A thread of basic info on Sehat Sahulat Program aka Naya Pakistan Qaumi "Sehat Card"
What is the Sehat Sahulat Program: It is a health insurance scheme by the govt of Pakistan via State Life Insurance. Started in 2015 in KP by PTI in 4 districts it steadily increased and in 2018
it covered all of KPs population, while increasing amount of medical coverage from 4 to 10 lakh/family. Initially it was based on a poverty survey of 2011 which left out poor people. That is why, despite the great cost, govt has decided to make it available to all Pakistanis.
What does it cover:
Existing govt hospitals, BHUs, RHCs, pharmacies and tertiary care hospitals already provide free of cost emergency and outpatient services. Sehat card covers what is left, in-patient costs for a numerous illnesses, for treatment in public and private hospitals
Family can benefit from the card till 10 lakh limit is available/year. Addl financial limits are allocated to family in life threatening conditions and maternity. Medicines and lab tests are covered while admitted. Insaf Medicine card (upcoming) will allow for free meds for life
Eligibility:
The Sehat Sahulat Program is meant for all residents of Pakistan, it will reach that objective in multiple phases. Currently all residents (those with CNIC permanent address) of Khyber Pakhtunkhwa are covered. All residents of 11 districts of Punjab
(Lahore, DG Khan and Sahiwal division) are covered, others to come part before March 31. In AJK, Baluchistan, GB and Tharparkar in Sindh covered for those below poverty line $2/day are covered.
SSP is linked with the NADRA database and the 10 lakh limit is per family (as designated by Nadra) the head of the family, spouse and unmarried kids. Once the kid get married and its recorded in Nadra records the couple is considered a separate family and also has a 10 lakh limit
How to use it
If you are sick and a doctor recommends in patient treatment, all you need is your CNIC (or Sehat Sahulat Card) and Bay-form (for childs treatment) and go to Sehat Sahulat Program desk at any hospital on panel. After verification, theyll provide free services
Long term benefits
Universal health coverage will allow for underprivileged population to access free healthcare and allow for investment and development into health care providers of all sizes, especially in the rural areas.
Some numbers (Jan 2022):
Overall covers 100+ million lives, 6000+ admissions daily, In 90+ districts and expanding, 670 hospitals on panel. Punjab – Total Families Enrolled 15,451,218 - Total Hospital Visits 2,850,908. 3rd party survey 96% beneficiaries satisfied.
Quality Control:
Strict QC measures are in place, incl having state life representative at each hospital. State Life plays a strong role in ensuring checks and balances are in place and are properly implemented.
Rates of all treatments are ascertained and that amount will be provided to the hospital by insurance provider. So far 10 hospitals have been kicked off the panel because of enquiries conducted on complaints raised.