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Overview

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Implementation Support

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Page Properties

Country/Region

Nepal

Scheme Operator

Health Insurance Board (HIB) Nepal

Scheme type

National Social Health Insurance

Scheme

Implemented since

2016

Implementation support

Technical Assistance: GIZ Support to the Health Sector Programme (S2HSP) & Swiss Tropical and Public Health Institute (Swiss TPH)

Version

Number of beneficiaries

Scheme Features:

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Country/Region

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Nepal

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Scheme type

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Health Insurance Scheme

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Cooperation partner

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Health Insurance Board (HIB) Nepal, German Development Cooperation

Implementing Partner(s)

HIB, GIZ Nepal, and Swiss TPH

Supporting Partner(s)

Financial Assistance: German Development Cooperation

Version

Functionalities used

  • Beneficiary Management

  • Claims Management

  • Claims Review

  • Reports

Coverage

77 districts of Nepal

Number of beneficiaries

5,968,051

Number of users

7147

Number of health facilities

375

Last update

November 2022

Scheme Features

Health scheme implemented since

Implemented since

Participation in the last implementer committee meeting

 

2016

Name of openIMIS focal point

 

 Mr. Suresh Tinkari

Total number of health scheme employees

 -

Total number of employees using openIMIS

 

7147 

Total number of employees not trained on openIMIS

 -

Number of health insurance products managed by the health scheme and using openIMIS

 

 3

Product Features

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Number of households covered

Number of beneficiaries

800,000

Average size of a household

4.6

Household contribution amount

NPR 3500

Individual contribution

-

Average amount paid for a claim

-

Excerpt
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Specifications of the openIMIS used

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Version

Has anything been modified (customization)

What standards are used to code services, items, diagnosis and products

Three main lessons learned

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One

Two

Three

Recommendations for Developers' Committee

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What to improve

What to add

What to remove

More information here.

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hiddentrue

Social Health Insurance in Nepal

Scheme Design

Benefit package

Contribution

Business Processes

Enrolment

Insuree verification

Service provision

Claiming from facilities

Claim review

openIMIS Implementation

Customization

Configurations

Deployment

User base

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Include Page
Nepal HIB Implementation Details
Nepal HIB Implementation Details