From Shrawan 1, patients suffering from 8 serious diseases in Nepal will receive up to Rs. 2 lakh in treatment under the government’s health insurance program. This support is double the earlier amount of Rs. 1 lakh.
Which diseases are covered?
The following 8 complex diseases are included:
- Cancer
- Heart disease
- Kidney disease
- Head injury
- Spinal injury
- Sickle cell anemia
- Parkinson’s disease
- Alzheimer’s disease
Health Minister’s commitment
Health Minister Pradeep Paudel stated that this decision aims to support poor patients who cannot afford treatment costs. He emphasized that the health insurance scheme will now better fulfill its promises with this expanded coverage.
Health Insurance Board decision finalized
Following ministerial instructions, the Health Insurance Board officially approved the two-lakh support for these eight diseases during its meeting on Tuesday. The decision will take effect from Shrawan 1, confirmed Executive Director Dr. Raghuraj Kafle.
Health insurance reforms and expansion
Access to treatment from local facilities
Now, insured members can receive treatment from their nearest facilities, thanks to updated policy changes. Health insurance is becoming more accessible and flexible at all levels.
Mandatory for government and organized sector employees
The new policy also mandates health insurance enrollment for all government and organized sector employees. This is expected to increase fund contributions and boost the insurance program’s sustainability.
Targeting migrant workers and families
The government is also working to include migrant workers and their families in the program. Coordination has started at both ministerial and local levels.
Debt clearance and revenue increase
To strengthen the fund:
- The government has pledged to clear outstanding dues of the insurance board.
- 1% of income from federal hospitals will now go to the Health Insurance Fund.
- Progressive tax revenues are also being redirected toward health insurance.
Tighter monitoring of hospitals
The board is cracking down on hospitals that make irregular payment claims. Improved monitoring and system upgrades are in progress to ensure transparency and efficiency.
