Health is one of the greatest assets of human life. We all have the same idea that we are staying healthy but we are also getting sick. Many of us are saving in banks. Can bank savings alone reduce future health risks? It is important to understand this.
In the bank, we all secure the money earned by keeping in mind the obstacles that will come in the future. But how important it is to have health insurance to avoid major diseases in the future. Few of us think about that. The government of Nepal had also brought rules related to health insurance.
The Ministry of Health had passed the Health Insurance Bill 2074. After all, if you benefit from it, why not take out health insurance? We can’t even say with certainty what kind of disease afflicts us at what time.
Below is information about the benefits of getting health insurance in case of a big problem tomorrow and the conditions under which health insurance will not be available.
What services are available after insurance ?
Under the social health security program, any insured person can get treatment including OPD service, emergency, lab treatment, general operation from any government hospital. Similarly, free medicines prescribed by the government can be obtained.
However, this service is not available if you are injured due to personal quarrels, if you are injured in an accident due to drug and alcohol abuse, if you have an abortion, if you have cosmetic surgery.
What is health insurance ?
Health insurance has been introduced in Nepal only since 2040 BS. Initially, institutional health insurance was provided. After getting health insurance, the medical expenses are insured in case of illness or injury. After paying Rs 2,500 annually, the family members get up to Rs 50,000 for treatment.
How to get personal health insurance ?
Personal health insurance requires a certified identity card. If the person has reached 5 years of age, according to the insurance company, it can be done by a person between the ages of 55 and 65. The sum insured varies from Rs 100 to Rs 5,000 depending on the sum insured.
How to get institutional health insurance ?
The insurance done by the institution is institutional health insurance, it should be done by the insurance institution itself. At least 5 to 10 people with letter pad with PAN number of any company or industry and no limit can be insured by the company itself. It is also paid in the name of the company.
If the insured person is chronically ill, pregnant or falls ill within 28 days of taking out insurance, the insurance company will not provide treatment. Simply pays when others are sick or disabled.
What services are available after insurance ?
Under the social health security program, any insured person can get treatment including OPD service, emergency, lab treatment, general operation from any government hospital. Similarly, free medicines prescribed by the government can be obtained.
However, this service is not available if you are injured due to personal quarrels, if you are injured in an accident due to drug and alcohol abuse, if you have an abortion, if you have cosmetic surgery. Dental fillings, dental implants, sex, cosmetic surgery and implants are also not covered by the insurance coverage.
What is in the health insurance bill ?
In order to ensure the access of the general public to health services, the Ministry of Health had passed this bill as per the Health Insurance Bill 2074. The Bill Act has ensured the right of every citizen to get services by joining the health insurance program.
Similarly, the Act covers newborns, senior citizens, single women and persons with disabilities. Under which, it will be the responsibility of the same organization to include the persons taking shelter in the protected health institutions including old age home, orphanage, correctional home in the insurance program.
It will be the responsibility of those who want to go for foreign employment to get compulsory insurance for their family and to get health insurance for all the employees working in any organization.
Anyone who joins the insurance program will be able to get promotional programs including yoga, nutrition, education, vaccination, safe motherhood, outpatient services, admission treatment, emergency, surgery, medicine and other therapeutic services.
There is a provision in the act to get the service. It is mentioned in the act that such service can be availed only by the insured person.