Health Insurance in Nepal
What is health Insurance?
Health insurance is a form of insurance that allows covering the cost of an insured individual’s medical and surgical expenses.
Insurers use the term “provider” to explain a clinic, hospital, doctor, laboratory, healthcare practitioner, or pharmacy that gives remedy/treatment for an individual’s situation.
The “insured” is the owner of the medical insurance policy or the individual with the medical insurance.
Depending on the form of health insurance a person has, both the insured will pay costs out of pocket and gets reimbursement, or the insurer makes bills immediately to the provider.
Objectives of Health Insurance
Ensures access to a health insurance service
- Ensures best health service
- Protects from financial problems and decrease out-of-pocket expenses
- Capacity and possession building of Health service provider.
Aim of Health Insurance Board (HIB)
- Extends health insurance to all districts through 2022 and to all population by 2030 in step with SDGs.
- Intends to reduce out of pocket expenditure (presently 55% of total health expenditure) and enhance financial safety amongst the population via health insurance.
Policy Tools for Health Insurance
Government policies were constant in confirming its dedication to equity and meeting the desires of the poor via the delivery of important health services:
- A Poverty Reduction Strategy Paper (PRSP), based at the work of the Public Expenditure Review Commission, has been endorsed by HMGN.
- The 1999 Local Self-Governance Act units out a framework for decentralized delivery of health & fitness care.
- The Second Long Term Health Plan (SLTHP) 1997–2017 defines the obligations of HMGN. To ensure that an essential health care package deal is to be had to all regardless of ability to pay. To make certain policies and strategies are in the vicinity for health needs that fall outside the important package & to regulate the personal health market/sector.
- The SLTHP put unique emphasis on improving the health status of the very poor and other inclined groups whose health needs often go unmet.
- The Medium-Term Expenditure Framework July 2002 categorized health budget in three prioritized health services and awarded first priority to Essential Health Care Services (EHCS).
- The Health Sector Strategy — Agenda for Change, 2002 units out the agenda for health reform.
