Benefits packages of sehat card/health card
Table of Contents
The sehat card/health card aims to provide many benefits for the needy people of Punjab:
- Free of cost emergency services
- Maternity care free of charge.
- Free surgical procedures available.
- No hospitalization expenses.
- Free consultations and monitoring.
- Transportation coverage
Benefit packages are details of benefits that are covered in sehat sahulat program.Total amount that is provided in the sehat sahulat program is 1.0 M in KPK and 0.720 M (720,000) federal
- The package refers to a list of diseases that are covered by an insurance program.
- The Sehat Sahulat program is a health insurance program and has a defined set of benefits.
- Benefits are different in each province. In general, it covers virtually all surgical procedures and medical conditions that require hospitalization. At present, the different provincial components of the Sehat Sahulat program do not cover ambulatory services (OPD). The provincial government of Khyber Pakhtunkhwa plans to cover OPD’s experimental services in four districts by 2021.
Benefit Packages Detail
|Salient Features||Sehat Sahulat Program, Khyber Pakhtunkhwa||Sehat Sahulat Program, Federal|
|Initial coverage for secondary care (Basic Treatment)||200,000 PKR per family per year||60,000 PKR per family per year|
|Additional coverage for secondary care (Basic Treatment)||60,000 PKR per family per year|
|Secondary care (Basic Treatment).||Emergency treatment requiring admission.Maternity Services (Normal deliveries, C-section).Fractures and Injuries.General Surgeries (Gallbladder, biopsy, colon, prostate, hernia).General Medicine (diabetes, hypertension, cardiac).||In Patient Services (All Medical and Surgical Procedures).Emergency Treatment requiring admission.Maternity Services (Normal Delivery and C – Section).Maternity Consultancy / Antenatal Checkups (4 times before delivery and one follow up after delivery).Maternal Consultancy for family planning, immunization and nutrition.Fractures / Injuries.Post hospitalization.Local Transportation Cost of PRK 1,000 (thrice per year).Provision of transport to tertiary care hospitals.|
|Coverage for tertiary care (Advanced Treatment)||400,000 PKR per family per year||300,000 PKR per family per year|
|400,000 PKR per family per year(Additional Coverage)||300,000 PKR per family per year(Additional Coverage)|
|Tertiary care (Advanced Treatment)||Cardiovascular (Angioplasty, bypass)DiabetesArtificial Limbs (Prosthesis)Kidney Diseases (Dialysis)Breast Cancer ScreeningManagement of Neurosurgical DiseasesCancer Treatment (Chemo, Radio, Surgery)Kidney TransplantAccident and EmergencyICU Care||In Patient Services (All Medical and Surgical Procedures).Heart diseases (Angioplasty/bypass).Diabetes Mellitus Completion.Burns and RTA (Life, Limb Saving TreatmentEnd stage kidney diseases/ dialysis.Chronic infections (Hepatitis/ HIV/ Rheumatology).Organ Failure (Liver, Kidney, Heart, Lungs).Cancer (Chemo, Radio, Surgery).Neurosurgical Procedure.|
|Total coverage for treatment||Health expenditure up to 1,000,000 PKR per family per year||Health expenditure up to 720,000 PKR per family per year|
|Amount of wage loss||250 PKR per day for three days|
|Maternity Allowance||1,000 PKR (transportation)||1,000 PKR (transportation)|
|Transportation Allowance||2,000 PKR||1,000 PKR (three times per year)|
|Funeral Allowance||10,000 PKR|
* Wage-loss replacement will start from the second day of hospitalization.
* Maternity allowance will be paid for the need of transportation after a childbirth.
* Transportation allowance will be paid in case a person is referred by a secondary care hospital to a tertiary care hospital.
* Funeral allowance will be paid to family if a member dies during a hospital admission.
In conclusion, sehat cards or health cards offer numerous benefits to individuals and communities alike. These comprehensive packages provide access to a wide range of healthcare services and cover medical expenses, ensuring financial protection and peace of mind. The key advantages of sehat cards include:
- Universal healthcare access: Sehat cards promote the principle of equal healthcare access for all. They help bridge the gap between the privileged and underprivileged sections of society by providing essential medical services to those who may otherwise struggle to afford them.
- Financial protection: Health cards offer financial security by covering a significant portion or the entirety of medical expenses. This protection is particularly valuable during emergencies or in the case of chronic illnesses, as it prevents individuals and families from being burdened by excessive healthcare costs.
- Improved healthcare outcomes: Sehat cards encourage regular health check-ups and preventive care, leading to early detection and timely treatment of diseases. By promoting regular healthcare utilization, these packages contribute to better overall health outcomes and reduced healthcare complications.
- Increased healthcare affordability: Health cards negotiate discounted rates with healthcare providers, making medical services more affordable for cardholders. This affordability factor ensures that individuals can access quality healthcare without worrying about exorbitant costs.
- Reduced healthcare disparities: Sehat cards aim to reduce healthcare disparities by ensuring that even the most marginalized populations have access to essential medical services. By prioritizing inclusivity, these packages help bridge the gap between different socioeconomic groups and promote a more equitable healthcare system.
The Sehat Card in Pakistan provides numerous benefits to its beneficiaries. It offers access to quality healthcare services, covering a wide range of medical treatments and procedures. This government-sponsored health insurance program aims to make healthcare more affordable and accessible, particularly for low-income individuals and families. With the Sehat Card, people can receive necessary medical care without the financial burden that often accompanies healthcare expenses, thus improving overall health outcomes and quality of life for many Pakistanis.
Frequently Asked Questions (FAQs)
What if my treatment cost exceeds the benefit limit?
If a beneficiary is admitted to an empaneled hospital and their coverage limit is exhausted, the treatment of the same admission will be continued. Similarly, if a beneficiary needs treatment for a life-threatening condition, or for maternity/delivery cases, they shall be provided with the services even if their limit is already exhausted.
If I do not use my coverage amount for treatment, will any amount be paid to me?
“Sehat Sahulat Program” only covers indoor treatment. No amount shall be paid if the services are not used.
What are some other features of the health card?
Initial limit for secondary care coverage for hospitalization up to Rs. 60,000 per family per year
Initial limit for coverage of major priority diseases for hospitalization is up to 400,000 per family per year
The coverage could be extended up to Rs. 1,000,000 under special circumstances.
Who is covered under “Sehat Sahulat Program?
Currently, all the permanent residents of the 36 districts of 9 divisions of Punjab are covered under “Sehat Sahulat Program”,
What additional benefits are available to the patients along with free treatment?
Rs. 1000 will be paid on discharge in case of maternity (normal or surgical).
Rs. 10000 burial allowance will be paid to a beneficiary’s family if the beneficiary dies during an admission under this program.
Where should I lodge a complaint or give feedback about Health card/sehat card?
You can submit your complaint or feedback in any of the following ways:
Call on our toll-free number 0800-89898
Email your complaint/feedback to: [email protected]
Register online complaint/feedback on this website in the Contact page.