Think Learn & Perform (TLP)

The Only Dedicated Platform for UPSC Mains Answer Writing

Day 22 – Q.5. Examine the status of insurance coverage in India. What is your assessment of the potential of Ayushman Bharat in this regard?

5. Examine the status of insurance coverage in India. What is your assessment of the potential of Ayushman Bharat in this regard?

भारत में बीमा कवरेज की स्थिति की जांच करें। इस संबंध में आयुषमान भारत की क्षमता का आपका आकलन क्या है?


Insurance coverage is the amount of risk or liability that is covered for an individual by insurance services. With increased incidences of communicable and non-communicable diseases, and increasing out-of pocket health expenditure, insurance has become a must to live a stable life.


Status of insurance coverage in India:

  • Insurance- As per the latest NSSO reports over 80% of India’s population remains uncovered by any health insurance scheme.
  • Insurance gap- The total value of assets not covered by an insurance policy is one of the highest in the world, standing at 1% of the GDP as per Lloyd’s report.
  • Insurance penetration- Total value of premium underwritten in a year in case of non-life insurance is rising on the back of government schemes to 0.9% of GDP.
  • Unequal distribution- Most of the insurance products cater to the urban areas, and rural areas lag behind.
  • Disparity among classes- While the rich have a higher coverage, mostly from private players, poor are dependent on meager government provided insurance sums.
  • Quality of coverage- Most of the insurance plans cover only in-patient expenses, leaving out-patient and other expenses on the insured.
  • Vulnerable citizens- Women and senior citizens, that require more healthcare intervention, have much less coverage compared to the adult males.

To fight this dismal state of coverage, government has launched Pradhan Mantri Jan Arogya Yojana under Ayushman Bharat. It aims to provide financial protection up to Rs.5 lakh per family per year to approx. 10 crore families, selected through SECC data.

Potential in improving insurance coverage:

  • Increased numbers- Increases number of people under insurance coverage by approx. 50 crores.
  • Reduces insurance gap- Providing Rs.5 lakhs per family will result in better coverage.
  • Reduced out of pocket expenditure- The insurance packages will cover costs of surgery, day care treatments, medicines and diagnostics.
  • Reduce disparity among classes and regions- Most of the beneficiaries will be poor and will be provided with a good insurance cap, thus reducing the gaps present.
  • Wider coverage- Coverage of pre-existing diseases and provision that the hospitals cannot deny treatment will bring such people also under the insurance net.
  • Helping vulnerable citizens- Priority will be given to girls, women and senior citizens, ensuring for them proper healthcare.


Ayushman Bharat can bring a positive change in the status of insurance coverage in India. However, it alone is not sufficient, we do need to increase awareness about insurance and as well increase public health expenditure to sustain the overall insurance ecosystem in healthcare.

No best answer

Print Friendly, PDF & Email