A new study published in The Lancet Regional Health - Southeast Asia highlights alarming gaps in health insurance coverage among India’s elderly, particularly those over 80.

Analyzing 10 years of data from 38,387 cataract surgery patients across four Indian states, researchers found only 16% had any form of insurance dropping to just 7.14% in those over 90.

The study found a significant correlation between insurance coverage and better visual outcomes after surgery. Insured patients were 1.38 times more likely to have improved vision than uninsured ones. Yet public insurance, though critical, showed limited reach hovering around 3–4% across all age groups.

Private insurance coverage also declined with age, from 13.3% in those aged 70 - 74 to just 4% in those over 90. Despite Ayushman Bharat’s launch in 2018 doubling coverage in some groups, uptake remains low and unequal - men had higher coverage (19.1%) than women (12.4%).

Even among the insured, disparities exist. Government-insured patients faced longer waits (18 vs 11 days) and were less likely to receive modern foldable lenses compared to those with private insurance.

‘Universal health coverage is essential for equity in care,’ said Dr. Raja Narayanan. Dr. Brijesh Takkar added, ‘This evidence strongly supports expanding insurance to reduce both financial and health burdens on India’s aging population.’