Government endorses health insurance bill

Kathmandu, April 12

The government has endorsed the draft of Health Insurance Act prepared by the Ministry of Health with a view to providing basic health care services to all Nepali citizens.

Raju Katwal, legal adviser to Minister for Health Gagan Kumar Thapa, said, “Once the bill is enacted into law, no one will be deprived of basic healthcare services.” He said a meeting of the Council of Ministers held yesterday had endorsed the bill and decided to register it in the Parliament.

According to the bill, people will get free access to yoga, immunisation, family planning, safe motherhood, out-patient care, in-patient care, surgery, medicines, emergency care, curative services, rehabilitation, ambulance service (except air ambulance service) and other services decided by the government.

The bill adds that civil servants and migrant workers have to enrol their families in  the health insurance policy system. People working in private institutions also have to get their families enrolled to ensure health insurance policy benefits.

Federal, provincial and local governments will be liable to bear insurance premium of poor and  marginalised families, adds the bill. Rehabilitation shelters, orphanages, old-age homes and  correction centres will have to enrol disabled, orphans and elderly people residing in their shelters for health insurance.

The bill, however, does not define  the treatment cost a family can claim under the scheme. According to Katwal, the government has not included the amount in the bill to make it flexible.   He said the government could increase both the premium and ceiling of treatment cost  through regulations.

The bill adds that patients can avail of free services in big hospitals on reference from health posts and primary healthcare centres where treatment for them is not available.

People having  government health insurance policy can receive service from private health institutions that have signed memorandum of understanding with the MoH. The MoH will reimburse the treatment cost.

The MoH had launched health insurance programme in Baglung, Ilam and Kailali, as  a pilot project last year.  Under  this project,  the MoH collected  Rs 2,500 from each five-member family and provided it treatment equivalent to Rs 50,000 per year. The MoH collected Rs 425 from each additional member of a family.

The MoH said any member of a family enrolled in the insurance programme could be covered for  treatment up to Rs 50,000 or all members could be covered for treatment up to Rs 50,000.