Overview

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Page Properties

Country/Region Nepal Scheme Operator Health Insurance Board (HIB) Nepal Scheme type National Social Health Insurance Implemented since 2016 Implementing Partner(s) HIB, GIZ Nepal, and previously https://openimis.atlassian.net/wiki/pages/resumedraft.action?draftId=835682333 Swiss TPH Supporting Partner(s) Financial Assistance: German Development Cooperation Version Functionalities used Beneficiary Management Claims Management Claims Review Reports Coverage 76 77 districts of Nepal Number of beneficiaries 35,700968,000051 Number of users 7147 Number of health facilities 375 Last update April 2021November 2022

Scheme Features

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Country/Region

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Nepal

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Insurance SchemeImplemented since

Health
Cooperation partner	Health Insurance Board (HIB) Nepal, German Development Cooperation
Implementation Support	Technical Assistance: GIZ Support to the Health Sector Programme (S2HSP) & Swiss Tropical and Public Health Institute (Swiss TPH)
Health scheme implemented since	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	-

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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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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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