Addressing Gender Disparities in Health Insurance: Pathways Towards Equitable Universal Coverage in India

India has made significant strides in expanding health insurance coverage over the past two decades, yet scale of coverage has not automatically translated into equity. Despite major public health schemes like Ayushman Bharat (AB-PMJAY) enrolling over 420 million beneficiaries, India continues to face persistent structural gaps in women’s health and survival, ranking 131st out of 148 countries in the World Economic Forum’s Global Gender Gap Index 2025.

This Policy Brief examines systemic gender disparities across India’s public and private health insurance frameworks, revealing that female-specific healthcare needs—such as maternity diagnostics, gynaecological conditions (e.g., PCOS/PCOD), and outpatient mental healthcare—are largely excluded, restricted, or treated as high-cost premium add-ons subject to multi-year waiting periods. Structured primarily around male-headed family units and acute hospitalisation triggers, current insurance products reproduce gender biases and fail to cover chronic or preventive female care. Consequently, high out-of-pocket health expenditures (OOPE)—accounting for nearly 45–50% of current health spending—continue to drive low-income and marginalised women into severe poverty traps.

To align national health governance with Sustainable Development Goal 3.8 (Universal Health Coverage) and SDG 5 (Gender Equality), the authors propose actionable regulatory and policy pathways. These include enforcing IRDAI-mandated minimum coverage standards for women's health across all base plans, capping waiting periods at 6–12 months, expanding public schemes like AB-PMJAY to include outpatient and preventive services, and institutionalising gender-disaggregated data collection to ensure an inclusive, needs-based healthcare system.