Frequently Asked Questions in English

How a person can check if they are eligible for the program or not?

Any Pakistani citizen can send their CNIC number in an SMS to 8500 to check their eligibility for the program. Within a few minutes, they will receive a response letting them know about their eligibility.

 

From where can I get my Health Card?

A beneficiary can go to any empaneled hospital with their CNIC and Health Card (in case of a minor, Form-B would be required), after verification of their data by the Health Card Representative / Hospital Facilitation Officer (HFO), they shall be provided necessary services.

 

Who is included in a family?

The coverage of family includes;

  • Husband & Wife.
  • Unmarried children.
  • Children born in the scheme hospitals would automatically be added into the family.

 

What are things to be considered before going to the hospital?

If the nature of the case is OPD then it is important to know that the OPD is not covered.

If the case is not emergency, the beneficiary should first consult a local doctor (in mohallah or village) and if the doctor suggests that the case could only be handled through hospitalization, then the beneficiary should visit nearest empaneled hospital.

 

How many times can I use the card in the hospital?

A family can use up to 400,000 PKR for priority healthcare services and 60,000 PKR for secondary healthcare services. Family can benefit from the card till cash limit is available.

Though in special circumstances, treatment limit could be exceeded to 1,000,000 PKR per year.

In some cases, the treatment / services will be offered even if the coverage limit is exhausted. Like, if a beneficiary is admitted in 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.

 

I visited the hospital and they didn't offer me admission, but I am sick. What can I do?

Services are only for Inpatient treatments (admissions), OPD is not covered.

In addition, certain treatments are not covered (e.g. cosmetic surgeries, dental, eye glasses, drug addiction, injuries incurred during a crime).

Once the benefit balance has been exhausted prior to admission, no further treatment is allowed, except in the case of life threatening or maternity cases.

 

Are medicines covered?

Only if you are admitted as patient.

 

Are lab tests and other diagnostics covered?

Only if you are admitted as patient.

 

What if my treatment cost exceeds the benefit limit?

If a beneficiary is admitted in 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.

 

How details of a person missing in family data, or newly added into the family (in case of marriage), will be added in family data?

The details of family member will be updated in NADRA database first, then the same data will be updated in “Sehat Sahulat Program”. NADRA updates SSP data after every 4-6 months.

Citizens are advised to keep their NADRA data updated to avail services of the “Sehat Sahulat Program”, in a timely manner.

 

Will the child born in registered family be eligible for the treatment?

The child born in registered family will be eligible if he/she is born in the empaneled hospital.

In case the child is not born in empaneled hospital, the newborn baby could be added by providing necessary information / documentation on any empaneled hospital’s help desk.
For addition of children, Form-B issued by NADRA, would be required.

 

In which disease can the Health Card be used?

The treatment of any disease that requires the patient to be admitted in the hospital is covered under “Sehat Sahulat Program”, except for the exclusions agreed with the Insurance Company.

Secondary Care and Priority Treatment include:

  • 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.
  • Heart diseases (Angioplasty/bypass).
  • Diabetes Mellitus Completion.
  • Burns and RTA (Life, Limb Saving Treatment, implants, Prosthesis).
  • End stage kidney diseases/ dialysis.
  • Chronic infections (Hepatitis/HIV/Rheumatology).
  • Organ Failure (Liver, Kidney, Heart, Lungs).
  • Cancer (Chemo, Radio, Surgery).
  • Neurosurgical Procedure.
  • Thalassemia
  • Kidney Transplant

 

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?

The program provides two distinct packages:

  • Secondary care coverage for hospitalization up to Rs. 60,000 per family per year
  • Coverage for major priority diseases for hospitalization up to 400,000 per family per year
  • The coverage could be extended up to Rs. 1,000,000 under special circumstances.  
     
  • The provision of services to the beneficiaries is executed through insurance company.
  • All hospitalizations will be covered except for the exclusions agreed with the Insurance Company.
  • The beneficiary can go to any empaneled hospital across the country.
  • No capping on family size.
  •  Pre-existing diseases are covered.
  • Coverage on yearly basis to all age groups.
  •  Both public and private healthcare facilities provisionally licensed by Punjab Healthcare Commission are entitled for empanelment in the scheme.
  •  Inter-district portability is also available.
  •  One day pre and Five days post hospitalization expenses including the medicine are covered.

Which people are included in this program?

Currently, whole population of 15 districts of Rawalpindi, Lahore, DG Khan and Sahiwal divisions is covered under “Sehat Sahulat Program”, while in remaining 21 districts, poor people (who earn less than 2 US $ a day / 32.5 PMT according to NSER based on BISP Survey), along with all special persons and transgender community registered with NADRA, are the beneficiaries of the program.

Government of the Punjab intends to include all citizens of the Punjab province into the program soon.  

I believe I am eligible for support, how can I become beneficiary of the program?

Any Pakistani Citizen can check their eligibility for the Program by sending their CNIC number in an SMS to 8500. If a person is not in the beneficiaries list, he cannot avail this facility as the list of beneficiaries has been provided by the Govt. and no addition or deletion could be made.

Government of the Punjab plans to include all citizens of the Punjab province into the program soon.