Banking News – More than 732 thousand citizens in Sudurpashchim have enrolled in the health insurance system. According to the Health Insurance Board Sudurpashchim Office, 732,752 people were connected to the insurance system as of mid-Bhadau last year. Janak Bahadur Saud, Sudurpashchim Coordinator of the Board, informed that according to data entered in the Insurance Management Information System, district-wise, the highest number of 361,979 citizens in Kailali have insured.

Similarly, he stated that there are 87,087 beneficiaries in Kanchanpur, 67,308 in Achham, 52,211 in Bajhang, 45,454 in Bajura, 34,270 in Baitadi, 33,378 in Dadeldhura, 27,862 in Doti, and 23,203 in Darchula.

In Nepal, the health insurance program was started on Chaitra 25, 2072 BS as a welfare-oriented social security scheme to provide accessible and quality health services to citizens and to reduce the financial risk of large treatment expenses. To operate it in an organized manner, the Health Insurance Board was established according to the Health Insurance Act, 2074 and the Health Insurance Regulations, 2075.

Coordinator Saud stated that the insurance scheme is expanding as an important aspect of implementing constitutional obligations, as Article 35 of the Constitution of Nepal provides for free basic health services and the right to social security. He stated that this has been providing significant relief in managing treatment expenses for economically weak families.

Article 51 (j) of the Constitution states that under the policy related to basic needs of citizens, arrangements will be made for access to health treatment by ensuring health insurance for citizens. Accordingly, the insurance scheme is being implemented. To enroll in health insurance, Rs 3,500 must be contributed annually per family (up to five members), and if there are more than five members, an additional fee of Rs 700 per additional member is charged.

According to the provisions of the Health Regulations, along with increasing the current benefit package by two times, there is a provision for free insurance for senior citizens above 70 years, the ultra-poor, persons with disabilities, and patients with leprosy/HIV/MDR-TB. Coordinator Saud stated that arrangements have been made for the government itself to pay the insurance premium for individuals in this group. Additionally, he informed that a mandatory arrangement has been made for the entire organized sector to enroll in insurance by contributing one percent of their income.

After enrolling in insurance, a family of up to five members can receive health treatment services of up to Rs 1 lakh, and thereafter Rs 20 thousand for each additional member, up to a maximum of Rs 2 lakh. Similarly, under the Social Health Security Program, any person who insures has been receiving treatment including OPD services, emergency, lab treatment, and general surgery from any designated government hospital.