📋 Medical Treatment Claim
✓ Verified: 2026-07-11Contributors, spouses, and children under 18
0/6 ready
Where/how to submit
Online via SOSYS; cashless at listed hospitals
- Collect all bills/reports after treatment
- Fill in and upload the claim form in SOSYS
- After approval the money arrives in your bank account (minus the 20% co-payment)
⚠️ Common mistakes
- Not keeping original bills
- Expecting more than the annual limit (inpatient Rs. 100,000 / OPD Rs. 20,000)
- Claiming without meeting the qualifying period (3 of the last 6 months of contributions)
💡 The final list is as prescribed by SSF — check the official notice before submitting.
📜 Official sources
- सामाजिक सुरक्षा योजना सञ्चालन कार्यविधि, २०७५ (५औँ संशोधनसहित) (मूल २०७५।०८।०६; ५औँ संशोधन २०८१।०९।१०, लागू २०८२।०१।०१)
- स्वास्थ्य संस्था छनौट तथा योजनाको रकम भुक्तानी सम्बन्धी कार्यविधि, २०७६ (२०७६ (संशोधन २०७६।०९।१८, २०७७।०४।२६))
For legal purposes always consult the original documents and latest amendments. Rates and limits can change through amendments.