 The results of this study suggest that the main reasons for dropping out of the National Social Health Insurance, SHI, Program and PACRA are related to drug availability, unfriendly behavior from providers, and difficulty accessing services due to renting homes. To reduce dropouts, the government should ensure that there is sufficient stock of medicines available in all health facilities, provide training to healthcare providers to improve their attitude towards SHI scheme holders, and create awareness campaigns targeting people who live in rented houses. This article was authored by Praban Sharma, Dipendra Jadav, Narendra Shrestha, and others.