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—apply-niramaya-disability-insurance-2026 [2026/09/01 19:02] (current) – created - external edit 127.0.0.1
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 +{{htmlmetatags>
 +metatag-title=(How to apply for Niramaya health insurance)
 +metatag-keywords=(Niramaya health insurance 2026,National Trust disability insurance,Niramaya scheme,intellectual disability insurance,autism cerebral palsy insurance,UDID Niramaya,Disability Certificate Niramaya,National Trust Act 1999,RPwD Act 2016,thenationaltrust.gov.in,National Trust RO,Niramaya BPL ₹250,Niramaya non-BPL ₹500,DEPwD CPGRAMS,RTI Niramaya)&metatag-description=(Step-by-step 2026 guide to apply for Niramaya — the National Trust health insurance for persons with autism, cerebral palsy, intellectual and multiple disabilities.)&metatag-og:title=(How to apply for Niramaya health insurance)&metatag-og:description=(Step-by-step 2026 guide to apply for Niramaya — the National Trust health insurance for persons with autism, cerebral palsy, intellectual and multiple disabilities.)&metatag-og:type=(article)}}
 +
 +====== How to Apply for Niramaya Health Insurance 2026 ======
 +
 +{{ :social:auto:apply-niramaya-disability-insurance-2026.png?direct&1200 |Niramaya 2026 — RTI Wiki citizen guide for persons with intellectual + multiple disabilities}}
 +
 +//Last reviewed: 1 September 2026.//
 +
 +
 +<WRAP info>
 +**Quick Reply:** **Niramaya** is the National Trust's health insurance scheme for persons with **autism, cerebral palsy, mental retardation (intellectual disability), and multiple disabilities** — covered under the **National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999**. Apply through any National Trust **Registered Organisation (RO)** in your district (list at **thenationaltrust.gov.in**), or directly via the **Niramaya portal**. Premium: **₹250/year for BPL** families, **₹500/year for non-BPL**. Cover: **₹1 lakh a year per person** — OPD, medicines, surgery, hospitalisation, ongoing therapies and transport costs, **on a reimbursement basis** (treatment at any hospital; scheme sub-limits apply). **Unique feature: pre-existing disabilities are covered from day one** — no waiting period. Eligibility: person with disability must hold a **UDID Card or Disability Certificate (40%+ disability)**. Membership card delivered in 15-30 days. Stuck? RO → National Trust HQ Delhi 011-20897275 / 011-20897959 → State Commissioner for Persons with Disabilities → CPGRAMS DEPwD → RTI to PIO National Trust.
 +</WRAP>
 +
 +===== An illustrative case — "₹38,000 hospital bill paid by an insurance card that cost ₹500" =====
 +
 +<WRAP center round box 80%>
 +//An illustrative case (not a named person). A 38-year-old accountant in a private firm in Lucknow; his wife is a homemaker. Their 12-year-old son has intellectual disability with epileptic seizures (UDID-certified at 60% disability since 2020). The family is non-BPL. The boy attends a special school near their home.//
 +
 +> "The school principal told us about Niramaya in August 2024. She gave us the contact of a National Trust **Registered Organisation (RO)** in a nearby neighbourhood. We went on a Saturday with: our son's **UDID card** (60% intellectual disability, valid till 2030), his and our three Aadhaars, our income certificate marking us as non-BPL, three passport photos of our son, and a copy of my cancelled cheque. The RO didi filled the Niramaya form online from their CSC computer. We paid **₹500 in cash** as the annual premium and got a receipt with the policy reference number on it. They told us the membership card would come in 3-4 weeks. It came on day 22 by Speed Post. The card listed our son's name, our address, and the policy validity 1 Sep 2024 to 31 Aug 2025. In **March 2025** he had a major epileptic seizure at school — he was rushed to a nearby hospital by ambulance. We followed and showed the Niramaya card at the reception. The receptionist made one phone call to verify the policy. ICU for 36 hours, EEG, MRI, 4 days general ward, anti-epileptic medication. Total bill: **₹38,000**. We paid the hospital first, then filed the reimbursement claim with the original bills, prescriptions and discharge summary — the full **₹38,000** came back within a few weeks. **My net out-of-pocket on his care that month: ₹0. My total Niramaya investment for the year: ₹500.** I renewed for 2025-26 immediately on 1 September 2025."
 +
 +— an illustrative account
 +</WRAP>
 +
 +Niramaya has enrolled lakhs of persons with disabilities since its 2017 revamp, yet most eligible families have still never heard of it. Under the current benefit chart, claims are settled on a reimbursement basis at scheme sub-limits. The biggest reason families miss out on Niramaya is simply not knowing it exists — most Disability Certificate holders are eligible but never enrol.
 +
 +===== What Niramaya is — and how it differs from PMJAY =====
 +
 +**Niramaya** is the National Trust's **flagship health insurance scheme** for persons with the four "National Trust disabilities". It was launched in 2008 and revamped in 2017; the Trust's current published benefit chart caps the cover at ₹1 lakh per person and settles claims on a reimbursement basis.
 +
 +The scheme is governed by:
 +
 +  * The **National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999** — particularly **§10** (objects of the Trust: support to live independently and within the family) and **§11** (powers of the Board to fund approved programmes), under which the Trust runs its schemes.
 +  * The **Rights of Persons with Disabilities Act, 2016 (RPwD Act)** — particularly **§37**, under which the appropriate Government and local authorities make schemes in favour of persons with benchmark disabilities.
 +  * **National Trust notifications** setting out the scheme parameters and the current published benefit chart.
 +  * Administered by the **Department of Empowerment of Persons with Disabilities (DEPwD)** under the **Ministry of Social Justice & Empowerment (MoSJE)**.
 +
 +**Niramaya is different from Ayushman Bharat PMJAY.** PMJAY is a national scheme for BPL/SECC-listed families with ₹5 lakh cover; Niramaya is **specifically for the four National Trust disabilities**, has a smaller ₹1 lakh cover, but is **far cheaper (₹250-500/year vs PMJAY's ₹0)** and **covers pre-existing disability conditions from day one** — which PMJAY does not. Many families hold both: PMJAY for general illness + Niramaya for disability-specific needs.
 +
 +===== Eligibility =====
 +
 +==== Person with disability ====
 +
 +The PWD must have one of the four "National Trust disabilities":
 +
 +  * **Autism Spectrum Disorder** (ASD)
 +  * **Cerebral Palsy** (CP)
 +  * **Mental Retardation / Intellectual Disability** (ID)
 +  * **Multiple Disabilities** involving any combination of the above + others (visual, hearing, locomotor)
 +
 +The disability must be certified by a competent medical authority. The Trust's published eligibility asks for a valid disability certificate with a **UDID card or a UDID enrolment number** — it states no minimum percentage (RO practice often mirrors the RPwD 40% benchmark) — and the certification must be in the form of:
 +
 +  * A **UDID (Unique Disability ID) Card** — preferred, mandatory for new enrolments since 2024. See [[:rti-for-udid-disability-certificate|RTI for UDID Disability Certificate]].
 +  * **OR** an old-format **Disability Certificate** issued before UDID rollout — accepted as interim until UDID is generated.
 +
 +==== Family members covered ====
 +
 +Niramaya insures the **person with disability**. The published benefit chart fixes the overall limit **per person** — ₹1 lakh — it is not a family floater:
 +
 +  * The **person with disability** is the insured beneficiary.
 +  * Spouse, children and parents of the PWD are **not** insured under Niramaya.
 +  * If more than one family member has a National Trust disability, each is enrolled separately and each gets the ₹1 lakh limit in their own right.
 +
 +In practice — for child PWDs (the most common case) — the cover is for the child; the parents act as claimants and guardians.
 +
 +==== BPL vs Non-BPL ====
 +
 +  * **BPL family** — concessional premium, historically published as **₹250/year** (confirm the current amount — and who pays it — on the Trust portal or with the RO at enrolment). Need to produce a state-issued BPL certificate / ration card showing BPL status.
 +  * **Non-BPL family** — premium **₹500/year**. No income proof needed — just a self-declaration.
 +
 +There is **no income cap** for Niramaya — even relatively well-off families can join at ₹500.
 +
 +===== Coverage =====
 +
 +The ₹1 lakh annual cover (per family per year) includes:
 +
 +  * **OPD consultation** — regular check-up visits, including with developmental paediatricians, neurologists, psychiatrists, and speech/occupational therapists (₹19,000 OPD sub-limit under the current benefit chart).
 +  * **Medicines** — both regular and emergency, prescribed by empanelled doctors.
 +  * **Pre-existing disability conditions covered from day one** — this is Niramaya's **biggest USP** and what private health insurance refuses to do.
 +  * **Surgery up to ₹1 lakh** — including elective surgery for disability-related conditions (e.g., cerebral palsy contracture release).
 +  * **Hospitalisation** — on a **reimbursement basis**; treatment can be taken at any hospital, with an overall ₹55,000 hospitalisation sub-limit.
 +  * **Emergency transportation** — reimbursable transport costs (₹2,000 sub-limit).
 +  * **Therapy** — physiotherapy, occupational therapy, speech therapy (limited per year).
 +  * **Aids and appliances** — wheelchairs, hearing aids, communication devices (limited per year, usually subject to additional documentation).
 +
 +===== Where to apply =====
 +
 +  * **National Trust portal** — **https://thenationaltrust.gov.in** → "Schemes" → "Niramaya".
 +  * **Registered Organisation (RO)** — the National Trust has ~1,000+ ROs across India; list filterable by state/district at the portal. **Most rural and small-town families apply through the local RO** because the RO does the form-filling, photo collection, and online submission for free.
 +  * **State Nodal Officer for Niramaya** — varies state to state; usually within the State Disability Welfare Department.
 +
 +===== Step-by-step process =====
 +
 +==== Step 1 — Confirm UDID / Disability Certificate ====
 +
 +Before applying, the PWD must hold a **valid disability certificate or UDID card** showing **40%+ disability** in one of the four National Trust categories.
 +
 +  * If you don't have UDID yet, apply for it first at **swavlambancard.gov.in** — process takes 30-90 days. See the dedicated guide [[:rti-for-udid-disability-certificate|RTI for UDID Disability Certificate]].
 +  * If you have an old-format Disability Certificate (issued before UDID), use it as interim — Niramaya RO will accept it but you must apply for UDID alongside.
 +
 +==== Step 2 — Find a Registered Organisation (RO) near you ====
 +
 +  * Go to **https://thenationaltrust.gov.in** → "Find an RO" → enter state + district.
 +  * Alternatively call National Trust HQ at **011-20897275 / 011-20897959** for the nearest RO.
 +  * Visit the RO with the PWD and required documents.
 +
 +==== Step 3 — Documents to carry ====
 +
 +  * **UDID card** (or old Disability Certificate as interim) of the PWD.
 +  * **Aadhaar** of PWD + spouse + dependent children + dependent parents (whoever is being covered).
 +  * **Income certificate / BPL ration card** if claiming BPL premium of ₹250.
 +  * **Three passport-size photos** of PWD; one each of family members being covered.
 +  * **Bank account details** of PWD or guardian (cancelled cheque) — for any future reimbursement claims.
 +  * **Address proof** (Aadhaar usually suffices).
 +
 +==== Step 4 — Fill the Niramaya enrolment form ====
 +
 +  * The RO has a digital terminal (CSC computer) connected to the Niramaya portal.
 +  * The RO operator fills:
 +    * PWD details (name, DOB, UDID number, disability type and percentage, address).
 +    * Family members to be covered (name, DOB, relationship, Aadhaar).
 +    * BPL status (Yes/No).
 +    * Bank account details.
 +    * Contact mobile for policy and renewal SMS updates.
 +
 +==== Step 5 — Pay the annual premium ====
 +
 +  * **₹250 (BPL) or ₹500 (Non-BPL)** at the RO counter — cash, UPI, or card.
 +  * The RO issues a **payment receipt** with a temporary policy reference number.
 +  * Some ROs also accept payment directly via the Niramaya portal's online gateway (BHIM / UPI / card).
 +
 +==== Step 6 — Membership card delivery ====
 +
 +  * After premium payment, the National Trust generates the policy and prints the **Niramaya Membership Card**.
 +  * The card is despatched by Speed Post to the address registered, or to the RO for collection.
 +  * Standard delivery: **15-30 days**. Some states (UP, Bihar, MP) have seen delays of 45-60 days.
 +  * The card lists: PWD's name, validity (1 year from policy date) and policy number. You can also download the **Niramaya e-card** from the Trust's portal.
 +
 +==== Step 7 — Use the card ====
 +
 +  * **Treatment:** Under the current benefit chart you can take treatment at **any hospital** — there is no empanelment restriction.
 +  * **Claims:** Pay the hospital first, then submit a **reimbursement claim** through your RO with the original bills, prescriptions, discharge summary, original films (X-ray / MRI / ultrasound) and a copy of the membership card or e-card. Reimbursement is at scheme sub-limits, not the full bill.
 +  * **Claims helpline:** 040-68178569 / 71326135 (the National Trust's dedicated Niramaya claims helpline).
 +
 +==== Step 8 — Annual renewal ====
 +
 +  * Renew **before** the policy expiry date (printed on the card) — the RO will remind via SMS.
 +  * Pay ₹250/₹500 again; the membership card is reissued or extended.
 +  * If you let it lapse, you must re-enrol fresh — but no waiting period applies (pre-existing disability still covered from day one).
 +
 +===== Sample fee + benefit table =====
 +
 +<code>
 ++--------------------------------+-------------------------------------+
 +| Annual premium (BPL)           | ₹250                                |
 +| Annual premium (Non-BPL)       | ₹500                                |
 ++--------------------------------+-------------------------------------+
 +| Annual cover (family floater)  | ₹1,00,000                           |
 ++--------------------------------+-------------------------------------+
 +| OPD consultation               | Covered (at empanelled facilities)  |
 +| Medicines                      | Covered                              |
 +| Pre-existing disability        | Covered from day one (USP)          |
 +| Surgery                        | Up to ₹1 lakh                        |
 +| Hospitalisation cashless       | Yes (at empanelled hospital)         |
 +| Emergency ambulance            | Covered                              |
 +| Therapy (PT / OT / Speech)     | Limited per year                     |
 +| Aids and appliances            | Limited per year                     |
 ++--------------------------------+-------------------------------------+
 +| Membership card delivery       | 15-30 days (target)                  |
 ++--------------------------------+-------------------------------------+
 +| Renewal cycle                  | Annual (before expiry date)          |
 ++--------------------------------+-------------------------------------+
 +| RTI to PIO National Trust      | ₹10 by IPO. BPL = free.             |
 ++--------------------------------+-------------------------------------+
 +</code>
 +
 +===== Common reasons your Niramaya application / claim gets stuck =====
 +
 +  * **UDID not yet issued** — most common roadblock for fresh applicants. Use Disability Certificate as interim; apply for UDID in parallel. See [[:rti-for-udid-disability-certificate|RTI for UDID]].
 +  * **BPL category contested** — BPL ration card may be expired or in a different family member's name. Update the BPL list at your block office or pay the non-BPL ₹500 and contest later.
 +  * **Insurance card not delivered to RO** — postal/dispatch delays from National Trust HQ Delhi to far-off states. RO can lodge a complaint; NT can issue a duplicate.
 +  * **Sub-limits bite on big bills** — the reimbursement heads are capped (hospitalisation ₹55,000 overall, corrective surgery ₹40,000 within it, OPD ₹19,000, therapies ₹20,000), so a high-cost private-hospital bill can leave a gap. Plan elective procedures with the caps in mind.
 +  * **Disability percentage below 40%** — the PWD doesn't qualify for Niramaya. Reapply for a re-evaluation if you believe the percentage is understated; see UDID guide.
 +  * **Family members not listed correctly** — sometimes the spouse or one parent gets dropped off the membership card. Verify on receipt; ask RO to update.
 +  * **Renewal lapse** — gap between expiry and renewal means **no cover during the gap**. Pre-existing disability is still covered on re-enrolment, so this is not catastrophic, but any event during the gap is uninsured.
 +  * **Reimbursement claim rejected for "rate cap"** — non-empanelled hospital bills are reimbursed only at scheme-approved rates, not full bill amount. Out-of-pocket may remain.
 +
 +===== If stuck — the escalation ladder =====
 +
 +==== Rung 1 — your Registered Organisation (RO) ====
 +
 +  * Most issues are RO-level: card not received, claim form pending, premium receipt missing.
 +  * Ask the RO to escalate to NT HQ on your behalf — they have a direct portal access.
 +
 +==== Rung 2 — National Trust Headquarters, New Delhi ====
 +
 +  * **Phone:** 011-20897275 / 011-20897959 (Niramaya and health-card support). Dedicated claims helpline: 040-68178569 / 71326135.
 +  * **Email:** [email protected] (mark it for the Niramaya cell).
 +  * **Address:** The National Trust, DEPwD, Ministry of Social Justice and Empowerment, 6th Floor, NISD Building, Plot No. G-2, Sector-10, Dwarka, New Delhi - 110075.
 +  * Best for: card delivery delays, RO non-cooperation, claim processing disputes.
 +
 +==== Rung 3 — State Commissioner for Persons with Disabilities ====
 +
 +  * Each state has a **State Commissioner for PWD**, appointed under §79 of the RPwD Act 2016.
 +  * Hears complaints regarding any scheme or facility for persons with disabilities, including Niramaya.
 +  * Has the powers of a civil court (§82) — can summon insurer, RO, hospital.
 +
 +==== Rung 4 — CPGRAMS — DEPwD ====
 +
 +  * **https://pgportal.gov.in** → Ministry **"Social Justice and Empowerment"** → **"Department of Empowerment of Persons with Disabilities"** → category **"Niramaya / National Trust"**.
 +  * SLA: 30 days; escalates to Joint Secretary level.
 +
 +==== Rung 5 — Chief Commissioner for Persons with Disabilities (national) ====
 +
 +  * For systemic / multi-state issues: CCPD office, MoSJE, New Delhi.
 +  * Can issue advisory orders binding on the National Trust and ROs.
 +
 +==== Rung 6 — Right to Information (RTI) ====
 +
 +The **National Trust** is a **public authority** under §2(h) of the RTI Act 2005 — it is a statutory body created under the National Trust Act 1999 and substantially funded by the central government.
 +
 +**RTI helps here when:**
 +
 +  * Your premium of ₹500 was paid 60 days ago but no membership card is in hand — RTI to PIO National Trust for **policy generation status, despatch register entry, Speed Post AWB number**.
 +  * Your reimbursement claim was rejected with a vague reason — RTI for the **dealing officer's name + the calculation sheet showing rate cap applied**.
 +  * Your child's enrolment was rejected for "incorrect disability percentage" but the UDID clearly shows 60% — RTI for the **rejection order + reasoning + reviewing officer**.
 +  * Your reimbursement claim has sat with the insurer for months — RTI for the **claim register, pending-claim list and state-wise settlement figures** for your state.
 +  * Your claim is "under processing" for 90 days — RTI for the **file movement note-sheet**.
 +
 +For how to file, see [[:rti-for-beginners|RTI in 12 simple steps — for first-time filers]], and use the ask-for lists above word-for-word in your application.
 +
 +**RTI does NOT help here when:**
 +
 +  * Your child's disability is **below 40%** — RTI cannot lower the threshold. Apply for re-evaluation of UDID first.
 +  * Your child has a disability **outside the four National Trust categories** (e.g., only locomotor disability without intellectual component) — Niramaya is restricted by statute to the four categories. Look at other schemes (state-level disability insurance, Rashtriya Vayoshri Yojana for elderly, etc.).
 +  * You want Niramaya to pay for treatment **outside India** — scheme is India-only; RTI cannot extend.
 +  * You want **₹5 lakh cover** like PMJAY — Niramaya cap is ₹1 lakh by notification; for higher cover you need a separate policy.
 +  * You want the **sub-limits raised** — the caps flow from the Trust's benefit chart and its agreement with the insurer; RTI cannot change scheme parameters. Raise it with the Trust or the Chief Commissioner instead.
 +  * You filed enrolment **last week** and want status — wait at least 30 days before RTI.
 +
 +===== FAQs =====
 +
 +**Q. My child is autistic but doesn't have UDID yet. Can I still enrol in Niramaya?**\\
 +Yes — for the first enrolment cycle, an **old-format Disability Certificate (40%+)** is accepted as interim. You must apply for UDID at swavlambancard.gov.in alongside; for renewal next year, UDID will be required.
 +
 +**Q. We are a BPL family but our state's BPL list is outdated and our name was dropped. Pay ₹500?**\\
 +Pay ₹500 to enrol immediately (don't lose a year of cover); contest the BPL listing separately at your block office. Once corrected, next renewal will be at ₹250.
 +
 +**Q. My son with cerebral palsy is 22 and unmarried. Is he covered?**\\
 +Yes — the person with disability is the insured person at any age. There is no upper age limit. You act as claimant and guardian; you are not insured under Niramaya yourself.
 +
 +**Q. The hospital bill was far bigger than what Niramaya reimbursed. Can I recover the balance?**\\
 +No — Niramaya reimburses only up to the scheme sub-limits (₹55,000 hospitalisation head, ₹19,000 OPD, ₹20,000 therapies and so on). Anything above the caps stays out of pocket, so ask the treating doctor for a scheme-aligned estimate before elective procedures and keep every original bill, prescription and film.
 +
 +**Q. Can both my children with disability be covered under one policy?**\\
 +Each **person with disability** is enrolled separately, and each gets the ₹1 lakh overall limit in their own right. If both children have one of the four NT disabilities, enrol both — two enrolments, two limits. A non-disabled child is not covered under Niramaya.
 +
 +**Q. We moved from Lucknow to Pune mid-year. Is the empanelled-hospital list updated?**\\
 +Treatment is allowed at any hospital under the current scheme, so a move does not restrict where you can be treated. Do inform the National Trust + your old RO + new RO of the **address and bank-account change** so the e-card, renewal SMS and reimbursement reach you without a gap.
 +
 +**Q. Niramaya vs PMJAY — which is better?**\\
 +Hold both. **PMJAY** gives ₹5 lakh general health cover (free, only BPL/SECC-listed). **Niramaya** gives ₹1 lakh disability-specific cover (₹250-500/year, includes pre-existing disability). For a PWD family, both running together is the gold standard.
 +
 +**Q. Therapy (PT / OT / Speech) is what we need most. Will Niramaya cover full year of therapy?**\\
 +Niramaya covers a limited number of therapy sessions per year (typically 30-60 sessions, varies by RO and empanelled centre). For long-term ongoing therapy, combine Niramaya with state-level scholarship schemes for special education, and with the **Sahyogi caregiver training scheme** of the National Trust.
 +
 +**Q. The membership card has only my child's name. Am I covered too when I take my child for treatment?**\\
 +No — Niramaya covers the **person with disability**; parents and siblings are not insured under it. You are the claimant and guardian for the child's treatment. For your own (non-disability-related) hospitalisation, you would need a separate health policy.
 +
 +===== Related on RTI Wiki =====
 +
 +  * [[:rti-for-udid-disability-certificate|RTI for UDID Disability Certificate — apply / track / fix errors]]
 +  * [[:claim-disability-employment-reservation-rpwd-2026|Claim disability employment reservation under RPwD Act 2016]]
 +  * [[:apply-ayushman-bharat-abha-card-2026|Apply Ayushman Bharat ABHA — for general health record]]
 +  * [[:apply-child-disability-certificate-2026|Apply for a child disability certificate — the UDID route]]
 +  * [[:rti-for-beginners|RTI in 12 simple steps — for first-time filers]]
 +  * [[:helplines:start|All Indian government helplines — one master directory]]
 +  * [[:forms:start|RTI forms + state-wise fee chart]]
 +  * [[https://righttoinformation.wiki/book|The RTI Playbook]]
 +
 +
 +**Also on RTI Wiki:** [[https://righttoinformation.wiki/legal-guardianship-disabled-adult-national-trust-india|National Trust legal guardianship for an adult with disability]]
 +
 +{{tag>niramaya national-trust intellectual-disability autism cerebral-palsy multiple-disability udid disability-certificate rpwd-act-2016 national-trust-act-1999 depwd thenationaltrust mosje state-commissioner-pwd rti-niramaya citizen-guide help-first 2026}}