PESHAWAR: The Khyber Pakhtunkhwa health department will introduce a top-up health insurance package to enable the government employees and other patients to get executive stay in hospitals of their choice for treatment of diseases.

Officials said that all residents of Khyber Pakhtunkhwa were entitled to avail cashless treatment in the empanelled hospitals up to Rs1 million per year on Sehat Card Plus under Social Health Protection Initiative.

“The government is in the process of consultation to introduce the new package. The government employees as well as general public will be allowed to select the top-up package. They will deposit premium and get executive services as opposed to Sehat Card Plus on which the people receive services in wards,” officials in State Life Insurance Corporation told this scribe.

Patients will have to deposit premium and get private rooms in health facilities of their choice

They said that presently all the people of Khyber Pakhtunkhwa were entitled to spend Rs1 million on their treatment on Sehat Card Plus and that amount would be transferred to those opting for the top-up package. “They will be able to get private rooms and treatment in those hospitals that are not empanelled by Social Health Protection Initiative (SHPI),” they said.

Officials said that each of 7.4 million families of Khyber Pakhtunkhwa was eligible to avail free treatment in general wards and examination by the doctors, who were empanelled with SHPI whereas the new package would enable its beneficiaries to get cure at the hospitals that were not empanelled. They added that the new plan would help the people to pay annual premium to the insurance company and get access to hospitals of their choice anywhere in the country.

“It will be optional and people would be given time to select a package, which may start from Rs10,000 to Rs100,000 to receive services up to Rs10 million depending on the premium,” they said.

Officials said that the present package did not suit officers in government and private sector and affluent people, who did not want to be admitted to general wards, therefore, they didn’t utilise the Sehat Card Plus.

Since launch of the free health scheme, 926,000 patients have been treated under it costing Rs22.600 billion but the beneficiaries include only poor people, who are not concerned about hospital stay but want cashless treatment.

SLIC, which is implementing the programme on behalf of Khyber Pakhtunkhwa government, has presented a couple of models in the past few months before the SHPI’s steering committee and is likely to come up with latest one for approval next month.

The programme, extended to the whole province in November 2020, is providing free services in 700 private and public sector hospitals in the country including 185 in Khyber Pakhtunkhwa. Only the people requiring hospitalisation can get treatment but they may get OPD services as well under the top-up programme.

“The government has already allocated Rs22 billion for the current year for the people, whose share from the funds would be transferred under the new package. Sehat card scheme will continue as usual but the new initiative is for those people, who want private rooms and medication from hospitals and doctors of their choice,” said officials.

They said that the programme covered most of the ailments. So far, three liver transplants, costing Rs5 million each with free subsequent treatment for one year, have been conducted in Shifa International Hospital and Quaid-i-Azam International Hospital, Islamabad, and Pakistan Kidney and Liver Institute and Research Centre, Lahore, under the programme.

“Even private hospitals under the existing package don’t give private accommodation to patients as per rules under which all people are treated equally,” said officials.

Published in Dawn, February 28th, 2022