUSH Treatment, Ambulance Charges. | In-Patient Care, Pre and Post-Hospitalization, AYUSH Treatment, Ambulance Charges. |
| Cashless Facility/Network Hospitals | 12000+ | 16,000+ | 14,000+ |
| Pre/Post Hospitalization | Pre-Hospitalization: 30 days; Post-Hospitalization: 60 days. | Pre-Hospitalization: 30 days; Post-Hospitalization: 60 days. | Pre-Hospitalization: 30 days; Post-Hospitalization: 60 days. |
| Coverage for OPD/Medication | Yes covered | Yes covered | Yes covered |
| Waiting Period | 30 days for all illnesses (not applicable for accidents). | 30 days for all illnesses (not applicable for accidents). | Initial waiting period of 30 days for all illnesses (not applicable for accidents or on renewals) |
| Pre-existing Disability Coverage |
24 months for pre-existing disability/ 36 months for all pre-existing conditions other than HIV/AIDS and Disability(as mentioned in Policy Schedule) |
24 months for pre-existing disability/ 48 months for all pre-existing conditions other than HIV/AIDS and Disability (as mentioned in Policy Schedule) | 24 months for pre-existing disability/ 36 months for all pre-existing conditions other than HIV/AIDS and Disability (as mentioned in Policy Schedule) |
| Unique Benefits |
Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines are covered up to 100% of sum insured, during each policy year as specified in the policy schedule |
Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during each Policy Year up to 50% of sum insured as specified in the policy schedule in any AYUSH Hospital. | Expenses incurred for inpatient care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines are covered up to 100% of the Sum Insured. |
| Is Portability Available | Yes. | Yes. | |
| Sum Insured (in ₹) | INR 4Lac & 5Lac | 4 lacs and 5 lacs | 4 lacs and 5 lacs |
| Entry Age |
For Adult : 18 to 65 years For Child : New born to 17 years |
Age eligibility for adults: 18 years to 65 years Age eligibility for Children: Newborn to 17 years |
For Adults – Minimum - 18 years & Maximum - Up to 65 years For Dependent Children – Newborn to 17 years |
| Policy Type (Individual, Family Floater) | Individual | Individual and Family Floater. | Individual. |
| Policy Tenure | 1 year. | 1 year. | 1 year. |
* Please read the disclaimer at the end of this page before purchasing this policy.
Our Top 3 Recommended Health Insurance for Handicapped
HDFC ERGO EquiCover Health is a specialised health insurance plan designed to provide financial protection for individuals with disabilities. Recognising the healthcare challenges faced by persons with disabilities, this policy covers medical expenses related to hospitalisation, surgeries, and modern treatments. It also extends support for pre- and post-hospitalisation costs, alternative treatments, and emergency ambulance services. With no upper age limit for renewal, this plan ensures long-term coverage, making it a reliable choice for individuals needing continuous medical care.
Covers hospitalisation for people with disabilities as per the Rights of Persons with Disabilities Act, 2016-this includes conditions like cerebral palsy, autism, muscular dystrophy, and more.
Pre- and post-hospitalisation expenses covered-it pays for medical costs 30 days before hospitalisation and 60 days after discharge.
If you prefer AYUSH treatments (Ayurveda, Homeopathy, Naturopathy, etc.), those are covered too, up to 100% of the sum insured.
No restrictions on renewal age, so you don’t have to worry about losing coverage as you get older.
Covers modern treatments like robotic surgery, deep brain stimulation, and stem cell therapy-something many policies don’t include.
Covers cataract treatment (up to ₹40,000 per eye).
You’ll have to pay 20% of the claim amount unless you opt for a higher premium to remove this co-payment clause.
If you’re looking for instant coverage, keep in mind there’s a waiting period of 24 months for pre-existing disabilities (36 months for other pre-existing conditions).
The sum insured is either ₹4 lakh or ₹5 lakh, which might not be enough if someone needs long-term intensive care.
No cashless OPD or therapy coverage—you’ll have to pay out of pocket for things like regular therapy sessions.
Niramaya Health Insurance Scheme (Government-Backed)
The Niramaya Health Insurance Scheme, launched by The National Trust under the Ministry of Social Justice & Empowerment, aims to make healthcare accessible and affordable for individuals with autism, cerebral palsy, mental retardation, and multiple disabilities. This government-backed scheme offers a flat premium rate across all age groups and provides coverage for hospitalisation, corrective surgeries, therapies, and alternative treatments. By eliminating the need for pre-insurance medical tests and offering nationwide coverage, Niramaya ensures that individuals with disabilities receive essential medical care without financial burden.
Why It Stands Out
No pre-insurance medical test required, making enrollment easier.
Covers hospitalisation expenses up to ₹70,000, including corrective surgeries.
Covers ongoing therapies like physiotherapy, speech therapy, and occupational therapy (₹10,000 per year).
Covers regular OPD consultations, medicines, and diagnostic tests (₹8,000 per year).
Alternative medicine treatments (₹4,500 per year) are also covered.
Works across India (except Jammu & Kashmir), making it accessible for most people.
Covers transportation costs (₹1,000 per year), which can help if travel is needed for medical care.
Affordable fixed premium, no matter the age.
Potential Limitations
Reimbursement-based-you have to pay upfront and claim the money back later, which can be difficult if finances are tight.
Limited coverage-₹1 lakh per year is helpful but may not be enough for someone needing frequent hospital visits or expensive procedures.
Only available to people with specific disabilities listed under The National Trust Act—if the condition isn’t on the list, it won’t be covered.
Swavlamban Health Insurance Scheme
If you’re looking for an affordable government-backed health insurance plan that offers family coverage, Swavlamban is a great choice. It’s designed for people with any disability under the Persons with Disabilities Act, 1995, making it one of the most inclusive disability insurance plans available.
Why It Stands Out
Covers all types of disabilities, not just specific ones, making it broader than most other plans.
Super affordable—you pay only 10% of the premium (₹310 per year), and the government covers the rest.
Family floater plan—unlike other disability-specific policies, this one covers the disabled person, their spouse, and two children under the same policy.
Sum insured is ₹2 lakh, which is higher than some other government-backed schemes.
Covers OPD (outpatient care) expenses—provides ₹3,000 per year for OPD treatments, medicines, and diagnostic tests.
Includes alternative treatments—if you prefer Ayurveda, Siddha, or Homeopathy, those treatments are covered too.
Potential Limitations
Waiting period of 30 days for new policyholders, plus additional waiting time for pre-existing conditions.
Coverage cap of ₹2 lakh-while helpful, it might not be enough for major surgeries or long-term treatments.
Entry age restriction (18-65 years)-not available for children under 18, which could be a limitation for families looking to cover younger dependents.
What is Disability?
Disability means having a physical or mental condition that makes certain activities or interactions more challenging. This can affect how a person moves, communicates, or processes information. Some people are born with a disability, while others may develop one due to an accident, illness, or a long-term health condition. Disabilities can be visible, like difficulty walking, or less obvious, like challenges with learning or mental health. No matter the type, it’s important to remember that having a disability doesn’t define a person-it’s just one part of who they are. With the right support and understanding, individuals with disabilities can lead fulfilling and
independent lives.
Who is Considered Disabled?
A person is considered disabled if they have a physical or mental condition that significantly limits their ability to perform daily activities. Disabilities can be present from birth or develop later due to accidents, illnesses, or aging. They may affect movement, vision, hearing, learning, or mental well-being, impacting how a person interacts with their surroundings.
Types of Disabilities
Disabilities Present from Birth (Congenital Disabilities)
Disabilities Caused by Accidents
Mental Health-Related Disabilities
Who Can Buy Health Insurance for Handicapped?
If you or a loved one has a disability, health insurance is available to provide financial support for medical expenses. In India, anyone with a disability recognised under The Rights of Persons with Disabilities Act, 2016 can apply for a health insurance plan designed for individuals with disabilities.
How is Eligibility Determined?
When applying for insurance, certain factors help decide whether coverage can be approved and how much the premium will be. Two important aspects that insurance companies consider are health conditions and family income.
1
Health Condition
Your current health plays a major role in determining eligibility for insurance. Companies assess whether any existing medical conditions could increase risk. The premium amount is based on this assessment, as higher health risks often lead to higher costs.
For individuals with disabilities, insurers may review medical history from the past few months to understand the extent of risk involved. This helps them decide whether coverage can be offered and under what conditions. In some cases, if the risk is too high, the company may deny coverage altogether.
2
Family’s Earning Capacity
Insurance providers also look at family income before issuing a policy. This helps them decide on a suitable coverage amount and premium that the insured person can afford. Many companies ask for bank statements from recent months to check financial stability. Based on this, they determine how much coverage can be provided and whether the applicant can keep up with premium payments.
By considering both health and financial factors, insurers ensure that the policy is manageable for the individual while also balancing their own risk.
What is Disability Insurance?
Disability insurance is a type of coverage that provides financial support if you are unable to work due to an illness or injury. It replaces a portion of your income, helping you cover daily expenses, medical bills, and other financial commitments while you recover. This insurance ensures that even if you can’t earn a paycheck for a while, you still have a steady source of income to manage your needs. Whether it’s a short-term issue or a long-term condition, disability insurance helps reduce financial stress so you can focus on getting better.
Types of Disability Insurance
There are two types of disability insurance in India, and both serve different needs. Understanding them can help you choose the right coverage based on your situation.
Short-Term Disability Insurance
Long-Term Disability Insurance
Why Should People with Disabilities Get Health Insurance?
Healthcare can be expensive, and for people with disabilities, medical needs can sometimes be more frequent or specialised. Having health insurance ensures that necessary treatments and hospital visits are covered without causing financial stress. Here’s why getting a health insurance plan designed for people with disabilities can be a smart decision:
Which Disabilities are Covered by Health Insurance Plans in India?
Health insurance plans in India cover various medical needs for people with disabilities, including:
Which Disabilities Aren't Covered by Health Insurance Plans in India?
Here are some expenses that are usually not included in health insurance for individuals with disabilities in India:
Why You Should Consider Disability Insurance in India
Here's why buying disability insurance in India is a good idea:
Things to Keep in Mind When Buying a Disability Health Insurance Policy
Getting a disability health insurance policy is an important step in protecting yourself and your family from financial stress in case of an accident or illness that leads to disability. But with so many options available, it’s important to choose a policy that actually meets your needs. Here are some things to consider before making a decision.
1
Type of Coverage
Disability insurance policies can cover temporary or permanent disabilities, and some also provide partial or full coverage depending on the severity of the condition. Check whether the policy covers both accident-related and illness-related disabilities. Some plans may only cover accidents, which can leave you unprotected in case of a serious illness.
2
Payout Structure
Different policies have different ways of providing financial support. Some offer a lump sum amount, while others provide regular payouts like a monthly income. Think about what would work best for you. If your family depends on your income, a plan that gives regular payouts might be more helpful.
3
Waiting Period
Most insurance policies have a waiting period before the benefits start. This could be anywhere from a few months to a couple of years, depending on the policy. Make sure you are aware of this period so you know when you can actually start receiving benefits if needed.
4
Premium and Benefits Balance
A lower premium might look attractive, but it often means fewer benefits. Compare different plans and find one that gives a good balance between affordability and useful coverage. Paying slightly more for a policy that provides strong financial support can be worth it in the long run.
5
Exclusions and Limitations
All policies have certain exclusions—conditions or situations they don’t cover. Common exclusions may include pre-existing disabilities, self-inflicted injuries, or certain high-risk activities. Read the policy carefully so you’re not caught off guard later.
6
Claim Process and Settlement Ratio
A good insurance policy should have a smooth and hassle-free claim process. Check the insurer’s claim settlement ratio, which tells you how often they approve claims. A high settlement ratio means a better chance of getting your claim approved when you need it the most.
7
Additional Benefits
Some policies offer extra benefits like rehabilitation support, hospital cash allowance, or even coverage for home modifications if you need adjustments to your living space after a disability. These small details can make a big difference in the long run.
8
Policy Renewal and Lifetime Coverage
Check if the policy allows renewal for a lifetime or has an age limit. A policy that covers you for life ensures long-term protection, especially since the risk of disability increases with age.
Disclaimer
