A total of 800 households, with around 4,000 members, have been enrolled in the government health insurance programme since its implementation a month ago. The scheme was introduced with an aim to protect poor and vulnerable people from any exorbitant healthcare cost.

The government, which had launched the health insurance programme from Kailali on May 14,  is now planning to expand it to Baglung and Ilam soon and eventually across the country and enrol all citizens in the programme.

Under the current health insurance programme, a household of five has to pay Rs2,500 in annual insurance premium. Each additional household member will have pay Rs425. The scheme covers medical expenses up to Rs50,000.

“Not all family members fall sick at once or might need medical attention. So the amount will help family members cope with any such events,” said Dr Guna Raj Lohani, chief of the insurance programme.

The amount would cover healthcare bills of the family members including cost of medicine, doctor’s consultancy fees and diagnostic services such as X-ray and blood tests. For patients willing to avail private hospital services, the Ministry of Health has also reached an agreement with the private hospitals in the area.

According to Dr Lohani, increased expenses for healthcare have remained a major contributing factors for poverty, and the health insurance programme provides a cushion against such external shocks.

While the Prime Minister’s Office had asked the ministry to run the health insurance programme in 2012, social health insurance programme was announced in the budget speech of 2011/12. In 2013/14, the government had worked on developing health insurance policy and there were suggestions that the insurance programme would be implement in Kailali, Baglung and Ilam by 2015/16. Even in the past, a health insurance programme named community-based health insurance programme was run for around six years, but without success. Experts blamed high dropout rates and poor coverage for its failure.

“We believe the programme is going well. It will be expanded to Baglung and Kailali soon,” said Dr Lohani. “People are yet to understand the concept of insurance. So our team on the ground is working hard to inform and convince them.”

Recently, Health Ministry officials had expressed their reservation to the government’s decision to expand the programme to 25 districts. The government has earmarked a budget of Rs2.5 billion for the programme, Rs1 billion more than what was proposed by the ministry. The officials said that the decision was taken without consultation with the ministry while they also lack capacity to rapidly expand the programme.