Niramaya Health Insurance Scheme
in Karnataka
Last updated:
Niramaya Health Insurance Scheme in Karnataka
Niramaya Health Insurance Scheme is a government scheme available to eligible residents of Karnataka.
Apply for Niramaya Health Insurance Scheme in Karnataka
Scheme Overview
Niramaya Health Insurance Scheme ,launched by the Department of Empowerment of Persons with Disabilities, aims to provide affordable health insurance to the Persons with Disabilities (PwDs).
Eligibility Criteria
- All the disable person who have at least one of the disabilities under the [National Trust Act, 1999](https://cdnbbsr.s3waas.gov.in/s3300891a62162b960cf02ce3827bb363c/uploads/2024/09/20240918793880368.pdf) with valid disability certificate.
Benefits
Health insurance coverage: Up to ₹1,00,000/- for various expenses.
Outpatient department (OPD) treatment: Covers medicines, pathology, diagnostic tests, etc.
Regular medical checkups: For non-ailing individuals with disabilities.
Dental care: Preventive dentistry services.
Surgery: To prevent further disability worsening or for existing disabilities (including congenital).
Non-surgical/hospitalization: Coverage for non-surgical treatments and related stays.
Ongoing therapies: For managing disability and related complications.
Alternative medicine: Coverage for alternative treatment options.
Section II: Outpatient Department (OPD) : The overall OPD treatment limit is ₹19,000/-, broken down as:
Section III: Ongoing Therapies
Section IV: Alternative Medicine (AYUSH)
Section V: Transportation
Required Documents
| # | Document |
|---|---|
| 1 | Need for ORIGINAL REPORTS / FILMS LIKE MRI, X-RAY, ULTRASOUNDS ETC.: Original documents are required including the film for settling of Claims. |
| 2 | Prescription for Ongoing Therapies: Doctor’s prescription at least once in Six months is essential in which the category of therapy and duration of therapy should be clearly mentioned. Thereafter other documents from Rehabilitation Professional for therap |
How to Apply in Karnataka
Step 1: Parents/ guardian of the PwD will visit the nearest Registered Organization (RO) for Niramaya enrolment with required documents.
Online Step 1: Parents/ guardian of the PwD will visit the nearest Registered Organization (RO) for Niramaya enrolment with required documents.
Step 2: RO will fill up the Niramaya application form online and upload the scanned documents as required after verification of the originals.
Online Step 2: RO will fill up the Niramaya application form online and upload the scanned documents as required after verification of the originals.
Step 3: On successful enrolment and approval, Health ID No. /card will be issued to each beneficiary or can be downloaded by the beneficiary online or through RO.
Online Step 3: On successful enrolment and approval, Health ID No. /card will be issued to each beneficiary or can be downloaded by the beneficiary online or through RO.
Step 1: The parent/guardian of the beneficiary can renew the scheme with the required documents online by logging on to the Niramaya website through providing below details: Policy Period, Beneficiary ID, UDID No/Enrollment no, Date of birth.
Online Step 1: The parent/guardian of the beneficiary can renew the scheme with the required documents online by logging on to the Niramaya website through providing below details: Policy Period, Beneficiary ID, UDID No/Enrollment no, Date of birth.
Step 2: RO to verify the validity of documents
Online Step 2: RO to verify the validity of documents
Step 3: Pay the application fees online.
Online Step 3: Pay the application fees online.
Step 4: After receipt of payment, the RO/beneficiary will be notified of the renewal for another year through the website.
Online All claims for settlement under Niramaya have to be submitted to the canters of the insurance provider in the prescribed Claim Form along with relevant vouchers/bills, etc. (preferably within 30 days of treatment) or discharge from hospital.
Step 1: Log on to https://portal.mediassist.in - MediAssist Employee portal. (Your username will be as <application_id>@NATIONALTRUST.Com and password will be your date of Birth of Beneficiary e.g. DD-MM-YYYY)
Online • You can also download the Mediassist App from Android/Apple/Window store in a phone [Username - <application_id>@NATIONALTRUST.Com and password will be DD-MM-YYYY (Date of Birth of the Beneficiary]
Step 2: Click on Submit claim option and fill the details to generate the claim form.
Online Step 2: Click on Submit claim option and fill the details to generate the claim form.
Step 3: Click on “Save and Next” once all the details are filled.
Online On 3rd Page, employee KYC documents are to be updated (one time activity).
Step 4: Upload relevant documents.
Online Step 4: Upload relevant documents.
Step 5: After Moving to the final Page ”Declaration and Claim Submission” select the ailment type.
Online Step 5: After Moving to the final Page ”Declaration and Claim Submission” select the ailment type.
Step 6: Upload the softcopy of the documents.
Online Step 6: Upload the softcopy of the documents.
Step 7: Acknowledge the declaration and Click submit to successfully generate the claim form.
Online Step 7: Acknowledge the declaration and Click submit to successfully generate the claim form.
Step 8: An Auto-generated mail will be triggered to your registered Email ID containing the claim form.
Online Step 8: An Auto-generated mail will be triggered to your registered Email ID containing the claim form.
Step 1: Visit: https://mediassisttpa.in
Offline Step 1: Visit: https://mediassisttpa.in
Step 2: Click on “Download Claim Form” or visit – https://mediassisttpa.in/#claim-forms
Offline Step 2: Click on “Download Claim Form” or visit – https://mediassisttpa.in/#claim-forms
Step 3: Click on “Claim Form Insured (Part A)” to download pdf file of claim form.
Offline Step 3: Click on “Claim Form Insured (Part A)” to download pdf file of claim form.
Step 4: Fill Claim form, attach required documents and send to Mediassist TPA on following address:
Offline MEDI ASSIST INSURANCE TPA PRIVATE LIMITED, 1st Floor, Block D, Noida Sector 3, Noida, Uttar Pradesh, PIN- 201301 Phone: 040-68213648, Toll Free – 1800 572 9792
Common questions in Karnataka
Who can apply for Niramaya Health Insurance Scheme in Karnataka?
Eligible residents of Karnataka who meet the scheme’s overall criteria can apply for Niramaya Health Insurance Scheme. Refer to the eligibility section above for the complete checklist.
What documents are required for Niramaya Health Insurance Scheme in Karnataka?
Applicants in Karnataka typically need identity proof (Aadhaar), state residency proof, bank account details, and any scheme-specific documents listed in the documents section.
Frequently Asked Questions
Niramaya Health Insurance Scheme ,launched by the Department of Empowerment of Persons with Disabilities, aims to provide affordable health insurance to the Persons with Disabilities (PwDs).