Navigating Long-Term Care and Health Insurance in India

If you’re planning to visit India or spend part of your retirement there, you may wonder how healthcare, especially long-term care, is handled. India’s population is aging rapidly, but its care system is still evolving. Families often remain the primary caregivers, and health insurance typically covers hospitalization, not daily care.

There are several ways people in India handle health insurance and long-term care.

• Health insurance: Most Indian residents purchase private health insurance policies, often renewed annually, that cover inpatient hospitalization and limited outpatient care. The Ministry of Health and Family Welfare says the government’s flagship program, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY), provides basic hospital coverage for low-income households but does not cover extended or custodial long-term care.
• Out-of-pocket spending: The WHO reports that more than 50 percent of India’s total healthcare spending still comes directly from households, especially for elderly care and medicines.
• Long-term care: According to the Global Observatory for Long-Term Care 2025, India has no national, formal long-term care system. Extended care usually occurs at home, supported by relatives or by privately hired caregivers. Assisted-living and nursing-home facilities exist in major cities, but standards and oversight vary widely.

For many middle-class families, long-term care is still “a family matter.” Professional in-home caregivers, visiting nurses, and private elder-care homes are emerging in metro areas such as Bengaluru, Chennai, and Mumbai—but costs are entirely out-of-pocket.

Health Insurance in India: What Residents and Expats Should Know

India’s health insurance market has expanded, but the best health insurance policies in India differ sharply from U.S. models. Most cover hospitalization rather than chronic-care services.

Key points to understand:

• Local private plans (from insurers like HDFC ERGO, Star Health, and ICICI Lombard) cover hospital stays, surgery, and some outpatient benefits. They typically exclude non-medical long-term care expenses, such as home care or rehabilitation.
• Long-term health insurance in India refers to multi-year policies—two- or three-year renewals—not long-term care coverage. This can be confusing for some people.
• Expatriates living in India often purchase international private medical insurance from providers such as Allianz Care, Cigna Global, or Aetna International. These policies cover both treatment in India and care abroad.
• Senior-citizen plans are available for aging parents in India, but premiums rise sharply after age 60, and pre-existing conditions often limit coverage.

For U.S. expatriates or NRIs (Non-Resident Indians) returning to live part-time in India, experts recommend maintaining a global health-insurance plan that includes evacuation or treatment benefits outside India.

Long-Term Care in India: A Gap Still to Be Filled

While the United States and Canada have well-defined long-term-care frameworks, India is still developing one. According to the Global Observatory for Long-Term Care, India’s system remains fragmented and informal, relying on family caregiving and a small private-facility sector.

• Professional elder-care homes, memory-care centers, and home-health agencies are concentrated in large urban areas.
• Services such as physical therapy, dementia care, and daily-living support are available but lack uniform quality standards or insurance reimbursement.
• Families often combine local domestic help with nurses hired from private agencies for around ₹25,000 to ₹60,000 per month (about $300 – $720 USD), depending on city and skill level.

(Source: India Elder Care Market Survey, LTC News Research 2025)

Without a regulated funding structure, the cost of long-term care is borne almost entirely by individuals, making planning essential for those with aging parents or for expats considering a return.

What Happens When U.S. Expats Visit or Stay in India

If you’re a U.S. expatriate living temporarily in India, your coverage depends on where your insurance was purchased and the scope of its benefits.

• U.S. health insurance: Most U.S. health plans, including Medicare, do not cover care received abroad except in very limited emergencies near U.S. borders.
• Travel medical insurance: Short-term visitors often purchase a travel medical policy to cover emergencies, evacuations, or hospitalization while in India.
• International expat plans: Long-term expatriates rely on global plans (e.g., Cigna Global or Allianz Worldwide Care) that include inpatient, outpatient, and evacuation coverage.

Before traveling, confirm your provider’s international claims process and whether treatment in India must occur at approved network hospitals.

U.S. Long-Term Care Insurance and International Benefits

Many Americans of Indian descent hold Long-Term Care Insurance policies in the U.S. Some modern LTC Insurance plans offer international benefits, meaning they can pay for care received outside the United States.

RELATED: The Unique Appeal of International Benefits in Long-Term Care Insurance

• Cash-benefit plans: Some hybrid or traditional LTC Insurance policies pay a cash benefit regardless of where care occurs, allowing you to hire caregivers in India. Others will just pay a limited amount in cash only for international benefits.
• Time or amount limits: Certain carriers cap benefits abroad at 50 to 75 percent of the U.S. daily benefit or limit overseas payment to one year.

(Source: LTC News Education Center 2025)

What this means for you:

If you hold a U.S. LTC Insurance policy and plan to spend extended time in India, review the “International Benefits” section of your contract carefully. Many major insurers, including Mutual of Omaha, Nationwide, and Brighthouse, offer global provisions that can help you receive care abroad.

Questions to ask your Long-Term Care Insurance professional:

1. Does my LTC Insurance policy cover services received in India or outside the U.S.?
2. Is the benefit paid in cash, or do I need to submit receipts for licensed-facility care?
3. Are benefits reduced while abroad, and for how long?
4. How are currency exchange and inflation handled?

Planning Tips for Cross-Border Families

If your family splits time between the U.S. and India, your planning should integrate both systems.

Here’s how to prepare:

• Maintain U.S. coverage: Keep your U.S. health insurance and LTC Insurance policies active to ensure access to high-quality care when you return.
• Add travel medical insurance: Even for short visits, a policy that covers medical evacuation and hospitalization can prevent catastrophic costs.
• Consider Indian health policies: For longer stays, a local health plan can help cover routine hospitalization costs.
• Build a care network: Use the LTC News Caregiver Directory to identify care professionals and agencies if you or your parents live in the U.S.
• Budget for out-of-pocket care: India’s cost of elder care is lower than in the U.S., but still significant relative to income.

Aging, Family, and Financial Independence

Whether you remain in the U.S. or reconnect with your roots in India, planning for long-term care is a financial and emotional decision. For Indian families, the tradition of multigenerational care remains strong, but demographic realities are shifting, and adult children born in the United States have their own careers and families and are usually unable to become caregivers.

Urbanization and migration mean fewer adult children live near aging parents, raising new challenges for caregiving.

Families straddling two countries must think globally about care and coverage. Having a Long-Term Care Insurance plan that travels with you can protect both your loved ones and your financial stability. If you don't yet have a Long-Term Care policy, be sure to get quotes from a specialist.

You can’t control where you may need care, but you can decide how prepared you’ll be.