Encourage yourself and others to get enrolled and be a part of the government health program, even if none of your family members are suffering from sickness or disease. Do not worry about the refund of Rs. 2500, if nobody gets sick within a period. You c

We all can agree with the fact that: in Nepal, especially in Kathmandu, pollution has reached high levels and is leading to serious health issues such as asthma, cardiovascular diseases, pneumonia, cancer, skin diseases, ocular diseases, respiratory diseases and so on. As a result, our health can deteriorate at any time. But unfortunately, the statement “Health is Wealth” has not been a taken seriously by city dwellers. According to WHO, diseases such as ischemic, heart diseases, stroke, bronchus, diabetes and hypertensive diseases are the leading causes of death globally.

Realizing the above facts, The Ministry of Health and Population of the Government of Nepal has introduced the Health Insurance (GHI) policy for the first time in Nepal. The program is implemented via District Social Health Security offices. Korean International Cooperation Agency (KOICA) and German Society for International Cooperation are the collaborative partners of this initiative.

A health insurance is a collaborative program to ensure timely health services, by covering the treatment costs. Simply put, it is a technique of managing health care expenses in advance.

In the context of Nepal, GHI has been introduced as a part of the government’s social security program. The basic philosophy of this “Universal health care program” is to ensure that all citizens have access to preventive, curative and rehabilitative health care services. However, many potential beneficiaries of the program are skeptical of the quality of services that will be provided under the program at government’s national, regional, district and local level hospitals as they are often considered to be of less than satisfactory quality.

What about the cost?

An individual household of five members have to pay an annual premium of Rs. 2,500 to get enrolled in the program, which is about Rs. seven a day. If there are more than five members in the family then Rs. 425 will be levied for every additional member. Interestingly, special provision has been made for people whose economic status is below the poverty line.

What about the benefits (monetary and non-monetary)?

  • Once the enrolled, an individual health card also known as ‘Azabko Card’ will be provided. Then after, a single family can claim health services and treatment costs of up to Rs. 50,000 in a year. If more than five members are enrolled from a family. Per person Rs 10,000 and up to Rs.100000 in total can be claimed. In such cases, the Government will make a direct payment to the tie-up hospitals.
  • It lessens minimizes the financial burden of medication on the rolled members and thereby makes them feel better about seeking medical services. So, it is highly recommended that everyone own this policy in time.
  • Direct expenses related medical cases, patient services and admit cases will be borne by the policy.
  • Only 15 % of the medical bills are payable by the insured and this excludes 70 types of medicine, which are distributed free of cost by the government.
  • In addition, the program protects the enrolled people from going bankrupt as a result of unexpected health problem.