How does healthcare work in India, and what travel insurance, health insurance or expat insurance do you need?

How does the health and healthcare system work in India?

• India has a diverse healthcare system with both public and private facilities and facilities for more traditional care (such as Ayurveda). 
• The quality of care can vary greatly between cities - with modern and high-quality medical care, and rural areas where care is often limited. 
• In rural areas, as well as cities, there are sometimes people who pretend to be doctors but are not. So always make sure you check in advance where you are going and if the person is trustworthy. 
• As an expat, it is best to go to private hospitals, just as well-off locals often do.
• There are many pharmacies in India. It is best to go to a pharmacy attached to a clinic. Most everyday medicines are available, but if you go to rural areas, bring your own supply. 
• The roads in India are enormously crowded, busy and chaotic - which affects ambulances and medical services. So if you don't find yourself in a life-threatening situation, it may be better to take yourself to the hospital. If you do need an ambulance, make sure you have the number of a good private hospital and are properly insured for it. 
• Even if you are insured by the company you work for, the coverage may be limited and only apply to certain hospitals, for example, let alone repatriation and the like.
• It is also common that hospitals do not recognize international insurers and you have to pay directly. In that case, make sure you leave with all the paperwork in English and declare it yourself to your insurer. 

How does the public health care system work in India?

• India has a system of public health care through a government network of hospitals and clinics. These are largely free, or operate at low cost. These institutions focus mainly on basic care and preventive measures. 
• The quality of public health care varies widely. There are hospitals in cities that provide good care, but overcrowding is often a problem there. In rural areas, hospitals are often understaffed, not hygienic and poorly equipped. 
• Expats choose public health care only rarely because of limited infrastructure and quality. 

How does the private health care work in India?

• India has a well-developed private healthcare system with high-quality facilities, often comparable to Western standards. 
• There are a number of international hospitals (Apollo, Fortis, Max Healthcare) known for their medical expertise and English-speaking doctors. Many expats choose these institutions. 
• Costs are significantly higher than in public care, but still relatively lower than in Western countries and it is absolutely worth it for a higher standard of care! India is therefore a popular country for medical tourism. 
• In private hospitals, you can undergo advanced treatments such as heart surgery, orthopedics and IVF. 

How is the general practitioner arranged in India?

• India does not have an extensive general practitioner system like in the Netherlands. Patients usually go directly to a specialist or clinic.
• In some larger cities you do have private practices where you can get basic care, but this is less common. 
• For routine checkups and smaller complaints, expats often go to private clinics. 

How is the dentist arranged in India?

• India has many private dental clinics with modern facilities. 
• Dental care is cheap and high quality, which also makes it popular for dental tourism.
• Public dental care also exists, but the quality is often low and less accessible. 

How is the pregnancy care arranged in India?

• In India, most births take place in hospitals. 
• Private hospitals offer comprehensive and personalized prenatal care and comfort for expatriates. You can choose from large hospitals as well as specialized birthing clinics.  Government hospitals are often overcrowded, but in urban regions basic care is considered reliable and it is cheaper. 
• Most expats choose a private hospital because of the modern facilities and personal attention.
• Breastfeeding is strongly encouraged. 
• India has made progress in reducing infant and maternal mortality in recent years, yet it remains a challenge in rural areas. 
• Maternity nurses are very scarce and can only be found in some large cities. 
• After birth, you can come back for checkups at 2, 4 and 6 weeks. In addition, during the first year, the baby has to go to the hospital regularly for check-ups and vaccinations. 
• In Indian culture, the mother is given a specific diet after giving birth - often full of clarified butter and fenugreek. It is also normal for the baby to receive regular massages. 

How safe or unsafe is a trip or stay in India?

What should you pay attention to in terms of safety in India?

• India is a huge country and the risks obviously depend on the region you are in. 
• In general, the majority of expats feel safe, but a large proportion do not. For example, there is a lot of petty crime and robberies also occur (especially on trains, buses and crowded places).
• Skimming cards and scams, where criminals pose as official service employees, are also a risk. 
• For women, the risk of (sexual) harassment is quite high, especially if you are traveling or walking around alone. Avoid deserted areas at any time of day, anywhere. If you become a victim as a woman, you can call the women's helpline: 1091. 
• For any expat, but especially women, walking alone on the streets after dark and traveling at night are better avoided. 
• Another risk is “drink spiking.” Be careful when taking drinks and never leave your food and drink out of your sight. 
• Strikes (sometimes called “bandh” or “hartal”), protests and demonstrations are common and can get out of hand. Pay particular attention around elections and after the death of party or government leaders. 
• There is also a risk of terrorism, particularly in certain regions of Kashmir, Punjab and in areas where naxalite groups are active. Terrorism does not usually target foreigners, but you can become a victim of it. 
• Landslides and floods are common during the rainy season. Make sure you avoid risk areas and are well-versed in local advice. 
• Always keep a copy of your passport, visa and plane ticket separate from the original documents. Also leave copies at home so others can access them. If your passport is stolen, go to the police immediately and get a police report. You will need this to travel out of the country. 
• Respecting local customs, such as following the local dress code and respecting the ban on public affection, is very important to avoid unpleasant situations.  
• Emergency numbers are 100 for the police, 112 for the national emergency number and 1091 for the women's helpline. 

What should you look out for in terms of diseases in India?

• There are several health risks in India that it is good to be aware of. 
• For example, most tap water is not safe to drink. So bring a filter or only drink from sealed bottles. 
• Hygiene standards for food are a lot lower than what we are used to in the West. So be especially careful when buying food on the streets and at local restaurants. 
• Several diseases transmitted by mosquitoes are present, such as dengue fever and malaria. So make sure you protect yourself well. 
• Many new expats have to get very used to the heat and humidity in India. Protect yourself well from the sun and drink plenty!
• Also check the required vaccinations, which can be quite a few. 

What should you pay attention to in terms of traffic in India?

• In India there are many traffic accidents and therefore many traffic deaths. Call the police immediately and cooperate with the police in case of a traffic accident. 
• The many cattle (especially cows) roaming the streets can make driving quite difficult, also it poses quite a safety risk if you hit a cow. 
• Avoid driving at night. There is a higher risk of robbery then and visibility is poorer. 
• Avoid public cabs, especially at night. Prepaid cabs and apps like Uber and Ola are safer to use. 
• Going by train? Then make sure you keep your important belongings close to you to prevent theft and never accept drinks or food at random. 

Which work and travel insurance policies are suitable for short and long stays in India?

• Is the trip to India and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

What emigration and expat insurance can you get for India if you are going to live there for a while?

• It is not mandatory to have international health insurance to get a visa to India, but it is essential because of the many security risks. Read more about insurances for abroad on Expatinsurances.org.