State Life, in collaboration with Government of Khyber Pakhtunkhwa, has taken initiative to launch Social Health Protection (SHP) to provide and promote social and micro health insurance scheme for the most deserving population of four districts of Khyber Pakhtunkhwa namely Kohat, Mardan, Malakand and Chitral. The scheme will target the most deprived segment of society and provide them access to the health facilities in a wide range of public and private hospitals. The proposed target market will tend to expand to include a wide range of society. The scheme aims to encourage:
Under the scheme, the members will be covered for hospitalization, day care surgeries and maternity benefits, albeit under a prescribed limit. Along with the provision of these facilities, the quality of services will also be monitored for improvement. Features such as transportation cash grant on maternity will encourage the female population to utilize the health provider facilities and will ultimately result in improving the female and child survival rate.
More than 1 Million beneficiaries will be enrolled under the scheme to get the benefit of hospitalization.
SHP is a micro health insurance scheme which covers the cost of hospitalization for medical & surgical procedures including day care surgeries and maternity benefits to the enrolled families’ up to Rs. 25,000 per person per annum. Pre and post hospitalization care/treatment of up to one day prior to hospitalization and up to five days from the date of discharge will be provided under the scheme.
Under the scheme, there is no age limit and exclusion of pre-existing condition (except “Standard Exclusions”). The scheme will cover hospital services normally provided at the secondary level (up to DHQ hospital) but such services can be provided even at tertiary care hospitals.
Under the scheme, there is no age limit and exclusion of pre-existing condition (except “Standard Exclusions”). The scheme will cover hospital services normally provided at the secondary level (up to DHQ hospital) but such services can be provided even at tertiary care hospitals.
Under the scheme, there is no age limit and exclusion of pre-existing condition (except “Standard Exclusions”). The scheme will cover hospital services normally provided at the secondary level (up to DHQ hospital) but such services can be provided even at tertiary care hospitals.
Maternity and New Born coverage includes treatment taken in empanelled hospital/nursing homes arising from child birth including normal delivery / caesarean section and / or miscarriage or abortion induced by accident or other medical emergency subject to exclusion. New Born child will also be considered as part of household and covered under the scheme. For maternity cases, transportation charges of Rs.1,000/- per hospitalization will also be provided.
The following treatment, items, conditions, activities and their related or consequential expenses are excluded from the Agreement and the Corporation shall not be liable for:
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