Clarification from the Health Insurance Board: Treatment Services Remain Unchanged

The Health Insurance Board has recently clarified that the annual treatment services of up to one lakh rupees for the insured will remain unchanged. According to the Board's Information Officer, Bikesh Mall, families with five members will be eligible for treatment services worth up to one lakh rupees annually, with a contribution of 3,500 rupees. This provision will offer significant relief to insured families.

The insurance amount is allocated for various services. A sum of 5,000 rupees is designated for OPD services, while 75,000 rupees are allocated for hospitalization and emergency services. For families with more than five members, an additional 5,000 rupees for OPD services is available. This ensures that larger families also have access to essential health services.

However, the Board has urged the public to avoid unnecessary use of OPD services and double services. It has also emphasized the need to ensure adequate resources for the treatment of serious, complex, and life-threatening diseases. Adhering to these allocations is considered crucial to improving the health insurance system and preventing potential issues.

Experts have warned that over 70% of the current health insurance budget is being spent on general OPD services. As a result, the insurance amount for serious diseases or expensive surgeries is becoming insufficient, forcing patients to bear additional costs. The Board has raised awareness about this issue and stressed the importance of taking necessary steps to resolve it.