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Financial protection

(Financial coverage)

  1. Sehat Sahulat Programme was launched to enable the poor population to utilize health services without further impoverishment due to spending on healthcare.
  2. Since inpatient care is associated with higher spending, with potential to make people poor, these services were covered under the scheme.
  3. The different provincial streams for Sehat Sahulat Programmes have different limits for treating secondary and tertiary care.
  4. The programmes also provide financial assistance in the form of wage loss during treatment, maternity allowance, travel allowance and financial support to a family for funeral if death happens during a hospital admission.
Salient Features Sehat Sahulat Program, Khyber Pakhtunkhwa Sehat Sahulat Program, Federal Sehat Hifazat Program, Gilgit Baltistan (SHP-GB)
Area covered All districts in Khyber Pakhtunkhwa Islamabad, Former FATA, Azad Kashmir and all districts in Punjab. All districts in Gilgit Baltistan
Population covered 100% population Households having a PMT <= 32.5
Premium The Government of KP pays the premium The Federal Government pays the premium The Government of GB pays the premium
Annual premium per family 2850 1850 (estimated)
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 PKR 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)
  • Diabetes
  • Artificial Limbs (Prosthesis)
  • Kidney Diseases (Dialysis)
  • Breast Cancer Screening
  • Management of Neurosurgical Diseases
  • Cancer Treatment (Chemo, Radio, Surgery)
  • Kidney Transplant
  • Accident and Emergency
  • ICU Care
  • In Patient Services (All Medical and Surgical Procedures).
  • Heart diseases (Angioplasty/bypass).
  • Diabetes Mellitus Completion.
  • Burns and RTA (Life, Limb Saving Treatmen
  • End 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 Health expenditure up to 250,00 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 second day of hospitalization.
    * Maternity allowance will be paid for 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.
    For further details, download the brochure.

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