Health Insurance Statistics of 2025
Recently, IRDAI announced the goal of "Insurance for all by 2047" in synchrony with India's broader national intent of becoming a global superpower. But are we truly cautious about our health insurance coverage? Often, we only become cautious when a medical emergency strikes. This highlights the irony of health insurance in India. Many view it as an expenditure, rather than a crucial financial tool that protects during emergencies. This perception is a significant challenge for much of the Indian population.
This article delves into the latest health insurance statistics in India, presenting interesting facts and insights.
Healthcare Systems in India: An Overview
The Indian healthcare industry is a powerhouse, ranking among the largest sectors in terms of revenue and job creation. In the annual budget 2023-24, the Ministry of Health and Family Welfare was allocated Rs 89,155 Crore, marking a 3.43% increase over the previous year.
Health insurance, an integral part of the healthcare system, provides financial coverage for:
- Hospital bills
- Charges for medical devices used in treatment
- Charges for any equipment
- Clinical trials
- Telemedicine
- Medical tourism
Segments of the Indian Healthcare Sector
The Indian healthcare system is divided into two segments: the public sector and the private sector. In the public sector, every Indian is eligible for free healthcare services through government facilities. However, private sector services come with significantly higher expenses. Health insurance is often essential for accessing treatment in private hospitals and healthcare centers.
This raises the question of choosing between free public sector medication and private sector care. While the public sector offers free services, it struggles to cater to the entire population of 141.72 crores. Consequently, many individuals must turn to the private sector for emergency medical care.
Health Insurance Statistics: A Snapshot
While the public sector provides free medical services, the private sector is often preferred for its superior care, quality services, and advanced systems.
Coverage Statistics
-
According to Statista
In 2021, approximately 514 million people in India were covered under health insurance schemes, representing about 37% of the population.
-
According to NITI Aayog
Approximately 400 million individuals in India lack access to health insurance. An estimated 70% of the population is covered by public or voluntary private health insurance. The remaining 30%, or over 40 crore people, remain uninsured.
Premium Statistics
-
According to Statista
In 2021, the gross written premium of the Indian health insurance industry exceeded INR 637 billion. Public sector health insurers recorded approximately INR 272 billion in premiums, private sector insurers INR 159 billion, and standalone health insurers INR 151 billion.
| Financial Year | Premiums (in billion) |
|---|---|
| FY15 | 20,096 |
| FY16 | 24,498 |
| FY17 | 30,392 |
| FY18 | 37,029 |
| FY19 | 45,532 |
| FY20 | 50,752 |
| FY21 | 58,237 |
NFHS India Report 2019-2021
Healthcare Expenditure Statistics
According to the Economic Survey 2022-23 (PIB Government press release),
In FY23, the budgeted expenditure on healthcare nearly reached 2.1% of GDP.
In FY22, it was 2.2%.
And in FY21, it stood at 1.6%.
Expenditure on healthcare services increased from 21% in FY19 to 26% in FY23.
Social security expenditure on health increased from 6% in FY14 to 9.6% in FY19.
State-wise Coverage
Health insurance coverage in India remains unsatisfactory across many states.
According to the National Family Health Survey (NFHS)
Only 41% of Indian households have at least one member covered by health insurance.
A concerning gender gap exists: only 30% of women aged 15-49 years have health insurance, compared to 33% of men in the same age group.
Geographically, health insurance distribution is uneven, as shown in the table below:
| State | % of families with at least 1 member covered under a Health Insurance |
|---|---|
| Rajasthan | 88% |
| Andhra Pradesh | 80% |
| Goa | 73% |
| Chhattisgarh | 71% |
| Telangana | 69% |
| Assam | 67% |
| Kerala | 58% |
| Mizoram | 50% |
| Gujarat | 44% |
| Himachal Pradesh | 39% |
| Tripura | 36% |
| West Bengal | 34% |
| Karnataka | 32% |
| Sikkim | 28% |
| Delhi | 25% |
| Nagaland | 22% |
| Maharashtra | 22% |
| Bihar | 17% |
| Jammu and Kashmir | 14% |
NFHS India Report 2019-2021
Corporate Health Insurance
Corporate health insurance, also known as employer-sponsored health insurance, is typically provided by companies to their employees.
According to the Health Trend report by Mercer Marsh,
The cost of employer-sponsored medical benefits in India has risen by 15%.
Why India Needs Better Health Insurance
In India, lifestyle diseases like heart disease, diabetes, and asthma are quite common. While treatments are readily available, their costs can be prohibitive for many. This is largely due to advancements in medical research and the use of advanced tools.
According to the MMB Health Trends Report,
Approximately 5.8 million people lost their lives due to non-communicable diseases in 2021.
In 2021, diseases such as cancer, circulatory system ailments, and COVID-19 were the top cost drivers of medical claims in Asia, with the following percentages:
- Cancer: 55%
- Circulatory System based diseases: 43%
- Covid-19: 36%
Conclusion
India's health sector is undoubtedly growing. While a more inclusive health insurance landscape is envisioned for the coming years, achieving "Insurance for all by 2047" remains a significant challenge. Despite increased government healthcare budgets, a substantial portion of the population remains uninsured. Raising awareness about the importance of health insurance and making it affordable are crucial steps to ensure every Indian has access to the financial security it provides during medical emergencies.
To read about the latest updates by IRDAI in health insurance, click here.
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