In India, healthcare financing largelyrelies on direct out-of-pocket spending, which causesimmense health-related financial burdens for the poor.Despite recent efforts by the government and the privatesector, only 15 percent of the population in India iscovered by health insurance. The Micro Insurance Academy(MIA) extends health insurance at the last mile through abottom-up approach to the design, implementation andmanagement of community-based health insurance. MIA developsan understanding of each community and delivers customizedtools and frameworks that build a community’s capacity toself-manage micro insurance schemes. MIA bridges the gapbetween insurers and the bottom of the pyramid by providingadvisory support and insurance education to establishinsurance schemes. To date, MIA-supported micro insuranceschemes cover more than 40,000 people in India and Nepal.