Medical experts in Tamil Nadu have cautioned that increasing the government health insurance cover from Rs 5 lakh to Rs 10 lakh may have limited impact unless the premium paid to the insurer is also raised.
The state’s Chief Minister’s Comprehensive Health Insurance Scheme is being implemented alongside the Centre’s Ayushman Bharat programme, covering about 1.52 crore families. The government reportedly pays more than Rs 1,200 crore a year to United India Insurance, with a premium of Rs 849 per family.
Doctors pointed out that the scheme is largely used in government hospitals, where claim amounts are typically limited to the cost of medicines and medical devices for surgeries, often staying within a lakh. In private hospitals, the same procedures can cost several lakhs, but insurers are said to be reluctant to release higher payouts.
They also cited field-level issues, claiming that a large share of applications are rejected, discouraging private hospitals from participating. Experts said that if the cover is raised, the premium must be increased as well, and the government should consider a dedicated monitoring mechanism to ensure eligible applicants actually benefit.
