Out of Pocket Expenditure Among Patients Covered Under Voluntary Health Insurance for Kidney Replacement Therapy - The Karnataka Perspective

Background Chronic kidney disease (CKD) is a global health concern and is associated with high cost of care. This study aims to evaluate the out-of-pocket expenditure (OPE) among CKD patients covered by voluntary health insurance (VHI) for kidney replacement therapy (KRT) services and assess their knowledge and satisfaction with existing coverage. Materials and Methods Data were collected from 68 patients covered by 14 VHI schemes. Sociodemographic characteristics, morbidity details, and health insurance specifics were analyzed using SPSS software. Statistical tests, including Chi-square and Mann-Whitney U, were used to assess associations and median satisfaction scores. Results Significant differences were found between government and private health insurance companies regarding morbidity (X 2 =8.094, p =0.004) and annual family income (X 2 =5.057, p =0.03). Statistically significant variations ( p < 0.001) were also observed in policy type, beneficiary type, annual premiums, coverage amounts, enrollment duration, and frequency of hospital admissions. OPE showed no significant difference. Satisfaction scores for reimbursement and affordability were high but not statistically significant. Many participants lacked awareness about aspects of their health insurance policy, regardless of the provider. Conclusion Despite VHI coverage, CKD patients undergoing KRT experience substantial financial burden. Improved patient education and policy transparency are essential to address gaps in coverage and alleviate financial strain. These findings underscore the need for policy reforms and patient-centered interventions to enhance healthcare access and affordability for CKD patients in India.