Ask an average Indian if they have health in surance and their answer will most likely be ‘yes’. Ask them if they can point to room rent clause or consumables coverage, and they’ll not be as confident. Health insurance in India has become table-stakes, but ‘insured’ and ‘cov ered’ aren’t the same thing. This gap may show up, for instance, on the day of discharge when a bill that looks fully protected on paper turns out to have a few thou sands or lakhs that a family needs to pay on its own.
Out-of-pocket expenses accounted for nearly 39% of total health expenditure in India, as per 2021-22 gov ernment data. Coverage has risen to about 46% of rural and 44% of urban households as of 2025, but coverage and protection haven’t moved in step. Even where a policy exists, benefit limits routinely fall short of what treatment actually costs. This is a global problem. A World Health Organization report found that out-of pocket expenses for medicines and other medical prod ucts push up to 12% of households in European coun tries into poverty or deepen their financial hardship.
