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Nepal Health Insurance

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Your guide to health insurance in Nepal

Best known for its high altitude and mountainous terrain, Nepal is a beautiful Himalayan country with a multitude of languages, cultures, and religions. If you are moving or traveling to Nepal, you will surely have many questions concerning their healthcare system, their national medical insurance scheme, healthcare for expats, and the commonest health threats. This short guide below offers a practical summary of healthcare and insurance in Nepal, as well as options from health insurance companies for expats dwelling there. Read on to learn more, or click the button below to obtain a no-obligation, free quote.

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Public and private healthcare systems in Nepal

Run by the Ministry of Health & Family Welfare, Nepal’s healthcare system is provided through 180 primary health centers, 711 health posts, and 3179 sub-health posts. There are both private and public facilities that provide medical care but most private facilities are located within the capital of Nepal, Kathmandu. These private centers are usually used by foreign visitors and wealthier Nepalese, including the Nepal International Clinic and CIWEC Clinic. A basic visit will set you back around US$20 and a three-day treatment of antibiotics is less than US$3.

On the other hand, public healthcare facilities throughout Nepal are generally poorly equipped and extremely limited by international standards, especially in rural areas. Nepal has improved public healthcare facilities, but due to lack of funding, there are still many issues with the care provided within rural areas. The majority of funding goes to hospitals and medical facilities within the larger urban areas, such as Kathmandu and Pokhara. With highly centralized planning and finance for healthcare, many rural areas lack proper medical facilities. Only within Kathmandu is it advised that you trust medical facilities for basic medical diagnosis and treatment. 

Public health insurance scheme in Nepal

The Nepal government launched its public health insurance plan in the 2016-17 fiscal year. According to this scheme, a household is considered as a unit and has to pay a premium of USD $113 every year to get the services worth up to USD $348. The government will compensate for households that are unable to pay for the premium. This public health insurance scheme provides coverage to services, such as nutrition, psychological counseling, vaccination, family planning, safe motherhood, OPD and emergency services, medications, and preventive services including ambulance.

However, as of 2018, it is yet to cover 38 of the 77 districts in the country. Given that the public has shown little interest in health insurance policies, the government plans to make it mandatory for more government staff and migrant workers.

Healthcare for expats living and working in Nepal

While Kathmandu, Nepal’s capital, boasts the best medical facilities in the country, the further away you are from the capital, the standards at clinics and hospitals decline even more. Should you suffer from any major illness or injury, it is advised that you get evacuated to the nearest adequate medical facility, which, in most cases, would mean evacuation to Singapore, Bangkok, or New Delhi. 

Given the high altitude, health risks, and potential cost of evacuation, it is strongly recommended that you take out a health insurance policy to cover the costs of hospital treatment and emergency evacuations. It is also a smart move to secure a plan that supports upfront payment instead of having you to pay out-of-pocket and submit claims later. 

Vaccinations

Visitors to Nepal should make sure that all their vaccinations are up to date. Recommended vaccinations include adult diphtheria, tetanus, hepatitis A and B, influenza, Japanese encephalitis, meningitis, polio, rabies, tuberculosis, and typhoid. Vaccination for yellow fever is required for entry into the country if arriving from a yellow-fever-infected country in Africa or the Americas. Most visitors to Nepal will visit remote areas so it makes sense to visit your doctor for a general health check-up and bring along medication for any pre-existing medical conditions that you may have.

What are the major health threats in Nepal?

Communicable diseases constitute close to 70% of the causes of morbidity and mortality in Nepal. People in Nepal may contract one of several potentially dangerous diseases, such as hepatitis A, hepatitis B, HIV/AIDS, dengue fever, malaria, typhoid, and bacterial diarrhea. 

Mosquito-borne diseases

For the mosquito-borne diseases of dengue, malaria, and Japanese encephalitis, they are mainly seen in the lower areas of Nepal and rarely seen in higher altitudes but expatriates should still be cautious not to get bitten.

Typhoid and bacterial diarrhea

As for typhoid and bacterial diarrhea, you should ensure you purchase food from hotels or trusted restaurants and filter or boil all of your drinking water. If you are not sure what your filter will actually clean from your drinking water, then boil it as well, but at higher altitudes, water boils at lower temperatures so it is advised to boil water for at least 10 minutes at higher altitudes in Nepal.

Acute mountain sickness

Nepal has one of the highest average elevations in the world, which also means expatriates have a high possibility of running into acute mountain sickness (AMS). AMS, or altitude sickness, is set on by the lack of oxygen at altitudes of over 2500 meters. The effect can be mild or severe and can crop up with little to no warning. It occurs because less oxygen reaches the muscles and brain requiring the lungs and heart to work harder and faster. AMS has been fatal at 3000 meters but usually is found fatal above altitudes of 3500 meters. 

The best way to prevent AMS is to avoid rapid ascents to higher altitudes. When traveling to the higher altitude locations of Nepal via bus or plane, make sure to take it easy for three days after you arrive to allow your body to adjust to the smaller amount of oxygen.

How to find the best private health insurance in Nepal

With extensive years of experience throughout the world, Pacific Prime can assist you with any health insurance needs in Nepal. Leveraging our close relationships with major insurers over the world, we offer professional advice and free plan comparisons to our clients. No matter what your budget is or what your requirements are, our professional consultants can match you with a policy that best fits you or your group. Our policies can cover a wide range of services including dental, maternity, specialist consultation, transportation, inpatient services, and many more aspects. Please contact us today for a free consultation.

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