Bipanna Nagarik Kosh: Free Treatment for 8 Serious Diseases in Nepal

The Bipanna Nagarik Ausadhi Upachar Kosh, usually shortened to Bipanna Nagarik Kosh ("Deprived Citizens' Medicine and Treatment Fund"), is a subsidy programme run by Nepal's Ministry of Health and Population (MoHP) through the Department of Health Services (DoHS). Its purpose is to protect poor and low-income families from the crushing, often bankrupting cost of a handful of serious, long-treatment diseases. Instead of the patient paying out of pocket, the fund settles an agreed amount directly with a listed government or partner hospital.

The scheme has operated under the MoHP for well over a decade and is governed by an operating directive, the Bipanna Nagarik Ausadhi Upachar Kosh Sanchalan Nirdeshika, first consolidated in 2075 Bikram Sambat (2018 AD) and revised in 2080 BS (2023) and again in 2082 BS (2025). Applications and hospital claims are tracked through the DoHS information system at bipanna.dohs.gov.np. It is one of Nepal's main financial-protection tools alongside the national Health Insurance Programme and the free-care lists for senior citizens and children.

This page is a plain-language reference, not the official rulebook. Grant ceilings and covered procedures have changed with each revision of the directive, and the 2082 amendment began folding the scheme into the national health insurance system. Always confirm the current figure and required paperwork with your listed hospital's Bipanna desk or your local government (palika) before you rely on it.

The fund is built around a fixed list of high-cost conditions. Under the long-standing directive, the standard ceiling is up to Rs 100,000 (one lakh) per patient for each of the covered diseases other than kidney disease, which carries larger, separately defined support. The money is meant to cover medicines, investigations and treatment at a designated hospital; if the total bill exceeds the ceiling, the patient bears the balance unless a further exceptional approval is granted.

A key limitation of the classic scheme is that the grant is generally one-time per patient and is not designed to be claimed repeatedly or stacked across several different diseases for the same person. Chronic conditions such as cancer, which need repeated cycles, historically exhausted the ceiling quickly, which is one reason the 2082 revision raised combined coverage and linked it to health insurance.

Kidney disease receives the most generous and distinctive treatment under the fund because dialysis and transplant are both lifelong and extremely expensive. Haemodialysis for citizens with end-stage kidney failure is provided free of charge at listed centres, and the government has progressively expanded free sessions and centres so that regular, ongoing dialysis is available without a per-patient cap. This free-dialysis provision is one of the most widely used parts of the whole programme.

For kidney transplant, the fund pays a much higher amount than the standard Rs 100,000. Under the established directive the transplant grant has commonly been cited at up to Rs 400,000, disbursed through a listed transplant hospital, with additional cash support of up to Rs 100,000 for the costly anti-rejection medicines a patient needs after the operation. Exact figures have varied between revisions of the directive, so confirm the current ceiling at the hospital before surgery.

The 2082 BS (2025) revision, which ties the scheme to health insurance, sharply increased kidney support: transplant coverage of up to roughly Rs 750,000 (7.5 lakh) combining insurance and deprived-citizen benefits, a monthly living allowance of about Rs 5,000 for eligible transplant patients, and continued free dialysis. Because this newer package requires health-insurance enrolment, patients should ask specifically which regime - the classic fund or the insurance-linked one - applies to their case.

Mutu rog (heart disease) is covered by the Bipanna fund up to the standard Rs 100,000, but heart patients in Nepal are also served by separate, more specific government cardiac schemes that are worth knowing about. The best known provides free heart-valve replacement and other cardiac surgery for children under 15 years and senior citizens over 75 years at the Shahid Gangalal National Heart Centre in Bansbari and the Manmohan Cardiothoracic Vascular and Transplant Centre in Maharajgunj.

These age-based free-cardiac and valve-replacement provisions are financed through targeted government grants to the heart centres rather than the deprived-citizens fund itself, so a child or an elderly patient may receive free surgery even if the household is not formally classified as "bipanna." The 2082 directive additionally references free operative costs at these centres for the under-15 and over-75 groups, with further insurance-side coverage of around Rs 200,000 for valve procedures.

In practice, families dealing with congenital or valvular heart disease should approach Gangalal or Manmohan directly and ask about both the age-based free scheme and the Bipanna fund, while the deprived-citizens grant remains the fallback for working-age adults who fall outside the age windows but cannot afford care.

Eligibility rests on two things: having one of the covered diseases, diagnosed and documented by a doctor, and being genuinely unable to bear the cost of treatment. The scheme is targeted at deprived (bipanna) and low-income citizens, and status is verified locally rather than by a fixed national income threshold. Any Nepali citizen who meets both tests can, in principle, seek support, subject to the fund's rules and available budget.

The exact paperwork is confirmed by the treating hospital's Bipanna desk, but the recurring core set of documents has long included proof of identity, proof of deprived status, and medical evidence. Because Nepal moved from the old Village Development Committee (VDC/gaviS) system to elected local governments after 2017, the recommendation that used to come from the VDC now comes from your ward or rural/urban municipality (palika).

There are two practical entry points. The traditional route runs through the local government: the patient submits a written request and documents to the ward/palika stating that the family is in the deprived category and cannot afford treatment; the local body issues a recommendation of bipanna status; and the patient then presents this, with the medical report, to a designated hospital, which processes the fund claim on the patient's behalf. In the old structure this verification happened at the district level, and some districts still convene a committee to confirm status.

The second, increasingly common route is hospital-led. Most large listed hospitals have a Bipanna Nagarik Kosh or social-service desk that helps eligible inpatients enrol, complete the form, obtain or verify the local recommendation, and claim the grant directly against the treatment bill, so the patient is not asked to pay the covered amount up front. Ask for this desk at admission.

Because the money flows to the hospital rather than to the patient as cash (except for defined cash components such as post-transplant medicine support), it is important to start the paperwork before or during treatment at a listed hospital, not after paying privately. Retrospective reimbursement of bills already paid at a non-listed facility is generally not possible.

The grant can only be used at hospitals the government has listed for each disease, and the DoHS publishes a disease-wise list. Over 180 hospitals across all seven provinces participate, with the largest concentration in Bagmati Province. Different facilities are approved for different conditions - for example, dedicated cancer hospitals for oncology, the national heart centres for cardiac care, and major teaching and transplant hospitals for kidney work.

Well-known listed centres include the B.P. Koirala Institute of Health Sciences (Dharan), Bir Hospital and the National Trauma Centre (Kathmandu), Tribhuvan University Teaching Hospital and Patan Hospital for general and kidney care; the Shahid Gangalal National Heart Centre and Manmohan Cardiothoracic Vascular and Transplant Centre for heart disease; and the B.P. Koirala Memorial Cancer Hospital (Bharatpur), Bhaktapur Cancer Hospital and Sushil Koirala Prakhar Cancer Hospital for cancer. Kidney transplant and dialysis are concentrated at TUTH, Bir, BPKIHS, Human Organ Transplant Centre and other listed units.

Because listings and approved procedures are updated with each directive revision, verify that your chosen hospital is currently listed for your specific disease before starting treatment. The authoritative, up-to-date roster is maintained by the DoHS; the hospital's own Bipanna desk can also confirm its current status.

A significant change is under way. The first amendment to the 2082 BS operating directive, approved by the Minister for Health and Population on 4 Bhadau 2082 (about 20 August 2025), begins integrating the deprived-citizens scheme into Nepal's national Health Insurance Programme through a single-window claims process. The stated aim is to end duplicate claims, pool resources, and give patients smoother access.

Under this revised package the headline amounts are larger: combined coverage of up to about Rs 300,000 (3 lakh) for the eight critical diseases, kidney-transplant support of up to about Rs 750,000 with a monthly living allowance, and defined free cardiac provisions for the youngest and oldest patients. The trade-off is that accessing the enhanced benefits increasingly requires enrolment in health insurance.

For families in the middle of treatment, the practical advice is simple: enrol in the national Health Insurance Programme where possible, keep every medical and identity document, and ask the hospital's social-service or Bipanna desk which regime currently applies and what the live ceiling is for your disease. The numbers in this guide are accurate to the directives cited but can be superseded by newer circulars.