Government Integrates Health Insurance Programs for Poor Citizens
Kathmandu — The Ministry of Health and Population has begun integrating scattered social health security programs under a unified framework aimed at improving access to healthcare for poor citizens.
Minister for Health and Population Pradeep Poudel on Wednesday launched the initiative by approving the Poverty Citizen Drug Treatment Program Operation Directive 2082 (First Amendment). The directive, prepared under Section 41 of the Health Insurance Act 2074, seeks to make health insurance services more systematic, transparent, and accessible.
According to the Ministry, families categorized as “extremely poor” by the Ministry of Land Management, Cooperatives and Poverty Alleviation (MPA) will now be automatically included in health insurance. Each identified family will be registered as a single unit. To access the service, beneficiaries must present a State Facility ID Card (MPA), a citizenship or national ID card, and, for minors, a minor ID card. Local-level Health Insurance Coordination Committees and registration officers will assist in the process.
“The government is committed to ensuring healthcare for poor citizens. By integrating health insurance services, we aim to prevent misuse of state funds and guarantee that benefits reach those who truly need them,” Minister Poudel said at the launch event.
The revised directive introduces a one-stop payment system through the Health Insurance Board for treatment under the Poor Citizen Treatment Program. While the Board will manage financial settlements, the Department of Health Services’ Nursing and Social Security Division will handle hospital enrollment, monitoring, and reporting.
Poor citizens enrolled in the program will receive the following benefits:
Kidney disease: Free hemodialysis services; up to Rs 750,000 for kidney transplant (including health insurance and poor citizen facilities); and a monthly allowance of Rs 5,000.
Eight serious diseases — including heart disease, cancer, Parkinson’s, Alzheimer’s, spinal and head injuries, and sickle cell anemia: Treatment coverage up to Rs 300,000.
Heart valve surgery: Free surgeries at Gangalal and Manmohan Hospitals for patients under 15 and over 75 years of age, plus an additional Rs 200,000 through insurance.