A Call for True Inclusion, ETHRWorld

A diverse boardroom celebrating inclusive healthcare policies among various employees representing different identities and backgrounds.

The boardroom celebrates progress. There are charts that showcase increasing gender diversity, hiring drives for neurodiverse candidates, and HR sessions on allyship and belonging. Pride flags make an appearance in June. Leadership panels echo a common sentiment: we are building inclusive workplaces.

But if you follow the money—if you really look at what gets funded—you’ll find that inclusion quietly stops at the door of the hospital.

For all the talk of diversity, corporate health insurance remains a masterclass in what is left out. The exclusions are rarely loud. They’re almost never deliberate. But they are telling.

Start with the LGBTQ+ community. Today, 60% of Indian companies offer insurance cover for same-sex partners and live-in relationships. On the surface, that sounds like progress. But inclusion here is cosmetic. Extending group insurance to a partner costs virtually nothing. It’s the simplest checkbox to tick. What’s missing is actual support for gender-affirming care—a process that can cost between Rs 2 lakh and Rs 8 lakh depending on the procedure. Fewer than 15% of employers offer cover for it. Even fewer acknowledge the cost of mental health support that often precedes and follows such procedures.This is a recurring pattern. We fund what’s symbolic. We skip what’s hard.

It’s especially visible in the way women’s health is handled. Most companies will cover the cost of childbirth up to Rs 1 lakh for a normal delivery and Rs 1.25 lakh for a C-section. But they often won’t touch the rest of the story. Complications that affect one in six pregnancies? Not covered.

Emergency NICU (Neonatal Intensive Care Unit) care, which can cost upwards of Rs 10,000 a day? Often excluded or capped. Miscarriages? Rarely acknowledged. Postpartum depression? Invisible.

One policy even denies coverage to a third child if twins are born during a second pregnancy—not because of any medical reason, but because of a clause in the contract that caps the number of dependents. It’s a kind of exclusion that looks like logic on paper but feels like punishment in real life.

Fertility is another blind spot. One in 15 Indian couples face infertility. IVF costs average Rs 1.5 lakh per cycle. Surrogacy, increasingly sought by same-sex couples and those with medical complications, is both emotionally and financially demanding. And yet, fewer than 5% of companies offer any fertility benefits at all. Treatments like egg freezing or sperm donation—critical to how many modern families are built—are often left off the table entirely.

We still treat fertility as a luxury. But for many, it’s not a choice. It’s a need, and a vulnerable one at that.

Children with disabilities face a different kind of erasure. Most policies will insure a differently abled child—but only until they turn 25. After that, the assumption is that the child no longer depends on their parents. But the truth is: disabilities don’t follow age limits, and care doesn’t stop at adulthood. Coverage does.

Autism, too, is barely recognised—fewer than 5% of companies offer any support. Parents who spend Rs 15,000 to Rs 20,000 a month on therapy, special education, or care are left to figure it out on their own.

And while mental health gets talked about more than ever, corporate policies rarely treat it with parity. Most only cover psychiatric illness if it results in hospitalisation. Outpatient therapy, which is how most people actually access mental health support, is still considered optional. Or worse, a luxury.

None of this is a coincidence. The numbers have a story to tell. We cover what is common. We ignore what is complex. We fund what is easy to explain. We exclude what feels uncomfortable, even when it’s part of someone’s everyday life.

At its core, this isn’t just a health policy issue. It’s a mirror. It shows us what our companies are willing to back—not just in public, but in policy. Not just when the cameras are on, but when the claims are filed.

The gap between our inclusion messaging and our actual coverage isn’t a policy oversight. It’s a cultural signal.

Because healthcare is not a perk. It is not a bullet point on the campus brochure. It is not a “nice-to-have.” It is one of the few benefits that can tangibly shift the trajectory of someone’s life. It is what helps a parent stay employed through a crisis. It is what protects a young couple from debt when pregnancy takes an unexpected turn. It is what makes an employee feel seen, even when their situation is not easy to talk about.

An inclusive benefits stack, then, is one that acknowledges the full spectrum of human experience. It covers every kind of family, parents, partners, same-sex spouses, and differently-abled dependents, and extends care to every kind of need, from fertility treatments and gender affirmation surgeries to mental health support and preventive care. It gives employees the flexibility to choose what matters most to them, and the assurance that their unique realities are accounted for. Because inclusion in healthcare is not about generosity, it’s about fairness, dignity, and meeting people where they are.

It is not inclusion if it only works in theory. It is not inclusion if it does not show up when life gets complicated.

So much of our DEI work focuses on how people enter the workforce. But maybe it’s time to also ask how we support them once they’re in it. Because people don’t bring only their ambition to work. They bring their families, their histories, their health, their identities.

If we want to build workplaces that truly support that, then health insurance is where inclusion must begin.

DISCLAIMER: The views expressed are solely of the author and ETHRWorld does not necessarily subscribe to it. ETHRWorld will not be responsible for any damage caused to any person or organisation directly or indirectly.