Swavlamban Health Insurance Scheme: All You Need To Know

Swavlamban Health Insurance Scheme was launched on October 2, 2016, exclusively for People with Disabilities (PwD).

New India Assurance Company is the implementing agency
Ministry of Social Justice is the ministry concerned with Swavlamban Scheme
Department of Empowerment of Persons with Disabilities under ministry of social justice is the monitoring agency

To give low cost and affordable health insurance to PwD (includes people with low vision, Blind, hearing impairment, mental illness, leprosy, mental retardation, loco-motor disability)
To improve quality of life of PwD
To improve PwD condition of general health

Uniform premium of 357 rupees (which is 10% of the actual premium + Service Tax) per PwD person throughout the country
Sum insured is 2 lacs for a year
Swavlamban will cover PwD people in the age group of 0 to 65 years
PwD must carry the PwD certificate issued by PwD Act, 1995 to get enrolled
PwD family including spouse and up to two children are covered by this scheme
In case of minor PwD, parents of PwD are also covered
PwD with family income not exceeding 3 lacs p.a are eligible
There are no premedical tests involved before enrolling into the policy
OPD benefits include 10000 p.a per PwD and 3000 p.a for mentally retarded people

New India Assurance in the nodal agency for Swavlamban
New India Assurance has created a network of hospitals for the beneficiaries of Swavlamban to get free treatment under the policy
PwD getting treatment outside the network must get the consent and approval of New India Assurance
However, in case of emergency, PwD insured can be admitted in another hospital outside the network without prior approval
Claims must be made to New India Assurance with PwD certificate
Grievances must be lodged to New India Insurance authorised person for resolution
Grievances are monitored by a Dispute resolution committee consisting of representatives from the Department of Empowerment of PwD and New India Assurance

Cashless treatment for PwD in the designated hospital networks identified by New India Assurance
Free OPD treatment up to 10000 rupees also included in the health insurance scheme
Family of PwD is also covered which is an additional benefit of the scheme
Swavlamban helps people with PwD to be recognised in the society and live with self-esteem
Treatment is offered to PwD for preexisting medical problems also
Claim settlement is done in a transparent manner
Redressal mechanism is efficient until the PwD concerned is satisfied
Enrollment procedure made simple through the New India Assurance network

Autism

Cerebral palsy and

Multiple disabilities

Swavlamban is a sign of progress for the welfare of PwD
Awareness about the scheme must be enhanced and more PwD must be enrolled in the scheme
GOI has introduced a slew of welfare measures for PwD in this fiscal year including Swavlamban but the implementation and monitoring must be enhanced further
Initial steps to be taken to cover all PwD’s working in the formal sector
Identification of beneficiaries is a key challenge
Overall, the scheme is a positive measure in utilising the PwD talent and recognising them as respectable individuals in the society