Treatment abroad from Nepal: the new USD 30,000 medical forex limit, and how to pay a hospital in Delhi or Bangkok

A cousin flew his father to Bangkok last year for a cardiac procedure the hospital in Kathmandu said it could do, but not soon. The bank gave him the full USD 15,000 the rules allowed. The hospital's estimate was higher. He spent the second week of the trip on the phone to Kathmandu, arranging for relatives to put money on their own cards.

That limit has now doubled. On or around 5 October 2026 Nepal Rastra Bank raised the yearly foreign exchange allowance for treatment abroad to USD 30,000. For families planning treatment in Thailand, Singapore or further away, this changes what they can do. For the far larger number of Nepalis who go to Delhi, Vellore or Chennai, the rules that matter are the Indian-rupee ones, and those have also moved this year.

What changed in October

Three outlets reported the revision on 6 October 2026: Online Khabar, Ratopati and Republica. All three give the same numbers. The circular itself could not be read for this post because NRB's site was not reachable, so the details below come from those reports.

The medical figure is the one families will use. At NRB's selling rate of Rs 155.08 to the dollar on 12 October, the old limit was worth about Rs 23.3 lakh and the new one about Rs 46.5 lakh. Some reports gave the old limit as USD 16,000; the three outlets above all say 15,000.

The carry-limit guide covers the other quotas: travel, study and cash declaration.

Does it cover India? Probably not

NRB's own foreign-exchange FAQ has described the medical facility as treatment at a hospital "भारत बाहेक अन्य मुलुकस्थित" (in countries other than India) since the days it was USD 10,000. The October reports do not say that changed. Nepal and India settle in rupees at the fixed 1.6 peg, and the dollar facilities have always excluded India for that reason.

So plan on the dollar limit for Bangkok, Singapore or anywhere else outside India. For India, plan on the rupee rules below, and ask your bank directly whether anything new applies to INR medical payments. None of the research for this post turned up a current INR-specific medical allowance.

Paying a hospital in Bangkok or further

The money is drawn from a bank or financial institution "by completing the prescribed procedures," in the reports' words. The last document list NRB published, in 2014, asked for three things, and banks are likely to ask for something close to it:

1. A recommendation from a doctor in Nepal that the patient needs treatment abroad.
2. A cost estimate from the foreign hospital.
3. After returning, a report to the bank of what was actually spent.

Your passport goes with it, as for any foreign exchange. Ask the bank whether it can send part of the amount straight to the hospital by SWIFT against the estimate, the way foreign tuition is paid. A wire to the hospital leaves a clean paper trail for the return report and means less cash in a hospital corridor. The reports do not say whether this is how the facility must be drawn, so the bank's answer is the one that counts.

A hypothetical bill of THB 5 lakh, at the 12 October selling rate of Rs 4.63 per baht, comes to about Rs 23.2 lakh. Under the old limit that bill used up the whole year's allowance. Under the new one it leaves room for a follow-up visit and the medicines.

If you carry any of it as cash, remember the airport line: foreign currency above USD 5,000 must be declared to customs on arrival back in Nepal.

Paying a hospital in India

Here the instruments are smaller and you will probably need more than one.

The cash rule is from the NRB circular of 7 Shrawan 2083: INR 200 and 500 notes printed after 9 November 2016 can now be carried, brought back and exchanged up to INR 25,000 per person. Older INR 500 and 1,000 notes are still unusable. A family of three travelling together can carry three times that.

The UPI figures are from Nepal Clearing House's page for the person-to-person link that opened on 9 June 2026. Sending banks are Everest, Global IME, Machhapuchchhre, Nabil and Nepal SBI, plus connectIPS. The Rs 240 fee works out to about 1% on a full INR 15,000 transfer. What you cannot do is scan the hospital's own QR code: the Nepal-to-India merchant direction has still not launched.

Put a real bill through that table. An INR 5 lakh procedure, about Rs 8 lakh at the peg, would take five months of the UPI monthly cap or the cash allowance of twenty people. The card at the counter or a planned remittance is the only workable route, and both depend on your bank. Some Nepali banks publish higher debit-card limits at hospitals and pharmacies than at ordinary shops in India, but the pages could not be checked for this post. Call the card centre with the hospital's estimate before you leave and ask for the limit in writing.

One saving worth knowing: Nepal Bank signed an agreement with Apollo Hospitals in June 2026 for a 10% discount for its customers. Ask your own bank whether it has a similar tie-up before you choose a hospital.

The route not to take

When the bank limit runs out, someone in the family will know a man who can get money to Delhi by evening. That is hundi, and it is prosecuted under the Foreign Exchange (Regulation) Act. Parsa alone saw over Rs 1.5 crore in hundi cash seized over three years, Kantipur reported in July. The hundi-versus-bank comparison covers why the saving is smaller than it looks even before the legal risk. Medical spending also leaves no paper trail through hundi, which is a problem when the bank asks for your spending report.

What insurance and tax will not do

Most Nepali health policies, and the government Health Insurance Program, are built around referral chains through Nepali hospitals. Check your policy wording for treatment abroad before assuming any of it comes back, and read the parents-over-60 guide if the patient is an older parent.

The tax side is small. Section 51 of the Income Tax Act gives a credit of 15% of approved medical expenses, capped at a prescribed limit. Older guides put that cap at Rs 750 and a FY 2083/84 payroll guide at Rs 1,500. On a Rs 23 lakh bill, either cap is a rounding error. The money that pays for treatment abroad is the fund you build before it is needed, which the parents' medical fund post sizes.

What you actually need to know

1. The medical forex limit is now USD 30,000 a year, about Rs 46.5 lakh. It covers treatment, medicines and equipment abroad, drawn from your bank against a doctor's referral and a hospital estimate, with a spending report afterwards.
2. India is a different system. INR 25,000 cash per person and a UPI transfer link capped at INR 1 lakh a month cannot pay a hospital bill on their own; your bank's card limit at the hospital and any direct remittance it offers are what you need to arrange before travelling.
3. Sort the payment route before the flight. Hospital estimate in writing, bank confirmation of how the money moves, card limit raised, receipts kept. The families who spend the second week of treatment on the phone to Kathmandu skipped one of these steps.

Planning treatment abroad for a parent and unsure how to move the money? Email parjanya57@gmail.com with the country, the estimate and your bank, and I'll help you work out the route.

This post is part of the Nepal Money Basics guide — the protect-what-you've-saved section.