Amogha is a nurse in the CARE Cardiac Center at Durgabhai Deshmukh Hospital. She is cheerful, kind, and empathetic, well-liked by all her patients. However, her patients do not realize that Amogha is responsible for family members with multiple illnesses and experiences much of the same pain and stress felt by her patients. Unable to continue to pay for her family’s health expenses, Amogha believes she is out of options. This is the case with many frontline healthcare workers in India.

Six hundred million Indians – almost half the country’s population – are categorized as middle-class. The lower-middle-class lives on $2-$4 per person per day while the upper-middle-class lives on $6-10 per person per day. Many lower-middle-income workers are unaware of and have limited access to suitable health financing options. As more Indians move from the lower to middle class, it is even more important for them to have options to save and pay for their healthcare services, as even just one unexpected health event can plunge them back into the cycle of poverty.

Entitled aims to enable access to financial services for more than 34 million workers in India. Entitled partners with factory and industry employers to provide access to emergency funds, rewards, discounts on healthcare and daily essentials, savings programs, and counseling for their employees. Entitled’s B2B2C model allows them to reduce risk and lower the distribution cost, opening up the opportunity to reach a large, underserved base of workers, a segment of the population that typically does not have reserve funds for health emergencies.

In April 2021, Entitled, in partnership with ACCESS Health International, launched the Entitled Sanjeevani health card for the employees of the CARE Cardiac Center at Durgabhai Deshmukh Hospital in Hyderabad. The Sanjeevani health card is a bundled financing product for lower- to middle-income employees and is customized to the income level and choice of the staff. The health card offers a combination of pre-approved health loans, micro-savings, and accident cover.

The Sanjeevani card has a host of useful features for employees and is available at zero cost to the employee and the employer. The card entitles them to a pre-approved credit limit up to twice their monthly salary for health and wellness expenditures which can be used for all family members. The credit limit of up to INR 7,500 (~ USD 103) for out-of-pocket expenses such as pharmacy bills, lab tests, and up to INR 50,000 (~ USD 685) for hospitalization expenses. The loan comes at a flat interest rate of 1.75% per month and a flexible repayment structure ranging from 3-12 months, through a digital EMI option.

The employee can avail telemedicine services and discounts of up to 30% on out-of-pocket expenses on medicines and diagnostics at a monthly membership of INR 99 (~USD 1). Add-on options include term life insurance and hospital cash plans. In the beginning stages of the project, the most well-received feature has been the micro-saving option, offering the flexibility to save for health certain months of the year and the option to withdrawal instantly in case of a health emergency. The users will have access to an emergency fund by investing as low as INR 200 (~USD 3) in a liquid mutual fund plan, which is a low-risk plan with an average annualized return of around 6%. Entitled also dedicates one local staff to regularly visit the hospital to educate employees and easily clarify issues with enrolment or availing benefits through the Sanjeevani card.

Through the Fintech for Health program, ACCESS Health supported Entitled to identify a willing healthcare provider, co-designed features and limits suited to the provider, and communicate regularly with staff at CARE to address their questions and receive feedback. Through this partnership, ACCESS Health facilitated Entitled’s foray into serving the healthcare worker segment, thereby supporting nurses, security guards, and housekeeping personnel. ACCESS Health continues to work with Entitled, connecting them to more healthcare partners such as clinics and health device manufacturers so more low- and middle-income healthcare workers are able to benefit from this bundled financing product.

Amogha now has easy access to an emergency health fund and her family has term life insurance of INR 100000 (USD 1370) within just two months of receiving the Sanjeevani card. The collaboration between Entitled and CARE Cardiac Center was made possible through Fintech for Health, a program by ACCESS Health and Metlife Foundation, which aims to provide faster, and more accessible, and affordable financing options for unmet healthcare needs. Stay tuned to this space for more updates from Fintech for Health and write to us at [email protected] to partner with us on this journey.

Author: Prashanthi Krishnakumar, Consultant, ACCESS Health International India