Sehat Card Plus KP Program– Healthcare For All

The Sehat Card Plus KP program, also referred to as the Sehat Card or Sehat Insaf Card, is one of Pakistan’s most comprehensive provincial health insurance schemes. Launched in 2016 and expanded province-wide by 2021, it provides every resident of Khyber Pakhtunkhwa (KP) with access to free inpatient healthcare services worth up to PKR 1 million per family per year. The program covers treatments in over 1,000 Empanelled Hospitals List, benefiting more than 7.2 million families, with annual expenditures exceeding PKR 18 billion.

1. How the Program Works

Sehat Card Plus KP – Key Features

Feature	Description
Eligibility	All permanent residents of KP, as verified by their CNIC/Form-B, are automatically eligible. Citizens can check their status by sending their CNIC number via SMS to 8500 or 9780.
Balance	Each family is entitled to PKR 1 million per year. Users can track their remaining balance, view treatment history, and locate hospitals using the Sehat Card mobile app.
Hospital Network	Services are offered through a wide network of empanelled public and private hospitals, ensuring access to care across urban and rural areas.

Treatment Coverage

The program includes both secondary and tertiary care services such as cardiac surgeries, cancer treatment, dialysis, kidney/liver transplants, and maternity care.

Patient Admission Process

From February 2025, biometric verification has been made mandatory for hospital admissions in both public and private sectors. This step improves transparency and eliminates fraudulent claims.

2. Recent Developments (2024–2025)

Sehat Card Plus KP: Key Initiatives (2024–2025)

Initiative	Details	Significance
Free OPD Pilot	Launched in February 2025 in Mardan, expanding to Chitral, Malakand, and Kohat. It offers free outpatient consultations, lab tests, and medicines for over 120,000 low-income families.	Moves the program toward full-spectrum universal health coverage.
Life Insurance Benefit	Introduced in January 2025. In case of death, the head of the family’s heirs receive PKR 1 million (under 60 years of age) or PKR 500,000 (above 60 years).	Provides financial protection beyond medical treatment.
Anti-Fraud Measures	Biometric verification and photo-based registration introduced to ensure transparency and reduce misuse.	Builds public trust in the system.

3. Program Impact

• Patients Treated: Over 3.89 million individuals have received care under the program, with 940,000 treated in the past year alone.
• Gender Inclusion: Approximately 53% of beneficiaries are women, indicating inclusive access.
• Healthcare Spending: Cardiovascular treatments account for 25–28% of the program’s total health expenditures, reflecting the province’s growing burden of non-communicable diseases.
• Total Health Investment (2016–2025): Around PKR 100 billion has been spent on free healthcare services.

4. Importance of Free Healthcare in KP

1. Reduces Poverty: High medical expenses previously pushed many families into debt. Free healthcare protects low-income households from financial hardship.
2. Promotes Equity: The program bridges the urban-rural gap in healthcare access, especially in remote or underserved areas.
3. Improves Public Health: Free and early medical intervention reduces mortality rates and improves overall population health.
4. Strengthens Public Trust: Free and accessible healthcare enhances the government’s credibility and strengthens its social contract with citizens.

5. Challenges and Recommendations

• Rising Costs: Annual claims have surged, putting fiscal pressure on the provincial budget. Sustainable financing and possible co-payments for higher-income families are under review.
• Disease Burden: The increasing prevalence of chronic diseases calls for preventive healthcare measures and public awareness campaigns.
• OPD Expansion: Scaling outpatient services across KP requires additional investment of approximately PKR 12 billion annually.
• Digital Access: While the mobile app is helpful, many elderly beneficiaries depend on relatives for usage. Kiosk-based solutions are being explored to improve accessibility.

6. Conclusion

The Sehat Card Plus KP program represents a major step toward making healthcare a basic right for all citizens, not a privilege. With its wide coverage, robust digital support, and focus on both public and private sector partnerships, the Sehat Insaf Card has laid the foundation for a stronger and more equitable healthcare system in Khyber Pakhtunkhwa. Continuous innovation, improved governance, and sustainable funding will be key to preserving and expanding this model in the years to come.

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