KATHMANDU, Dec 27: The Kathmandu Metropolitan City (KMC) is going to implement a health insurance program. 

On Wednesday, a memorandum of understanding was signed between the KMC and the Health Insurance Board to initiate the health insurance program.

The memorandum of understanding was signed by Basanta Adhikari, Chief Administrative Officer of the KMC, and Madan Kumar Upadhyaya, Executive Director of the Board.

The agreement specifies that the service will be operated in accordance with the standards outlined in the Health Insurance Act 2074, Health Insurance Regulations 2075, and the Local Level Health Insurance Coordination Committee Formation and Operation Procedures, 2078.

Under the insurance, a family of five members will receive free medical services up to Rs 100,000 per year, assuming one unit. The Insurance Board will reimburse an amount equivalent to that to the designated health centers under the KMC, as stated by Ram Prasad Paudel, chief of the Health Division of Kathmandu Metropolis.

He said that health promotion centers within the KMC will now be enlisted in the insurance board and will commence providing health treatment under insurance.

Paudel added that due to the larger population in the KMC, the number of insured citizens is also significant.

“To manage the potential burden on major hospitals, where all insured individuals might seek direct treatment, doctors at the entry point hospitals will handle the treatment of minor diseases. Patients requiring special services will be referred to larger hospitals,” he said, “Provisions will be made for testing services such as x-rays and lab work with a medical officer-level doctor in the province entry hospital.”

 
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