Health insurance coverage doubles in seven years as rural India overtakes urban areas
HYDERABAD: Health insurance coverage in India has more than doubled over the past seven years, with rural residents overtaking their urban counterparts in access to health insurance, according to the government’s latest Household Social Consumption: Health Survey.
The survey found that 47.4% of rural residents and 44.3% of urban residents were covered under at least one health insurance scheme in 2025. In 2017-18, the corresponding figures were 14.1% and 19.1%, respectively.
The coverage includes public health insurance schemes run by the Centre and state governments. Conducted between January and December 2025, the survey covered 1,39,732 households and serves as the government’s principal source for assessing out-of-pocket medical expenditure and access to healthcare.
Institutional childbirths continue to rise
The survey reported significant gains in maternal healthcare, with 96.2% of childbirths taking place in healthcare institutions in 2025. Only 3.8% of deliveries occurred at home.
In rural India, institutional deliveries increased from 90.5% in 2017-18 to 95.6% in 2025. Urban institutional deliveries rose from 96.1% to 97.8% during the same period.
Home births declined from 9.5% to 4.4% in rural areas and from 3.8% to 2.2% in urban areas. The survey found that rural women continued to rely more on government healthcare facilities, while urban women increasingly opted for private hospitals.
Private treatment remains costlier
The survey found that 13.1% of people reported an illness during the 15 days preceding the survey. Urban residents reported slightly higher illness levels than rural residents, reflecting a growing burden of chronic and age-related diseases, particularly among older people.
Average out-of-pocket expenditure for hospitalisation stood at ₹34,064. Patients spent an average of ₹6,631 in public hospitals compared with ₹50,508 in private hospitals.
The hospitalisation rate remained stable at 2.9%, suggesting that higher illness levels did not translate into more hospital admissions. The survey said this could reflect financial constraints or greater reliance on outpatient care.
Medical expenses increased with household consumption levels, although lower-income families also faced substantial healthcare costs.
Among the costliest illnesses were cancer, kidney failure, cardiovascular diseases and injuries, particularly in private hospitals. Obstetric care remained comparatively affordable in government hospitals, highlighting the role of the public healthcare system in supporting childbirth and maternal care.
