Coverage
रु. 5 लाख (NPR 5 Lakh)
NPR
Description
Comprehensive health insurance covering hospitalization, OPD, and critical medical expenses. Cashless treatment at network hospitals.
Features
- अस्पताल भर्ना कभर
- OPD कभर
- भर्ना पूर्व र पश्चात्
- एम्बुलेन्स शुल्क
- डे-केयर प्रक्रिया
Highlights
- क्यासलेस उपचार
- विस्तृत नेटवर्क
- छिटो दावी
Riders
Critical Illness
Additional coverage for 20+ critical illnesses
Personal Accident
Lump sum on accidental death/disability
Pros & Cons
Pros
- Cashless treatment at network hospitals
- Wide network coverage across Nepal
- Day-care procedures included
- Ambulance charges covered
- 100+ branches for easy claim filing
Cons
- −No maternity coverage
- −Pre-existing diseases excluded for 2-3 years
- −No coverage for dental treatments
- −Co-payment may apply from 2024
- −OPD limit may be lower than expected
Coverage Breakdown
Hospitalization
Up to Rs 5 lakhOPD
Up to Rs 10,000Pre-hospitalization (60 days)
IncludedPost-hospitalization (90 days)
IncludedAmbulance
Up to Rs 5,000Day-care procedures
Included−Maternity
Not included−Dental
Not includedClaim Process
- 1Cashless: Show insurance card at network hospital
- 2Reimbursement: Pay first, submit bills within 15 days
- 3Submit discharge summary and bills
- 4Settlement within 30 days of document submission
Eligibility
Age5 - 65 years
Policy Term१ वर्ष (नवीकरणयोग्य)