Prime Minister National Health Program (PMNHP)
Punjab Health Initiative Management Company has been mandated by the Specialized Health Care and Medical Education Department for execution /implementation of PMNHP on its behalf. The PMNHP program’s objective is improve access of the poor population to good quality medical services, through a micro health insurance scheme. In the first six months of the project, population under approx. 32% (2 USD) of the proxy means test in 4 districts of Punjab is covered. The program is benefiting 1.28 million families (9 million individuals) in the selected districts of Rahim Yar Khan, Khanewal, Narowal and Sargodha.
Salient Features
The salient features of the Program for Punjab are as follows:
- Coverage Districts in First Phase: 4 Districts (Rahim Yar Khan, Khanewal, Narowal, Sargodha)
- Number of Beneficiaries in four districts: 1.28 million families (9 million persons)
- Beneficiaries are provided with health insurance card
- Both public and private healthcare facilities having ten plus (10+) beds and provisionally licensed by Punjab Healthcare Commission are entitled for empanelment in the scheme
- After enrolment in the scheme, the beneficiary will be eligible to go to any empanelled hospital
- The program provides two distinct packages for which are interlinked through an effective referral and gate keeping from secondary care to selected disease treatment at tertiary level
- Secondary care coverage for hospitalization upto Rs. 50,000 per family per year
- Coverage for 7 priority diseases upto 250,000 per family per year
- No capping on family size
- Coverage on yearly basis to all age groups
- All hospitalizations will be covered except for the exclusions agreed with the Insurance Company
- Pre–existing diseases are covered
- Inter-district portability is also available
- One day pre and three days post hospitalization expenses including the medicine are covered
- Transportation cost equal to Pak Rs: 350/- per trip for 3 trips/ year is also provided
- The provision of services to the beneficiaries is executed through insurance company. The State Life Insurance Corporation of Pakistan has been selected for provision of services in all districts selected for PMNHIP
The payment of premium to the insurance company for Punjab for the provincial districts is done by Punjab government. An amount of Rs. 1.5 billion has been allocated for the Health Insurance Initiative in the current budget for PHIMC.
