After months of disruption caused by unpaid government dues, hospitals across Nepal have started restoring health insurance services following the release of more than Rs 2 billion by the government to settle pending claims.
The Health Insurance Board (HIB) said it has distributed payments to 364 health institutions nationwide, enabling several hospitals to gradually resume services that had been suspended due to prolonged financial constraints.
Among the first to restart services is Tribhuvan University (TU) Teaching Hospital in Maharajgunj, which will resume outpatient (OPD) health insurance services from June 29 after receiving Rs 40.4 million in partial reimbursement. The hospital had halted all insurance-related services on January 1, citing the government’s failure to clear outstanding payments for more than six months.
According to the hospital, insured patients can access OPD services between 7:00 am and 11:00 am and 1:00 pm to 2:30 pm. However, the hospital has yet to announce when insurance coverage for inpatient treatment and surgical procedures will resume.
The disruption had triggered widespread criticism, as thousands of insured patients were forced to pay out of pocket or postpone medical treatment after hospitals stopped honoring health insurance claims. Hospital administrators had argued that continued delays in government reimbursements made it financially impossible to sustain the program.
The Health Insurance Board stated that it has approved insurance claims worth Rs 27.81 billion for fiscal years 2024/25 and 2025/26, adding that the recent payment is part of efforts to clear accumulated arrears and restore confidence in the national health insurance system.
Health experts, however, caution that while the latest payment offers temporary relief, timely and predictable reimbursement mechanisms remain essential for ensuring uninterrupted healthcare services. They argue that unless the government establishes a sustainable financing system, hospitals may again face liquidity shortages that could jeopardize the long-term credibility of Nepal’s health insurance program.
