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.