Over 80% of disabled people in India still lack health insurance – Here’s why
Despite being a vulnerable section of society, more than 80% of persons with disabilities (PwDs) in India remain uncovered by health insurance. A recent nationwide survey conducted by the National Centre for Promotion of Employment for Disabled People (NCPEDP) highlighted glaring gaps in access to both government and private medical insurance. This article examines the key findings of the survey and explores the systemic, financial, and social factors contributing to the widespread exclusion of PwDs from India's health insurance ecosystem.
A growing concern in public health
Health insurance is a critical safeguard against rising medical costs, yet for persons with disabilities, this essential protection remains largely out of reach. A staggering 80.5% of surveyed PwDs lacked any form of health insurance, whether from government or private sources. This alarming figure points to more than just individual oversight—it suggests systemic neglect.
The survey, which involved 5,000 PwDs across 34 Indian states and union territories, found widespread unawareness, high rejection rates, and poor information dissemination as major obstacles. It especially emphasised the exclusion faced by those with Haemophilia, Thalassemia, multiple disabilities, and locomotor impairments.
Lack of awareness about government schemes
The government’s flagship scheme—Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)—was launched with the vision of providing universal health insurance. Yet, more than 42% of PwDs had not even heard of the programme, and only 58.8% were aware of it at all. This points to significant communication failures, particularly in reaching vulnerable populations.
Even among those who knew about AB-PMJAY, many faced hurdles in applying. Only 28.4% of respondents had applied for any health insurance at all, and of them, just 46.8% were successful in securing a policy.
Rejections and discrimination
One of the most worrying findings was the high rejection rate among applicants. Over 53% of those who applied were denied health insurance. Key reasons included:
● Pre-existing conditions (36%)
● Lack of insurer knowledge about disability-specific issues (32%)
● No response or follow-up from insurance providers
● Exclusion of disability-related needs in policy assessments
Shockingly, around 60% of rejected applicants were not even informed why their applications were declined. This lack of transparency adds to the frustration and financial uncertainty faced by PwDs.
Gender gaps in insurance access
The survey also revealed gender-based disparities. Women with disabilities faced even more significant challenges in obtaining health insurance. Those who did have insurance were mostly individuals with Thalassemia (46.6%), followed by those with locomotor disabilities (16.4%) and sickle cell disease (14.5%).
In contrast, women with Haemophilia, dwarfism, multiple disabilities, and speech impairments were among the least insured. These patterns point to overlapping discrimination based on gender and type of disability, indicating the need for inclusive and targeted policy reforms.
Private medical insurance is no solution either
Although private medical insurance schemes are often touted as alternatives to public coverage, the survey results show they are not adequately serving PwDs either. Of those who were insured, only 27% had private medical insurance, while 53% were covered under PMJAY and just 9% through state government schemes.
Many private insurers still view disabilities as high-risk or uninsurable conditions, often resulting in higher premiums or outright rejections. In addition, the absence of disability-specific products and a general lack of awareness among insurance agents contribute to the underrepresentation of PwDs in the private insurance segment.
Systemic barriers and the need for reform
The findings of the NCPEDP survey reflect a broader systemic failure. Despite the legal and constitutional mandates for equal access, the lived experience of most PwDs is one of exclusion. Several structural issues exacerbate the problem:
● Inadequate grassroots outreach by insurers and government officials
● Policy design gaps that exclude non-income-based coverage for PwDs
● Poor coordination between healthcare providers and disability rights groups
● Lack of representation of PwDs in insurance policy-making
The way forward
Improving access to health insurance for persons with disabilities requires a multi-pronged approach:
1. Policy inclusion – Government schemes must remove income and age barriers for PwDs and include disability-specific provisions.
2. Awareness campaigns – Extensive education and outreach efforts are needed, especially in rural areas, to inform PwDs of their rights and options.
3. Private sector reform – Private insurers must be encouraged and regulated to offer affordable and inclusive products for persons with disabilities.
4. Transparency and grievance redressal – Application processes should be simplified, and reasons for rejection must be clearly communicated to every applicant.
5. Gender sensitivity – Focused efforts should be made to address the gender gap in insurance coverage for disabled women.
Conclusion
The lack of health insurance for over 80% of persons with disabilities in India is not just a healthcare issue—it’s a human rights issue. With rising medical costs and an ageing population, timely intervention is critical. The survey results serve as a wake-up call to policy-makers, insurers, and civil society to address the barriers that keep millions of Indians from receiving the protection and dignity they deserve through private medical insurance or government schemes.
