Insurance and Medical Care in India: What You Need to Know

When it comes to insurance, a financial safety net for unexpected medical expenses. Also known as health coverage, it’s meant to protect you from high hospital bills—but in India, it often falls short of what people expect. Many assume insurance means full coverage, but the truth is more complicated. From denied claims for weight-loss drugs like Zepbound to out-of-pocket costs for surgeries that aren’t fully covered, the gap between policy and reality is wide.

Health insurance in India doesn’t automatically cover everything. Procedures like knee replacements, IVF, or even certain mental health therapies often come with limits, waiting periods, or outright exclusions. For example, insurance denial, the common reason people pay for expensive treatments themselves happens often with newer medications like Ozempic or semaglutide-based drugs. Even routine tests like a full body blood test might not be covered unless they’re tied to a diagnosed condition. And while hospitals push for preventive care, insurers rarely pay for it unless it’s part of a specific plan.

Then there’s the issue of medical costs, the real price tag behind surgeries, medications, and recovery. A heart surgery might cost ₹5 lakh, but your policy might only pay ₹3 lakh. A rotator cuff repair could be the 5th most common orthopedic surgery, but if your plan doesn’t list it as a covered procedure, you’re stuck with the rest. Even something as basic as showering after knee replacement surgery can become a financial headache if your insurer doesn’t cover post-op care supplies.

What you’ll find in these articles isn’t theory—it’s what people actually face. From why insurance won’t cover Zepbound to how mental health therapies are treated under Indian policies, these posts cut through the noise. You’ll learn how to fight denials, what to ask before signing up for a plan, and which treatments are most likely to leave you paying out of pocket. This isn’t about marketing brochures. It’s about the real, messy, often frustrating world of medical insurance in India—and how to protect yourself in it.