Health Insurance: Awareness and Coverage in Urban Slums of Northern India.

Background: Health is a fundamental right of every individual. As lifestyle diseases are becoming more common these days, need for health care services increases. Globally, medical inflation has been on the rise. Even in a country with a robust healthcare system, the unexpected costs of medical emergencies can pose a significant financial burden. Hence, there is a need for health insurance schemes as it provides financial security to the family. Unfortunately, many people remain unaware of the benefits of health insurance, leaving them vulnerable to financial distress during times of medical crisis. Materials and Methods: This cross-sectional study was conducted at the Urban Health Training Centre. Adult patients (age ≥25 years) attending the OPD were included. A semistructured questionnaire assessed sociodemographic factors, health insurance awareness, type, coverage, and reasons for nonenrollment. Descriptive statistics and Chi-square tests analyzed associations between sociodemographic factors and health insurance awareness/enrollment. Binary logistic regression identified predictors of awareness and enrollment. Results: Above 70% were aware of health insurance. Colleagues were a primary source of information. Lack of awareness was the main barrier to enrollment. Higher education, male gender, and joint family living were associated with greater awareness. Enrollment rates were significantly higher in government employees (P = 0.004), individuals with higher education (P = 0.001), and living in joint families (P = 0.04). Conclusion: The study revealed a significant gap between health insurance awareness and coverage. Government-sponsored schemes without premiums and employer mandates were the main reasons for enrollment (36.5%). Lack of awareness, perceived good health, and affordability concerns were the primary barriers to enrollment.