“Health is wealth”- everyone must have heard this phrase at least once in their lifetime. It is as well a very believable phrase as nothing is more precious than life. But with the rising expenses on medical services, health care is almost impossible with enough wealth in the present context world. And with the increase in globalization, different new diseases, pandemics and viruses are also on the rise. So more is added on the medical budget for individuals. 

So what can we do to ensure our health and bear the expenses? Well hygienic living can be used as preventive measures while health insurance (स्वास्थ्य बीमा) can be the precaution for easiness in bearing the expenses. With the increase in the number of sedentary workers, there is a higher chance for lifestyle-related diseases such as diabetes, cardiac problems etc. and sudden mishap like accidents that can happen in any stage of life. The higher incidences of these mean more spends on such accounts. To protect the family from such shocks, it is best to buy a Health Insurance policy.

So, What Is Health Insurance (स्वास्थ्य बीमा)?

Health insurance is an agreement whereby an insurance company agrees to undertake a guarantee of compensation for medical expenses in case the insured falls ill or meets with an accident which leads to hospitalization of the insured.

Generally, insurance companies have tie-ups with the leading hospitals so as to provide cashless treatment to the insured. In case the insurance company has no tie-ups with the hospital, they reimburse the cost of expenses incurred by the insured. Health insurance offsets costs associated with routine care, illnesses and injuries, making medical services more affordable.

It is a type of insurance coverage that pays for medical and surgical expenses that are incurred by the insured. Health insurance can either reimburse the insured for expenses incurred from illness or injury or pay the care provider directly. Health insurance is often included in employer benefit packages as a means of enticing quality employees.


How Does Medical Insurance Differ From Other Types Of Insurances?

There are several different types of insurances. Different types of insurance vary from each other depending on what type of insurance policy the insured is trying to apply for. There are several types of insurance policies like life insurance, health insurance, auto insurance, disability insurance, property insurance, pet insurance, marine insurance, fire insurance, and so on.  According to most of the financial experts, there are four types of insurance policies that are required for us. They are: life insurance policy, health insurance policy, auto insurance policy, and disability insurance policy.

Life insurance policy

The greatest factor in having life insurance is providing for those you leave behind. This is extremely important if you have a family that is dependent on your salary to pay the bills. Industry experts suggest a life insurance policy should cover “ten times your yearly income.” This sum would provide enough money to cover existing expenses, funeral expenses and give your family a financial cushion. That cushion will help them re-group after your death.

Health insurance policy

As discussed earlier, Health insurance aims at covering the actual cost towards treating illnesses/medical conditions subject to the sum assured. Buying a health insurance policy for yourself and your family is important because medical care is expensive, especially in the private sector. Hospitalization can burn a hole in your pocket and derail your finances. It will become even tough, if the person who brings in the money, is now in a hospital bed. All this can be avoided by just paying a small annual premium which would lessen your stress in case of medical emergencies. 

Auto insurance policy

It is a policy purchased by vehicle owners to mitigate costs associated with getting into an auto accident. Instead of paying out of pocket for auto accidents, people pay annual premiums to an auto insurance company; the company then pays all or most of the costs associated with an auto accident or other vehicle damage.

Disabilityinsurance policy

This is the one insurance most us think we will never need, as none of us assumes we will become disabled. Disability insurance is a type of insurance that will provide income in the event a worker is unable to perform their work and earn money due to a disability. This is a potential insurance for those whose work endangers their lives such as factory workers, labourers, firefighters and many others.

Difference In Health Insurance And Life Insurance Plans

You might have heard about different insurance plans that help make your life easier. But did you know that life insurance and health insurance plans are two different insurance plans yet works to make your life easier.        

Some key differences between health insurance and life insurance plans are mentioned below:

  1. Health insurance helps pay for medical expenses such as doctor’s visits, hospital stays, medications, tests, and procedures. This helps ensure that people can afford their medical expenses and stay healthy. Health insurance aims at covering the actual cost towards treating illnesses/medical conditions subject to the sum assured. There is no life cover, meaning there is no payout on death.
  2. On the other hand, life insurance pays out a death benefit to your beneficiaries in the case of premature death. The purpose is that the death benefit is sufficient to replace future income lost, as well as cover expenses and obligations outstanding such as funeral costs, medical expenses, and other debts – or to fund college savings accounts or spousal retirement. This gives the family continuity of their finances so they do not struggle after death. Providing life cover to the policyholder is the main objective behind opting for life insurance. The policyholder wants to be sure that his family or dependents can maintain their lifestyle in his absence. In an eventuality, proceeds from the life insurance policy will replace his income allowing his family members to lead a near-normal life as far as the household finances go.

5 Reasons To Have Health Care Plans

Everyone has only one life and it is valuable. It is not known when an emergency may occur. And, another thing to note is that medical fees are expensive. In such a situation, Health Insurance is a must and below are five major reasons to have it.

Medical costs are ever rising

The fact that ‘medical fees are becoming expensive’ is undeniable. And, in case of emergency not everyone can afford such high medical expenses in a short time. But, health insurance can ease up that problem.

Changing lifestyle has made us more prone to illness

The modern lifestyle may have benefited us in many ways but it is also true that it has made us prone to disorders involving heart and lung conditions. Moreover, hectic work schedules lead to untimely eating and rising pollution has developed more health problems.

Coverage of pre-existing diseases

If it is under the policy of health insurance, all the pre-existing diseases as well as past health conditions are covered by it.

Tax Benefits

Having health insurance also makes you eligible for tax deductions if it is under the policy of Health Insurance. This will definitely help in your savings

Covers more than hospitalization

Health insurance also covers annual health check up. It even has maternity benefits, helping your newborn baby.

Types Of Medical Insurance In Nepal ​

Some of the health insurance available in Nepal are:


Private Health Insurance

Private health insurance are schemes provided by an employer and organization or purchased by an individual through a private organization.

  1. Employment Based Plans      
  2. Direct Purchase Plans

Government Health Insurance

Government health insurance plans are funded by the government and some of the major categories are Medicare, Medicaid, military health care and state plans. Medicare is for people of age 65 and over helping them to pay health care costs. Medicaid provides medical assistance to needy and differently abled people.


Community Based Health Insurance

Community based health insurance is a program managed by community-based organizations. They provide small scale health insurance and are specially designed for low income families. It enables low income groups to afford health care and even raises awareness among the rural peoples.


Five Key Term In Health Insurance


The amount you have to pay on a timely basis in order to access the health insurance scheme. Usually, you will pay a premium on a monthly or annual basis and are agreed beforehand.


A deductible is an amount you have to pay for medical care out of pocket before your insurance company pays its share. Only once you reach the maximum out of pocket, insurance companies will cover 100% of the expenses.


It is a fixed amount you pay for a specific service and one of the methods that will split the cost between company and you after you pay deductible.


Coinsurance is another method to split costs. While copayment is fixed, coinsurance doesn’t have a fixed amount as it is a portion of cost incurred for a service.

Maximum Out of Pocket amount 

Out of pocket limit is similar to coverage limit but once you reach out of pocket limit the insurance company will pay for further costs.

How To Buy Private Health Insurance In Nepal?

One can buy private health insurance through health insurance companies. There is no rigid way to buy health insurance but, you can follow these tips: 

Choosing right plan   

There are a lot of different health insurance plans available such as individual health insurance, maternity health insurance, short-term health insurance and so on. You should access your situation and choose the right plan you require.

Compare the policies of different private insurance companies 

Once you have decided which plan you require, you should compare the policies offered by different insurance companies. Compare on following terms:


  • Check the network: Compare the network of companies with hospitals, doctors and health centers and see if your preferences match or not.
  • Check coverage of insurance: Check if your pre-existing condition and the prescriptions are included in the plan.
  • Annual Premium: Compare the annual premium you have to pay.
  • Review the deductible, copayment and coinsurance amounts.

Contact the agent   

After comparing the plans and policies, you should contact the official agents and discuss the terms and conditions thoroughly. You should ask and clear any doubts you have regarding the health insurance plan before you make a deal with the agent. If you are satisfied, then you should proceed to official documents and make sure you read the agreement document before you sign it.


Nepal Government Health Insurance Programs 


Some programs that our government has planned for health insurance is mentioned as:

Social Health Security Program in Nepal 

Social Health Security Program (SHSP), a health insurance program that aims to enable people to access quality health care service without any financial burden. It helps to prevent people from falling into poverty due to medical expenses. One of its goals is to improve the overall health of Nepalese people. It is also a voluntary program based on family contributions.

// //