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The government has been questioned regarding the continuously rising health insurance premiums and medical treatment costs in the country. Responding to this issue in the Lok Sabha, Pankaj Chaudhary, the Minister of State in the Ministry of Finance, stated that health insurance premiums increase annually due to several factors. These include medical inflation, the aging of the population, the opting for higher insurance coverage, and the inclusion of new features in policies.

Question: How are premiums determined?
According to the government, the average health insurance premium has risen gradually over the past few years. However, insurance companies are also required to ensure that premiums are determined fairly and transparently.

Question: How much have health insurance premiums increased over the last three years?

According to information provided by the government, the average health insurance premium has indeed increased.
In the financial year 2024-25, the average premium for a 'Family Floater' health policy stood at approximately ₹7,020 per person.
This represents an increase of approximately 3.35% compared to the previous year.
Meanwhile, the average premium for an 'Individual' health insurance policy was approximately ₹11,187.
A growth of approximately 9.95% was recorded in this category as well.

What are the major reasons for the increase in premiums?
According to the government, there are several reasons behind the rising cost of health insurance:
Continuous increase in medical expenses.
Increase in the average age of policyholders.
Opting for higher insurance coverage.
Addition of extra features/benefits to policies.
Consequently, insurance companies periodically revise their premiums based on these factors.

Meeting with insurance companies and hospitals?
The government stated that a meeting was held on November 13, 2025, with representatives from insurance companies and hospitals. During this meeting, all stakeholders were urged to take measures to make healthcare services more affordable and accessible to the common people.

What did the government say regarding Tamil Nadu?
 It is worth noting that certain reports had raised the question of whether policyholders in Tamil Nadu were disproportionately facing issues such as premium hikes, claim rejections, or delays in cashless treatment. In response, the government stated that the insurance regulator, IRDAI, possesses no information to substantiate the claim that people in that particular state have been adversely affected to a greater extent.

What are the regulations regarding premium hikes exceeding 10%?
The government further clarified that if the premium for a senior citizen health policy is to be increased by more than 10%, insurance companies are required to consult with the IRDAI beforehand. However, there is currently no proposal to extend this specific regulation to all categories of health insurance policies.

What is the government's plan for senior citizens?
The government also highlighted that, under the Pradhan Mantri Jan Arogya Yojana (PMJAY), health insurance coverage is provided to poor and needy individuals upon hospitalization. The scope of this scheme has now been expanded to include approximately 60 million senior citizens aged 70 years and above. The objective of this initiative is to provide senior citizens with relief from the rising costs of medical treatment.

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