Using data from the 75th round of the National Sample Survey, 2018, this chapter examines the extent of health insurance coverage and reimbursement among the elderly and the non-elderly in India. Descriptive statistics, logistic, and Tobit regression models were used. Results indicate that less than one-fifth of the population was insured by any kind of health insurance. Among those insured, only 27% of the elderly and 18% of the non-elderly received any form of reimbursement after hospitalization. Reimbursement accounted for only about one-fifth of the total medical expenditure among the elderly. Coverage and reimbursement showed a strong economic and education gradient. Households with up to five members had higher coverage and reimbursement. Asymmetric information, restriction on covering higher household size, and poor governance are the major factors in low health insurance coverage and low reimbursement in India.