The Government of Nepal has announced a significant enhancement to its national health insurance program, doubling the treatment coverage for eight critical illnesses from Rs 100,000 to Rs 200,000 per patient. The new provision will come into effect on July 17, according to Minister for Health and Population, Pradeep Paudel.
The health minister made the announcement on social media, adding that the scheme is aimed at providing financial relief to low-income citizens facing high treatment costs for severe medical conditions. Minister Paudel stated that the decision fulfils a prior commitment and targets patients diagnosed with cancer, heart disease, kidney disease, head and spinal injuries, sickle cell anaemia, Parkinson's disease, and Alzheimer’s.
The Health Insurance Board formally approved the policy at a meeting on Tuesday evening. Executive Director Dr Raghuraj Kafle confirmed that the increased coverage will be implemented starting July 17.
The initiative is part of a broader push by the government to expand access to healthcare and improve enrollment in the national health insurance scheme. Minister Paudel also endorsed policies aimed at strengthening the Health Insurance Fund's financial base. Recent national policy directives include mandatory enrollment of all public and organised sector employees, a provision already mandated under existing health insurance law but previously unenforced.
Efforts are also underway to extend insurance coverage to Nepali migrant workers and their families. Following ministry-level correspondence, several government bodies have initiated action at the local level to facilitate their inclusion.
The government has pledged in the upcoming fiscal year’s budget to clear the Board’s outstanding dues and has introduced new funding mechanisms. This includes channelling 1% of revenue from the Federal Hospital Development Committee and increasing allocations to the insurance fund via progressive taxation.
Additionally, the distribution of government-provided medical aid is gradually being integrated into the health insurance framework, with the goal of expanding beneficiary reach. The Health Insurance Board has also taken disciplinary action against hospitals submitting irregular claims and is implementing system upgrades to enhance oversight, according to Dr Kafle.