More Indians have health cover—but hospital bills still burn a hole

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.