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Context: The WHO estimates that 100 million people are pushed into poverty by direct payments for medical services. This work explored the constraints and challenges for setting up health microinsurance in a developing country, the Democratic Republic of Congo (DRC). Methods and materials: This is a cross-sectional, analytical, quantitative, and household survey based on two-stage cluster sampling. Data entry was done using the EPI DATA software and analysis by the SPSS software. Main results: The average income per capita in DRC 119.35 USD per year. The total amount was USD 3.87 for a disease episode. The average cost paid for health care at the last episode of illness was 5.91 USD. Just over six out of ten households (64.43%) felt that health care was too expensive.Nearly nine out of ten households would be willing to subscribe to a microinsurance health plan, even though four out of ten households felt the premium was exorbitant (US $ 6.65 per person per year). The willingness to pay for the contribution to a voluntary health insurance scheme was $5.16 per household per year, or $0.71 per person. Conclusion: We have shown that universal coverage with an expanded package of offered services is not economically feasible in the health zone of Katako-Kombe, through the establishment of a quality health micro insurance, if it relies only on the contributions of its members.