Out-of-pocket expenses remain high in health insurance coverage 

Health insurance coverage amongst Indians improved significantly over the years, with nearly half of Indians having some form of health coverage by 2025, but out-of-pocket expenses on medical expenses remained high, according to a new survey by the Ministry of Statistics and Programme Implementation (MoSPI).

“A substantial improvement has been seen in health insurance coverage across India between 2017–18 and 2025 with government-sponsored schemes accounting for the majority of enrolments.,” said the NSS Survey on Household Social Consumption: Health that was carried out between January and December 2025.

The survey found that in 2025, about 47% of rural Indians and about 44% of urban Indians had health insurance, as against just 14% in rural areas and 19% in urban areas in 2017-18.

It revealed that the estimated average out-of-pocket medical expenditure per hospitalisation case (excluding childbirth) during the last 365 days was about ₹34,064—₹31,484 in rural and ₹38,688 in urban, while the median out-of-pocket medical expenditure was about ₹11,285. 

In public hospitals, the average expenditure per hospitalisation case (excluding childbirth) at the all-India level was ₹ 6,631, while half of the hospitalised cases treated in public hospitals involved spending of ₹1,100 or less. But when combined with all hospitals, including private, the average out-of-pocket medical expenditure per hospitalisation rises significantly to ₹34,064.

For childbirth, the average out-of-pocket medical expenditure during the last 365 days was about ₹2,299 in public hospitals. The average expenditure in all hospitals combined per childbirth was much higher at about ₹14,775.

For out-patient care during the last 15 days, the average out-of-pocket medical expenditure in India was about ₹861, with expenses in rural and urban areas largely the same – ₹847 in rural areas and ₹884 in urban areas. The median expenditure was ₹400. But for government hospitals, this was much lower and roughly just a fourth of the cost at ₹281.