India has seen a remarkable improvement in health insurance coverage, with nearly half the population covered by 2025. This positive trend, largely attributed to government-sponsored schemes, is detailed in a recent survey by the Ministry of Statistics and Programme Implementation (MoSPI).
The NSS Survey on Household Social Consumption: Health, conducted between January and December 2025, found that approximately 47% of rural Indians and 44% of urban Indians now possess some form of health insurance. This marks a substantial jump from 2017-18, when coverage stood at just 14% in rural areas and 19% in urban centers.
Persistent Burden of Out-of-Pocket Expenses
Despite the expanded coverage, the survey highlights a significant challenge: high out-of-pocket medical expenses, particularly for hospitalisation.
- Average Hospitalisation Cost: The estimated average out-of-pocket medical expenditure per hospitalisation case (excluding childbirth) over the last 365 days was approximately ₹34,064 across India. This figure was ₹31,484 in rural areas and ₹38,688 in urban areas. The median expenditure was ₹11,285.
- Public vs. Private Facilities: While public hospitals offered more affordable care with an average expenditure of ₹6,631 per case (median ₹1,100), the overall average surged when private hospitals were included, indicating a substantial financial burden for those utilizing private healthcare.
Childbirth and Out-Patient Care Costs
The financial impact also extended to other medical services:
- Childbirth: The average out-of-pocket cost for childbirth was ₹2,299 in public hospitals, but significantly higher at ₹14,775 when all hospitals (including private) were considered.
- Out-Patient Care: For out-patient care over a 15-day period, the average expenditure nationwide was about ₹861 (median ₹400). Public hospitals offered a much lower average cost of just ₹281 for similar services.
The findings underscore a dual reality in India's healthcare landscape: while access to health insurance is improving, the financial strain of medical treatment, especially in private facilities, remains a pressing concern for many households.