Now the Treatment of Impoverished Citizens Will Be Through Insurance

Nepal Health News, Kathmandu. The Ministry of Health and Population has taken a significant step toward making the health service system for underprivileged citizens more integrated and strengthening social health protection. The ministry has officially launched a new system by approving the "Directive for Operation of Medicine and Treatment Program for the Impoverished Citizens, 2082 (First Amendment)."

Health Minister Pradeep Paudel, while approving the directive, stated that the government is working to make the health insurance program more integrated, transparent, and people-centered. He clarified that reforms in the insurance system have been made to ensure the effective management of state resources and to deliver services to citizens.

He said, "Our goal is to bring scattered health services under one umbrella and build a strong and unified social health protection system." According to him, since enrollment in insurance is now mandatory, misuse of state funds will be reduced and there will be greater assurance that services reach underprivileged citizens.

The amended directive states that the payment process of the Impoverished Citizens Treatment Program, previously operated by the Nursing and Social Security Division under the Department of Health Services, will now be managed through the Health Insurance Board.

However, tasks such as hospital listing, monitoring, and report management will still be conducted by the Nursing and Social Security Division.

With the implementation of this directive, services previously provided for serious and chronic illnesses will now be included under the insurance system. Hemodialysis services will be provided free of cost for kidney patients, and up to seven hundred fifty thousand rupees will be available for transplants by combining health insurance and the support program for the underprivileged. Additionally, they will receive a monthly living allowance of five thousand rupees.

Likewise, for the treatment of eight serious diseases including heart disease, cancer, Parkinson’s, Alzheimer’s, spinal injury, head injury, and sickle cell anemia, assistance of up to three hundred thousand rupees will be provided. Patients under 15 and over 75 who require heart valve surgery will receive free treatment at Gangalal and Manmohan Cardiothoracic Centers, and an additional two hundred thousand rupees will be available through the insurance program.

Minister Paudel clarified that this decision was made according to the priorities and action plans he had announced last year. The ministry stated that the directive was finalized based on the recommendations of the Health Insurance Reform Task Force and discussions with stakeholders.

Ministry spokesperson Dr. Prakash Budhathoki expressed confidence that this new system will resolve previous problems such as duplication in service delivery, lack of coordination, and absence of data. From now on, expenses from the state treasury will be managed transparently, and the identity of the beneficiaries will be clearly established. The ministry believes this will help maintain financial discipline, accountability, and transparency in the health sector.