What is the Health Insurance?
Health insurance sum insured should be based on what a serious hospitalisation actually costs in your city, not on what feels affordable. A cardiac procedure or cancer treatment in a metro private hospital routinely exceeds ₹8–15 lakh.
With medical inflation near 14%, costs double roughly every five years — so a ₹5 lakh policy bought today is worth about ₹2.5 lakh of real cover in five years.
Formula & worked example
Worked example: a metro family of two adults (eldest 40) and two children → base ₹10 lakh × 1.3 (age) × 1.8 (family) = ₹23.4 lakh recommended. Against an existing ₹5 lakh policy that is a gap of ₹18.4 lakh. In ten years the same protection would require about ₹86 lakh of cover.
How to use this health insurance calculator
- Enter the number of adults and children on the policy.
- Use the eldest member's age, which drives both risk and premium.
- Select city tier — metro treatment costs roughly double Tier 3.
- Compare against your current sum insured to see the gap.
Smart tips
- A super top-up is the cheapest way to raise cover — ₹20 lakh on top of a ₹5 lakh base costs a fraction of a ₹25 lakh policy.
- Employer cover is rarely enough and disappears with the job. Hold your own policy independently.
- Buy young. Pre-existing conditions declared later face waiting periods of 2–4 years.
- Check room-rent capping and disease sub-limits — they cause more claim shortfalls than the sum insured does.
- Section 80D allows ₹25,000 of premium deduction (₹50,000 for senior citizen parents) in the old regime.
Frequently asked questions
How much health insurance cover do I need in India?
For a metro family, ₹20–25 lakh is a reasonable target today. In Tier 2 and 3 cities ₹10–15 lakh is often adequate.
What is a super top-up plan?
A policy that pays above a deductible — for example covering claims beyond ₹5 lakh. It is far cheaper than raising the base sum insured by the same amount.
Is my employer health insurance enough?
Usually not. Group covers are commonly ₹3–5 lakh, carry room-rent caps, and end the moment you leave the job.
Does medical inflation really run at 14%?
Industry estimates place Indian medical inflation at 12–15% a year, well above CPI, which is why cover must be reviewed every few years.
Want the theory behind the numbers? Read our insurance guides on the Money Blog.
Written by Gurjeet Singh, Sharpen Solutions. Last reviewed 15 Oct 2026. Sources: Income Tax Department — deduction limits for AY 2026-27: 80C ₹1,50,000, 80CCD(1B) ₹50,000, 80D ₹25,000/₹50,000, 80TTA ₹10,000, 80TTB ₹50,000, s.24(b) ₹2,00,000 (page updated 9 Jul 2026). How we check these numbers.