How to check the eligibility for the program?
Any permanent resident of Punjab province can send his/her CNIC number in an SMS to 8500 to check his/her eligibility for the program. The person will get a message within a few minutes, letting him/her know about the eligibility.
From where can I get my Health Card?
Your CNIC is your Sehat Card: If you are eligible, you can use your CNIC card as your Sehat Card. Take your original CNIC when you visit the empaneled Government/ Private hospital. For your assistance
A hospital Facilitation Officer (HFO) will be available in the hospital to facilitate the requirements related to admission through “Qaumi Sehat Card”.
Who is included in a family?
The coverage of family includes;
- Husband & Wife.
- Their unmarried children.
- Children born in the empaneled hospitals would automatically be added into the family.
What are things to be considered before going to the hospital?
Services are only for Inpatient treatments (admissions), OPD is not covered.
So, 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 the nearest empaneled hospital.
How many times can I use the card in the hospital?
A family can use initially up to 400,000 PKR for priority healthcare services and 60,000 PKR for secondary healthcare services per year.
Though in special circumstances, the treatment limit could be exceeded to 1,000,000 PKR per year.
In some cases, the treatment/services will be offered even if the initial coverage limit is exhausted. Like, if a beneficiary is already getting treatment in an empaneled hospital and the 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 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 or denied to give treatment on Sehat Card. 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 issues, eyeglasses, drug addiction, self-inflicted injuries, injuries incurred during a crime).
If the allocated amount is exhausted before admission, no further treatment is allowed, except for life-threatening cases or maternity cases.
If all the above are not applicable, you can consult the HFO in the hospital or can reach us at info@phimc.punjab.gov.pk or contact helpline number 0800-09009
Are medicines covered?
Only if you are admitted as a patient.
Are lab tests and other diagnostics covered?
Only if you are admitted as a patient.
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.
How can I add the person in the family who is missing in family data, or newly added into the family (in case of marriage)?
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”, on time.
Will the child born in a registered family be eligible for the treatment?
The new-born child in a registered family will be eligible if he/she is born in the empaneled hospital. (Form-B will be required after 60 days of birth)
In case the child is not born in an empaneled hospital, the new-born baby could be added by providing necessary information / documentation on any empaneled hospital’s help desk.
For the addition of children, Form-B issued by NADRA, would be required.
In which diseases 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.
Treatments include:
- In-Patient Services (All Medical and Surgical Procedures).
- Emergency Treatment that requires admission.
- Maternity Services (Normal Delivery and C – Section).
- Maternity Consultancy / Antenatal Check-ups (4 times before delivery and one follow-up check-up after delivery).
- Maternal Consultancy for family planning, immunization and nutrition.
- Fractures / Injuries.
- Heart diseases (Angioplasty/bypass).
- Diabetes Mellitus Complication.
- Burns and RTA (Life, Limb Saving Treatment, implants, Prosthesis).
- End-stage kidney diseases/ dialysis.
- Complication of 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:
- 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.
- The provision of services to the beneficiaries is executed through an insurance company.
- All hospitalizations will be covered except for the exclusions agreed with the Insurance Company.
- The beneficiary can go to any empanelled hospital across Pakistan.
- No capping on family size.
- Pre-existing diseases are covered.
- Coverage limits are on yearly basis to all age groups.
- Both public and private healthcare facilities registered by Punjab Healthcare Commission are entitled to empanelment in the scheme.
- Inter- district & provincial portability is also available.
- One day pre and five days post-hospitalization expenses are covered including the medicine.
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”,
I believe I am eligible for support. How can I become a beneficiary of the program?
Any permanent resident of Punjab province can send his/her CNIC number in an SMS to 8500 to check his/her eligibility for the program. If a person is not eligible but he/she is a permanent resident of the Punjab, he/she should visit the NADRA office to update the data.