Tuesday, December 16th, 2025

Health insurance participants to cover 20% of treatment costs



KATHMANDU: The Health Insurance Board has announced that individuals covered under the health insurance program will now be responsible for covering 20% of their treatment costs at private and community hospitals.

Dr. Damodar Basaula, the Executive Director of the Board, stated that starting today, those covered under the scheme will need to cover 20% of the total treatment expenses.

This new provision aims to discourage unnecessary health tests among insured individuals.

According to Dr. Basaula, only those who are sick and insured will benefit from this new provision.

Previously, insured individuals were required to cover 10% of the treatment costs at community hospitals and 20% at private hospitals.

Dr. Basaula clarified that this scheme will not be applicable in basic hospitals with 15 beds.

The cost-sharing for treatment will apply to federal and provincial hospitals, private and community hospitals, as well as medical colleges offering specialist services.

A total of 7,741,483 people have enrolled in the insurance scheme, with 3.6 million currently benefiting from it.

However, there are still 4.8 million individuals who have yet to renew their coverage.

 

 

 

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