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Health Insurance: Patients must pay 20% for treatment in private health institutions



Kathmandu, April 14: Under the health insurance program of the Health Insurance Board, from today onwards, insured persons who are treated in private and community hospitals have to pay 20 percent of the amount themselves.

The #Executive Director of the board, Dr. Damodar Basaula, said that from today onwards, patients receiving treatment in private and community hospitals will have to pay 20 percent of the treatment expenses themselves (co-payment).

“To discourage unnecessary health check-ups, we have implemented a rule to pay 20 percent of the treatment costs from today, so that only the insured who do not undergo unnecessary health check-ups and those who are ill will benefit from health insurance,” he said.

By amending the Health Insurance Program Co-payment Implementation Procedure 2080 BS, the insured affiliated to the board has implemented a provision that patients who receive treatment in private and community hospitals must pay 20 percent of the cost of treatment.

Earlier, the board had implemented the rule of paying 10 percent for treatment in government hospitals from Magh 1, 2080 BS. He said that the system of co-payment has been implemented to develop the capacity of government hospitals and to attract patients to government hospitals.

According to Executive Director Dr. Basoula, the co-payment is not applicable in basic hospitals with up to 15 beds. It is mentioned in the procedure that co-payment system will be applied in federal and provincial hospitals, basic hospitals where specialist services are available, private, cooperative, community hospitals, medical colleges.

The total number of insured persons in the insurance program is 7,741,483 people and the number of service takers among the total insured persons is 3,652,432 people. #nepal