Health Insurance Scheme finally comes into being

Health Insurance

KALPANA POUDEL, KATHMANDU, Oct 11: A meeting of Legislature-Parliament on Tuesday passed the bill related to providing health services through insurance to all the citizens. The Health Insurance scheme comes in accordance with Article 296 (1) of the Constitution.

The Health Insurance Act is deemed necessary to make the expenditure of health sector useful by reducing the financial risk of insurance policy holders through post-paid system. It is expected that the health insurance would end the huge financial burden on ordinary people while using health services.

There is also provision in the bill which says that the government would bear the premium for poor people, completely differently able, single woman, senior citizens and orphan children.

Families of those going for overseas employment, civil servants, and those working in informal sector have been mandatorily affiliated in the insurance.

The people would get free basic health services from primary health institutions once the health insurance act is implemented. The act would also incorporate other specialized health services.

Referral System would be brought into practice to make the service systematic and effective. Way has been opened in order to widen the coverage of insurance after establishing Insurance Board as an autonomous body. Now, all people would be incorporated in health insurance and a separate health insurance board would be formed for the same.

Health Minister Giriraj Mani Pokharel said that it is a great achievement in the health sector while former Health Minister Gagan Kumar Thapa said that health insurance bill was indispensible to address the health rights of people guaranteed in the Constitution.

The government has already started health insurance program from Kailali from April 7, 2016 by constituting Social Health Security Development Committee. The programme has now been expanded in 18 districts.

A five-member family can be a member the program after paying Rs 2,500 for a year. In return, the family could get treatment service worth Rs 50,000 for the year. Families with more than five members can avail of services worth more than Rs. 10,000 by becoming a member with an additional Rs. 450 per person.

The insurance has to be renewed every year. Those covered by the insurance will be able to receive diagnosis and lab test services as well as drugs, including the 530 types of drugs provided for free by the government.

The health insurance however does not cover plastic surgery, expensive spectacles, hearing aid and injury caused by a drunken brawl. The treatment can be received from all the health institutions from the health post to the central hospital. While registering into the health insurance scheme one has to mention the health facility where the person wants to get treatment from. The scheme is also based on a referral system, where you start from the lowest level of health facility.
The treatment provided for free for specific number diseases by the government will continue.