On an average, 10% Indians are covered under different types of health insurance schemes, mostly inadequate. This low coverage might be because of lack of awareness about health insurance or might be because of lack of financial literacy. The aim of the present study was to investigate the awareness, and utilization of health insurance in the selected population of State of Sikkim. A cross-sectional descriptive study was carried out in northeastern region (NER) of India, which is considered as

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... ne of the backward regions of the country. Sample unit was revisiting Central Referral Hospital Manipal, Gangtok Sikkim. The study was conducted among 1500 Out-patients revisiting the various outpatient departments of the hospital. Finding was significant for awareness of health insurance; enrolment for the scheme; reason for non- enrolment. 49.9% of the non-enrollees were not aware of the health insurance schemes. 25.1% of the participants have utilized the services more than five times in a year. An important finding of the current study is that education and economic class seldom influence peoples' enrollment in health insurance schemes. The study supports this statement as 89.6% of literates were from non-enrollees group and 77.7% were from lower middle class and upper lower income groups. This indicates the need for financial education for people and their families to take up better financial investment decision and increase their health security. Enhancing the financial literacy and to create awareness and benefits of health insurance among the people of the selected region is important. It is suggested that the issues related financial literacy can be taken up by insurance companies or the organizers by conducting more and more awareness programs in identified regions of low and moderate enrolment across the country.