 This study found that the main factors associated with the intention to renew annual membership for the National Health Insurance Program in Nepal are household income, health service quality, and health service utilization. Households with higher income have lower odds of renewing their annual membership, while those with better health service quality and more frequent use of health services have higher odds of renewing their membership. Additionally, almost two-thirds of the respondents indicated they would renew their membership if the services were improved. This article was authored by Guy Bahadur Garum and Alessio Panza.