Health Insurance services suspended in private hospitals except emergency care from today

Kathmandu-Following a recent government decision, private hospitals across Nepal have suspended all health insurance services except emergency care starting today.The Health Insurance Board had earlier announced that, effective from today until further notice, all non-emergency services under the national health insurance program would be halted at private healthcare institutions. The decision was made during a board meeting held on May 25 (Jestha 11).

With the implementation of this decision, insured citizens who have been receiving healthcare services through hundreds of private hospitals and medical colleges nationwide will no longer have access to routine services covered by health insurance, including outpatient consultations, diagnostic tests, medications, and other regular treatments.According to the Health Insurance Board, more than NPR 15 billion remains unpaid to service providers under the insurance scheme. Private hospitals have repeatedly complained about delayed reimbursements, outstanding claims, and increasingly complex administrative procedures associated with the program.

The suspension of health insurance services in private hospitals is expected to cause significant inconvenience to insured patients. Service users have urged the government and concerned authorities to reconsider the decision and ensure the continuity of the health insurance program.Meanwhile, Acting Executive Director of the Health Insurance Board, Shakuntala Prajapati, stated that revised rates under the “Benefit Package” have also come into effect from today. She said that all healthcare providers have been instructed to charge for medicines, medical supplies, healthcare services, surgeries, and laboratory tests according to the newly revised rates.