Coverage of Health Insurance Schemes: Unstarred Question in Loksabha

Coverage of Health Insurance Schemes

(a) whether only 15 per cent population of the country has been covered under Health Insurance Schemes and if so, the details thereof and the reaction of the Government thereon;
(b) whether the expenditure incurred only on admission in the hospital is reimbursed under health insurance schemes, if so, the details thereof and the reasons therefor;
(c) whether the Insurance Regulatory and Development Authority of India (IRDAI) has suggested to include the expenditure incurred on OPD treatment and maternity cover etc.; and
(d) if so, the details thereof and the steps taken/being taken by the Government to increase coverage of health insurance schemes?

GOVERNMENT OF INDIA
MINISTRY OF FINANCE

LOK SABHA

UNSTARRED QUESTION NO: 2502                                        ANSWERED ON: 09.03.2018

Coverage of Health Insurance Schemes

KAPIL MORESHWAR PATIL

Will the Minister of FINANCE be pleased to state:-

(a) whether only 15 per cent population of the country has been covered under Health Insurance Schemes and if so, the details thereof and the reaction of the Government thereon;
(b) whether the expenditure incurred only on admission in the hospital is reimbursed under health insurance schemes, if so, the details thereof and the reasons therefor;
(c) whether the Insurance Regulatory and Development Authority of India (IRDAI) has suggested to include the expenditure incurred on OPD treatment and maternity cover etc.; and
(d) if so, the details thereof and the steps taken/being taken by the Government to increase coverage of health insurance schemes?

ANSWER

THE MINISTER OF STATE IN THE MINISTRY OF FINANCE


(a) As per Insurance Regulatory and Development Authority of India (IRDAI), the total number of lives covered under any type of health insurance policy as on 31st March, 2017 were 43.75 crore which is approximately 36 per cent of India’s population as per Census 2011.

(b) to (d) Health Insurance Policies generally provide coverage for inpatient treatment including Domiciliary Hospitalization benefits subject to policy terms and conditions. However, more number of health insurance products now provide coverage for Out Patient Department (OPD) treatment in order to encourage policyholders to go for treatment at early stages. IRDAI (Health Insurance) Regulations, 2016 inter-alia enable the insurers to introduce wellness and preventive features as part of health insurance policies. During the year 2016-17, the Rashtriya Swasthya Bima Yojana (RSBY) was in implementation in 15 States/UTs involving 265 districts, covering 3.63 crore families. Some of the insurance products where OPD treatment and maternity cover are being covered is at Annexure. 


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Source: Loksabha
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