Medicines and Facilities Available From the Health Insurance Nepal.

List and Price of Medicines and Facilities Available From the Health Insurance Nepal

The health insurance program is a priority program brought by the government under the concept of providing financial protection by managing the risk of unplanned expenses incurred while using health services in advance. The health insurance facility will increase the access of the general public to health services in a situation where a large amount of money is spent on health care and the poor and low-income people are forced to live with the disease due to financial constraints.

Nepal’s constitution provides free health care and the right to social security. In addition, the National Health Insurance Policy has taken the policy of ensuring health care for all through health insurance by improving the access and use of quality health care. It is against this background that the health insurance program has been started from Kailali district on April 9, 2072, assimilating the essence of the constitution and policy.

Currently, the program is planned to be expanded to 68 districts across the country in phases. The service providers who have entered into an agreement with the Health Insurance Board will be responsible for providing health services and facilities to the insured.

The service providers who have entered into an agreement with the Health Insurance Board will be responsible for providing health services and facilities to the insured. To facilitate this process, the Health Insurance Board has fixed the price of various health services. This includes outpatient, emergency, inpatient, diagnostic and medications. Out of the mentioned services, the service providing health institutions have to provide services to the insured as per the agreement and pay the service claim as per the price list mentioned in this booklet.

1108 Allopathic medicines are included in the Health Insurance Board and 25 types of Ayurvedic medicines

Services not covered by the Health Insurance program:

The following services will not be included in the health insurance program

Glasses worth more than one thousand rupees annually, more than five thousand rupees a hearing aid worth more, a white stick worth more than a thousand rupees, Baishakhi worth more than two thousand five hundred rupees
Burnt, treatment for severe disability, lip palate Plastic and cosmetic surgeries other than incisional surgery
Extraction, abscesses and primary management of dental trauma & Dental services

List and Price of Medicines and Facilities Available From the Health Insurance Board Nepal