Before the recent reform, health insurance premiums in India included an additional 18% GST (Goods and Services Tax). These taxes applied to the base premium amount, which increased the amount policyholders paid for health insurance coverage. Here is how the old GST structure worked on premiums:
Central Goods and Services Tax (CGST)
The central government imposed CGST on intrastate transactions, in which the policy was purchased or renewed in the same state or union territory (for the CGST, an intrastate transaction is when a premium is paid for a policy that is purchased or renewed in the same state or union territory). The CGST tax was charged at 9% of the premium.
State Goods and Services Tax (SGST)
In addition to CGST, state governments imposed SGST on the same intrastate transactions at 9% of the premium. Between CGST and SGST, the combined GST on policies purchased in that state was 18%.
Integrated Goods and Services Tax (IGST)
For transactions between states, where a policy was purchased across jurisdictions, the federal government imposed IGST instead. This combined tax was a flat fee of 18% instead of the split of CGST and SGST.
For example, if you purchase a health policy within your state with a premium of ₹20,000, you will pay 9% CGST + 9% SGST (totalling 18%), coming to ₹3,600 GST. If you purchase from another state, the policy would attract IGST at 18% which also totals ₹3,600.
This structure made health insurance too expensive and added a financial strain, especially for families and senior citizens. It discouraged people from buying or renewing coverage, even though health insurance was intended to provide economic relief amid a medical crisis.