Only 31% of Indian seniors insured for health

Unfortunately, 16% had applied for coverage but were denied.

India’s elderlies are facing high-health related vulnerabilities, with only 31% of elderly persons having health insurance.

On the other hand, 33% of elderly men have coverage versus the smaller 29% women population in India, the “Ageing in India: Exploring Preparedness & Response to Care Challenges” report revealed.

Most insured elderly lived with their children and spouse (65%) or just with their children (22%). 

However, it was noted the respondents had a high literacy rate of 72%, and two-thirds of those with income earned less than Rs1 lakh per annum. Additionally, only 26% had no income, relying on government schemes.

More than two-thirds (68%) of insured respondents were covered under the Ayushman Bharat Programme (ABP) – Pradhan Mantri Jan Arogya Yojana (PMJAY), the world's largest government-financed health insurance scheme.

Another 36% had state-sponsored health insurance, whilst only 3% had commercial insurance. The main reasons for lacking insurance were lack of awareness (32%), affordability (24%), and perceived lack of need (12%). 

Most elderly (55%) were unaware of their insurance coverage amount, whilst 27% reported coverage above Rs1 lakh, and 18% below Rs1 lakh. Government-sponsored insurance mainly covered hospital care, with families bearing outpatient and regular medical expenses.

Key challenges in claiming insurance included long processing times (45%), claim amount deductions (43%), and claim rejections (40%). Additionally, 25% did not have access to cashless facilities, requiring reimbursement.

Respondents suggested improvements such as having quality healthcare facilities nearby, reducing waiting times, providing free medicines, lowering treatment costs, and increasing doctors' sympathy towards the elderly.