Kathmandu — Beginning Shawran 1 (Mid-July 2025), individuals enrolled in Nepal’s Health Insurance Program will be able to receive medical services from any government-approved healthcare institution, regardless of their initially assigned service point.
This significant change comes after growing public complaints about difficulties in accessing health services through the insurance program. In response, the Health Insurance Board has announced this decision to simplify access and improve flexibility for insured citizens.
According to the Board, starting from the fiscal year 2082/83, policyholders will no longer be restricted to a single, pre-assigned primary care center. Instead, they can directly seek services from any approved health facility recognized under the program.
Previously, insured individuals were obligated to receive care only from their designated “Primary Service Point.” This limitation caused delays and dissatisfaction, particularly in areas with limited health infrastructure or accessibility issues.
However, with recent amendments to the Health Insurance Act, 2074 and the Regulation, 2075, insured individuals are now legally entitled to access treatment from any authorized service provider within the network.
This reform is expected to significantly improve healthcare access and reduce logistical barriers for thousands of insured citizens across the country.
