Health Insurance Board Urges Insured Citizens to Avoid Unnecessary Medical Tests, Pays Rs. 23.44 Billion in Claims

Health Insurance Board Urges Insured Citizens to Avoid Unnecessary Medical Tests, Pays Rs. 23.44 Billion in Claims


Banking News — Nepal’s Health Insurance Board has announced that it has cleared all insurance claims submitted by empaneled healthcare providers up to the end of Mangsir 2082 (mid-December 2025).

According to the board, it has disbursed a total of Rs. 23.44 billion (Rs. 23,44,02,98,016) to healthcare service providers on various dates during the current fiscal year.

The board stated that despite limited resources and structural challenges, the national health insurance programme continues to provide healthcare services to thousands of insured citizens every day. It added that the programme has played a significant role in reducing out-of-pocket medical expenses and protecting citizens from financial risks associated with healthcare costs.

However, the board acknowledged that the absence of a fully established sustainable financing mechanism had resulted in delays in claim settlements to some healthcare providers. With the latest payment, all outstanding claims submitted by healthcare institutions affiliated with the board through the end of Mangsir 2082 have now been settled.

The board said it is continuing to coordinate with the relevant authorities to secure the necessary budget and establish a sustainable financial source for the settlement of claims submitted after Mangsir 2082.

It has also urged all empaneled healthcare institutions to continue providing uninterrupted, quality medical services to insured citizens in accordance with the prescribed standards under the health insurance programme.

In addition, the board appealed to the public to avoid undergoing unnecessary medical tests and to cooperate in ensuring the effective implementation and sustainability of the health insurance programme.