India’s middle class, especially the self-employed and daily wage earners, faces a silent healthcare crisis, with millions pushed into poverty each year due to out-of-pocket medical expenses. In this context, Senu Sam, Founder & CEO, Mykare, in an exclusive conversation with Dr. Asawari Savant, sheds light on how a purpose-driven, patient-first model can drive both impact and profitability in one of India’s most pressing sectors. Edited excepts 

Mykare positions itself as a “fin-health startup” targeting India’s 400 million self-employed middle class. How does this unique positioning differentiate you from traditional healthcare platforms, and what specific insights led you to focus on this segment?

The journey began when my father was admitted for surgery. In just four days, I lost nearly four years of savings to cover his hospital bills. While waiting at the hospital, I noticed I wasn’t alone; hundreds of families were going through the same crisis, forced to sell their gold, auto-rickshaws, or even homes to afford treatment.

Every year, nearly 55 million people in India face bankruptcy due to catastrophic healthcare expenses.

There are over 400 million people in India who belong to the “missing middle class”, largely self-employed or daily wage earners, making up nearly 30% of the population. Yet, more than 96% of them pay out-of-pocket for healthcare. Most don’t set aside funds for medical emergencies. Today, 71% report that inflation and rising medical costs have made it difficult to manage unexpected health expenses.

From our interactions with them, two major struggles stand out in their healthcare journey:

• Arranging Money: They have no health coverage. Private insurance is unaffordable and requires upfront lump-sum payments, which many daily wage earners simply can’t manage. Medical loans are either inaccessible or come with extremely high interest rates.
• Finding the Right Provider and Managing Paperwork: Even after arranging funds, they struggle to find trusted care providers and often get lost in complex, unfamiliar paperwork.

Can you walk us through how your model works across your 1,000+ provider network, and what specific operational strategies enabled you to achieve profitability in just three years while delivering 30-40% cost savings to patients?

We cater to a 400 million-strong population, becoming their trusted partner in their healthcare journey, a segment that many digital health companies struggle to serve.

By earning their trust, we aggregate a large volume of users and become their go-to care provider. On the other side, we partner with 1,000+ healthcare providers and facilities to ensure patients receive quality care when they need it the most.

When we onboard facilities, we negotiate and fix prices upfront, offering the best possible rates, often 30% to 40% lower than most large branded hospitals, while ensuring equally qualified doctors and NABH-accredited infrastructure. We pass these cost savings directly to our patients, ensuring they receive the right treatment at the right cost.

What were the key turning points that led to the EBITDA-positive status in your flagship vertical, and how do you plan to replicate this success as you target company-wide profitability within four months?

From day one, the founders and team clearly understood that healthcare is not something you scale first; it’s something you build with trust. Every decision we made was focused on finding the right, viable business model while ensuring long-term scalability.

One of our key strategies was playing a regional game. Instead of expanding blindly across India, we focused on building depth city by city, doubling down with the right metrics and operational excellence in each region before scaling further.

We ensured that every rupee spent was directed toward impact, not vanity. Instead of chasing monthly volume spikes, we focused on delivering maximum care to each patient. That led to strong word-of-mouth growth, allowing us to acquire many customers without any marketing spend.

We deliberately chose not to waste money on celebrity endorsements. For us, the true brand ambassadors in healthcare are patients, not public figures.

We also focused on building a high-performance team, ensuring each member contributed meaningfully. We avoided expensive and flashy setups, choosing instead to build a cost-effective ecosystem. Our main office is in Kochi, Kerala, following a Zoho-like model of building locally with global ambition.

With the digital health sector expected to grow from $3.8 billion in 2022 to $18.3 billion by 2030, how are you positioning Mykare to capture this opportunity?

We see a massive opportunity in the segment we serve, India’s middle class, which makes up 30% of the population. According to projections, this segment is expected to double in size over the next 10 years.

Today, most players in digital health are still struggling to gain traction even in Tier 1 cities. While companies like Amazon and Zepto focus on Tier 1 markets, we’re more like Meesho, with an extreme focus on the middle class, aiming to become their trusted healthcare partner.

As we deepen our penetration in this segment, we believe it will usher in a new era for digital health in India. And to truly serve this evolving demographic, all our approaches come with a fresh mindset tailored to their needs and realities.

What personal experiences or professional background drove you to start Mykare in 2022? How has your leadership philosophy evolved as you’ve scaled from startup to achieving profitability, and what keeps you motivated in tackling India’s healthcare accessibility challenges?

I started Mykare because of a deeply personal experience during my father’s treatment. We didn’t have health insurance for our parents, not because we couldn’t afford it, but because we didn’t believe in its importance at the time. When my father was admitted to the hospital, we ended up spending nearly four years’ worth of savings in just a few days. We had neither planned for healthcare expenses nor knew how to find the right provider.

I bring over 13 years of experience from leading healthcare groups in India, including Apollo Hospitals, Gleneagles, IHH, Lyca, MGM Healthcare, and SIMS Hospitals (SRM Group), where I served as a senior leader across sales, marketing, and international business.

Throughout my career, I have extensively travelled across India and more than 40 international markets, driving medical sales and outreach. In one year alone, I generated over $1 billion in revenue, building a deep understanding of both patient needs and provider dynamics.

Can you walk us through Mykare’s complete service offering, from the moment a patient approaches you with a surgical need to post-surgery support? What specific services within your end-to-end care coordination model deliver the most value to patients?

Our surgery vertical is activated when a patient is in need of elective surgery and reaches out to Mykare for support in finding the right provider, cost transparency, and end-to-end guidance.

Our Care Manager team immediately connects with the patient to understand their needs. We then help them choose an NABH-accredited, trusted provider and offer a fixed treatment cost to avoid any surprises.

We also arrange a direct consultation call with the surgeon, handle all necessary paperwork, and, if required, provide interest-free medical loans to ease the financial burden.

From picking the patient up from home to managing their post-operative care, Mykare ensures a seamless, stress-free surgical journey for every patient.

Also read: Expanding Care Beyond Metros: Tech-Driven Solutions for India’s Infertility Care Crisis

What trends are you seeing in India’s healthcare accessibility landscape? How does Mykare plan to scale across India’s underserved healthcare markets?

Indian healthcare is undergoing a significant transformation, and the traditional brick-and-mortar hospital-centric model is set to evolve. Digital healthcare aggregators are poised to lead this shift by offering patients a truly end-to-end care experience.

Patients today are no longer looking for just treatment; they expect personalised, patient-centric care, where the entire system revolves around their well-being, not just the hospital’s operations.

In particular, the middle class is missing the ‘care’ in healthcare.

At Mykare, we are addressing this gap head-on. We are in a focused phase of growth, building and launching a new product designed specifically for the middle class to help them prepare for future healthcare expenses and access quality care.

We do this by:

• Educating them and helping them save money for future healthcare needs
• Providing free health coverage to eliminate hospital admission costs
• Offering up to 10% cashback on outpatient expenses
• Delivering end-to-end patient care support, from consultation to recovery at home, whenever they need it

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Disclaimer: The views and opinions expressed in this article are solely those of the author and do not necessarily reflect the official policy or views of any organisation. The content is intended for informational and educational purposes only and should not be construed as medical advice.

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