Waseela-e-Sehat (Health Insurance) Program

To provide free medical treatment, a health insurance scheme (Waseela-e-Sehat) had been launched under the Benazir Income Support Programme (BISP).

According to the official website of the programs, the following are the salient features of the BISP’s targeted Health Insurance:

- The insured would be covered for hospitalization resulting from illness or injury with an annual maximum of Rs. 25,000 per family.

- Normal deliveries and hospitalizations due to complicated deliveries and C-Sections.

- Diagnostic tests/procedures conducted during hospitalization would be covered.

- The beneficiary family members belonging to any age group will be covered.

- The scheme would provide opportunity to the insured to get services from any enlisted hospital; this would be a ‘floating’ benefit - a family would be covered under one premium.

- Health insurance would not exclude pre-existing conditions.

Benefit package

1. Full hospitalization
2. Pre-existing diseases and all age groups will be covered
3. Maximum benefit cap Rs.25000/- per family per year.
4. Benazir Health Cards will be issued to enrolled families.

Eligibility Criteria

1. Identified BISP beneficiaries and their families.
2. BISP will define the cut off point for providing health insurance.
3. BISP beneficiaries enrollment.


Policy Period

1. One year starting the month after first enrollment in a particular district.
2. Enrollment will have to be completed within two months of the starting date in a particular district.

Methodology

1. Patient with Benazir Health Card goes to the health facility and meet the BISP focal person at BISP desk.
2. The focal person will facilitate her/him, swipe the card and refer to the concerned department.
3. At the time of discharge, the patient will receive a computerized bill and the amount will be deducted from the account of the user.
4. This process will go on simultaneously in all hospitals providing this facility.
5. Data of each health facility will be shared with stakeholder simultaneously management through MIS.

Enrollment & Premium

1. To make the scheme transparent, per household premium will be determined through a national competitive bidding process.
2. Criteria/ qualifications for the bidders are being developed.
3. Selected insurance company will be responsible for enrollment of BISP beneficiaries, collection of accurate data/ information with regard to each enrolled household.
4. Enrollment will be validated by the BISP central database of beneficiaries.
5. Biometric cards to be issued to enrolled families.
6. List of empanelled hospitals in public as well as private sector is being developed.
7. A community-based mechanism will be evolved for social mobilization to enhance enrollment and utilization of services.

For details, visit the official website of the BISP program.

Tags: Pakistan, Health, Education, Finance, Insurance, Government, Hospitals

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