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Health Insurance Now Covers Nearly Half of India's Population, Survey Reveals

A government survey indicates a substantial expansion in health insurance coverage across India, reaching nearly half the population. The data reveals significant out-of-pocket costs for private hospitalization, averaging over Rs 34,000 per case. In contrast, treatment in public hospitals is far more affordable, with half of outpatient cases being free. The survey also highlights that non-communicable diseases become most prevalent after the age of 30.

Key Points: India's Health Insurance Coverage Nears 50%, Govt Survey Shows

  • Insurance covers nearly half of India
  • Avg. hospitalization cost over Rs 34,000
  • Public hospital care significantly cheaper
  • Non-communicable diseases rise after age 30
2 min read

India's health coverage expands rapidly, insurance reaches nearly half the population: Govt

A new government survey shows a major expansion in health insurance, with nearly half of India covered. It details out-of-pocket costs for hospitalization and outpatient care.

"half of the treatment episodes in public hospitals were received free of cost - Household Social Consumption: Health Survey"

New Delhi, April 20

A government survey showed on Monday that a substantial improvement has been seen in health insurance coverage across India between 2017-18 and 2025.

The Ministry of Statistics and Programme Implementation (MoSPI) released the findings of the survey on health, titled 'Household Social Consumption: Health'. The survey was conducted during January-December 2025.

According to the findings, the estimated average out-of-pocket medical expenditure per hospitalisation case (excluding childbirth) during the last 365 days was about Rs 34,064 (Rs 31,484 in rural and Rs 38,688 in urban), while the median out-of-pocket medical expenditure was about Rs 11,285 (Rs 10,500 in rural and Rs 12,400 in urban).

"In public hospitals, the average expenditure per hospitalization case (excluding childbirth) at all-India level was Rs 6,631 while half of the hospitalized cases treated in public hospitals involved spending of Rs 1,100 or less," the survey showed.

For out-patient care during the last 15 days, the average out-of-pocket medical expenditure in India was about Rs 861 (Rural Rs 847, Urban Rs 884) while the median expenditure was about Rs 400 (Rural Rs 395, Urban Rs 420).

In public hospitals, the average expenditure per spell for out-patient care during the last 15 days was about Rs 289 and the median was about Rs 0, indicating that half of the treatment episodes in public hospitals were received free of cost, according to the survey.

"The average out-of-pocket medical expenditure per childbirth during the last 365 days was about Rs 2,299 in public hospitals, while the average expenditure in all hospitals combined was about Rs 14,775.

Median expenditure for childbirth in public hospitals (Rs 801) was less than one-third of the median expenditure in all hospitals (Rs 2,851).

The survey further showed that about 13.1 per cent persons reported illness (responded as ailing) during the last 15 days preceding the date of survey, where persons in urban areas (14.9 per cent) reported illness slightly more than the persons in rural areas (12.2 per cent).

The highest proportion of individuals reporting illness was observed in the age-group 60 years and above (43.9 per cent), followed by those aged 45-59 years (22.5 per cent) and children aged 0-4 years (9.9 per cent).

Infections and respiratory ailments were most frequently reported during childhood and adolescence, while psychiatric/neurological and gastro-intestinal conditions peaked in young adulthood, said the report.

Non-communicable diseases (NCDs) such as cardio-vascular (hypertension) and endocrine/metabolic (diabetes) were most frequently reported after the age of 30 years, it added.

- IANS

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Reader Comments

R
Rohit P
The numbers look good on paper, but the ground reality is different. The average out-of-pocket expense of Rs 34k for hospitalization is still a huge burden for most families. Insurance might be reaching more people, but are the policies actually covering enough? We need more transparency.
A
Aman W
The data on NCDs like diabetes and hypertension peaking after 30 is alarming. We need massive awareness campaigns about lifestyle diseases. Insurance is important, but prevention is better than cure. Junk food and sedentary jobs are a real problem now.
S
Sarah B
As someone who has used both public and private healthcare here, the cost difference is staggering. Rs 2,299 vs Rs 14,775 for childbirth says it all. Public hospitals need more investment and staff to handle the load if they are the affordable option.
V
Vikram M
Good step forward. The Ayushman Bharat scheme has been a game-changer for my relatives in the village. But the survey says urban areas report more illness? That's interesting. Maybe better reporting, or maybe city stress and pollution are taking a toll.
K
Kavya N
The median expenditure being much lower than the average means a few very expensive cases are skewing the data. Most people probably spend around Rs 11k for hospitalization, which is still significant. We need to focus on bringing down the cost of medicines and diagnostics.

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