An additional treatment benefit of 1 lakh rupees from health insurance for complex diseases

Nepal Health News, Kathmandu: Minister for Health and Population, Pradeep Paudel, has decided to provide an additional treatment benefit of up to NPR 100,000 through the Health Insurance Fund for the treatment of complex diseases.

Minister Paudel has been actively engaged in policy reforms and systemic transformations to make the Health Insurance Fund more effective. In line with this initiative, patients suffering from cancer, heart disease, kidney-related ailments, head and spinal injuries, sickle cell anemia, Parkinson’s disease, and Alzheimer’s disease will now be eligible to receive an additional NPR 100,000 in treatment support beyond the currently available insurance benefits.

According to the ministerial decision, this provision will be implemented under the enforcement of the Health Insurance Regulations. Additionally, the Ministry has already communicated with the Health Insurance Board to ensure that this benefit will be granted only to senior citizens aged 70 and above, and that it will not be repeated for the same beneficiary.

Minister Paudel is also moving forward with plans to introduce the concept of “insurance packages” based on financial sustainability, with the goal of increasing public interest in health insurance. The Ministry remains committed to preventing misuse of the Insurance Fund during the development of these packages.

The Ministry of Health has instructed the Health Insurance Board to base the development of insurance benefit packages on factors such as disease burden, public health needs, cost-effectiveness, and financial sustainability, while also ensuring strong safeguards against misuse of the Insurance Fund.