Niramaya is a health insurance scheme managed by the National Trust, under the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment. The scheme is meant for eligible persons with disabilities covered under the National Trust Act.
Under the scheme, beneficiaries can get health insurance coverage of up to ₹1 lakh. The coverage includes several healthcare expenses such as hospitalisation, OPD treatment, medicines, diagnostic tests, therapies, dental care, AYUSH treatment and transportation, subject to the applicable limits.
In this article, let us understand the Niramaya Health Insurance Scheme 2026, including its eligibility, coverage, benefits, documents, application process and claim procedure.
Table of Contents
What is Niramaya Health Insurance Scheme?
The Niramaya Health Insurance Scheme is a government-supported health insurance scheme for eligible persons with disabilities.
The main purpose of Niramaya is to help beneficiaries manage healthcare expenses without facing the full financial burden themselves. It covers different types of medical and health-related expenses within the limits fixed under the scheme.
The scheme provides coverage of up to ₹1,00,000 per beneficiary. There is also no requirement for a pre-insurance medical examination.
Niramaya Scheme 2026 Highlights
| Particular | Details |
|---|---|
| Scheme Name | Niramaya Health Insurance Scheme |
| Managed By | National Trust |
| Ministry | Ministry of Social Justice and Empowerment |
| Target Group | Eligible persons with disabilities |
| Maximum Health Cover | Up to ₹1 lakh |
| Medical Test Before Enrolment | Not required |
| Treatment | Available at any hospital, subject to scheme rules |
| Claim Type | Reimbursement |
| OPD Treatment | Covered |
| Hospitalisation | Covered |
| Therapy | Covered |
| Dental Care | Covered within applicable limit |
| AYUSH Treatment | Covered within applicable limit |
Who Can Apply for Niramaya Scheme?
Niramaya is available to eligible persons with disabilities who fall under the categories covered by the National Trust Act.
The applicant needs to have the required disability documentation. According to the National Trust, a valid disability certificate along with a UDID Card or UDID enrolment number is required.
Therefore, before applying, applicants should check their disability certificate and UDID details.
Basic eligibility requirements
An applicant generally needs to:
- Be covered under the National Trust Act.
- Have a valid disability certificate.
- Have a UDID Card or eligible UDID enrolment details.
- Complete the required enrolment process.
- Provide the documents requested during registration.
If you are unsure whether you qualify, it is better to check the latest eligibility information provided by the National Trust before applying.
What Does Niramaya Insurance Cover?
Niramaya provides financial assistance for different healthcare requirements. The total available cover is up to ₹1 lakh, but this amount is divided into different categories.
This is important because a beneficiary cannot necessarily use the complete ₹1 lakh for one treatment. Each category has its own limit.
1. Hospitalisation
Hospital treatment is one of the major benefits available under Niramaya.
The current benefit structure provides up to ₹55,000 under the hospitalisation category, subject to the applicable conditions and sub-limits.
This can include eligible hospitalisation and corrective surgery expenses.
Before getting treatment, beneficiaries should keep all prescriptions, bills, reports and other medical documents because these may be required when submitting a reimbursement claim.
2. OPD Treatment
Not every medical problem requires hospitalisation. Many people regularly visit doctors or need medicines and diagnostic tests.
Niramaya also provides coverage for eligible outpatient treatment, commonly called OPD treatment.
The current benefit structure provides up to ₹19,000 under the OPD and dental category, including the applicable limit for preventive dental care.
Depending on the rules, eligible expenses can include medicines, pathology tests and diagnostic investigations.
3. Ongoing Therapy
Regular therapy can be an important part of healthcare for many persons with disabilities.
Niramaya provides coverage for eligible ongoing therapies within the prescribed limit. The current benefit structure provides up to ₹20,000 for this category.
A doctor’s prescription is important for ongoing therapy claims. The National Trust states that a prescription should be obtained at least once every six months and should mention the type and duration of therapy.
Beneficiaries should therefore keep their prescriptions and therapy-related bills safely.
4. Dental Care
Dental problems can also require medical attention and regular care.
Niramaya includes a provision for preventive dental treatment. The current benefit structure provides up to ₹4,000 for preventive dentistry.
The amount is subject to the applicable scheme conditions and limits.
5. AYUSH Treatment
Niramaya also provides a benefit for eligible AYUSH treatment.
AYUSH includes systems such as Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy.
The current benefit structure provides up to ₹4,000 under this category, subject to the applicable rules.
6. Transportation Expenses
Medical treatment may also involve transportation costs, particularly when a person needs to travel for healthcare.
Niramaya provides a separate provision for eligible transportation expenses. The current limit is ₹2,000.
Beneficiaries should keep relevant receipts or supporting documents wherever required for the claim.
Niramaya Scheme Coverage Limit
The maximum overall coverage under the current benefit structure is ₹1 lakh.
The major categories are:
| Benefit | Maximum Limit |
|---|---|
| Hospitalisation | ₹55,000 |
| OPD and Dental | ₹19,000 |
| Ongoing Therapy | ₹20,000 |
| AYUSH | ₹4,000 |
| Transportation | ₹2,000 |
| Total | ₹1,00,000 |
These amounts represent category-wise limits. They should not be understood as one common amount that can be freely spent on any treatment.
The National Trust may also revise the allocation or conditions from time to time.
Is Medical Examination Required?
One useful feature of the Niramaya Health Insurance Scheme is that a pre-insurance medical examination is not required.
This means eligible applicants do not have to undergo a medical test simply to enrol in the scheme.
However, applicants still need to provide the required disability and identification documents.
Where Can Niramaya Beneficiaries Get Treatment?
According to the National Trust, treatment under Niramaya can be taken at any hospital.
However, beneficiaries should remember that Niramaya is based on reimbursement. Therefore, simply visiting a hospital does not mean that every expense will automatically be paid.
The treatment and expense must fall within the scheme’s coverage and applicable limits.
It is also important to keep original bills, prescriptions, medical reports, test reports and other documents needed for submitting the claim.
Documents Required for Niramaya Scheme
Applicants should keep their documents ready before starting the enrolment process.
Common documents may include:
- Disability certificate
- UDID Card or UDID enrolment number
- Identity proof
- Address details
- Passport-size photograph, if required
- Bank details, where required
- Medical documents for claims
- Bills and receipts for eligible treatment
The exact documents can depend on the current enrolment and claim process. Therefore, applicants should verify the latest document list before submitting their application.
How to Apply for Niramaya Health Insurance Scheme 2026?
Eligible applicants need to follow the enrolment process prescribed by the National Trust.
A simple step-by-step process is given below.
Step 1: Check Your Eligibility
First, confirm that you are eligible under the National Trust Act and have the required disability certificate and UDID details.
Step 2: Collect the Documents
Keep your disability certificate, UDID details, identity documents and other required papers ready.
Step 3: Complete Enrolment
Complete the Niramaya enrolment process through the applicable authorised channel.
Step 4: Pay the Required Premium
The applicant needs to pay the applicable premium according to the current scheme rules.
Before making payment, check the latest premium amount and payment instructions from the official National Trust information.
Step 5: Keep Your Details Safe
After enrolment, keep your Niramaya-related documents and enrolment information safely. These details may be needed when you use the scheme or submit a claim.
How to Claim Niramaya Insurance?
Niramaya works on a reimbursement basis. Therefore, beneficiaries should follow the claim process after receiving eligible treatment.
The National Trust currently provides the claim process through Medi Assist TPA.
For a claim, beneficiaries may need to provide documents such as:
- Claim form
- Medical bills
- Prescriptions
- Doctor’s reports
- Investigation reports
- Hospital documents
- Payment receipts
- Other supporting documents
For certain investigations such as MRI, X-ray and ultrasound, original reports or films may be required.
The National Trust provides online and offline claim options. Beneficiaries should check the latest claim instructions before submitting their documents.
Official Portal – Click Here
Frequently Asked Questions
What is the Niramaya Health Insurance Scheme?
Niramaya is a health insurance scheme for eligible persons with disabilities covered under the National Trust Act. It provides health-related financial support of up to ₹1 lakh per person under the current benefit structure.
What is the maximum coverage under Niramaya?
The current maximum overall coverage is ₹1 lakh per beneficiary. Different healthcare services have separate limits.
Is a medical test required before joining Niramaya?
No. A pre-insurance medical examination is not required for enrolment under the scheme.
Does Niramaya cover medicines?
Eligible medicine expenses can be covered under the applicable OPD benefit and within the prescribed limit.
What is the Niramaya insurance claim process?
Niramaya claims are submitted for reimbursement. Beneficiaries need to provide the required claim form and supporting medical documents through the prescribed claim process.
Conclusion
The Niramaya Health Insurance Scheme 2026 is an important healthcare support scheme for eligible persons with disabilities covered under the National Trust Act. It provides coverage of up to ₹1 lakh and includes different healthcare needs such as hospitalisation, OPD treatment, medicines, therapy, dental care, AYUSH treatment and transportation.
Since government schemes can change over time, applicants should always check the latest information from the National Trust before applying, paying the premium or submitting a claim.
Also, read – Ambani Scholarship 2026: Eligibility, Amount, Documents and Application Process
Pingback: Bharathi Cement Scholarship 2026: Eligibility & How to Apply