Health Insurance Coverage Calculator
How much health insurance cover do you need in India? Accounts for city tier, family size, age, and medical-inflation over the next decade. Rule of thumb: ₹25L for metro families, ₹15L for tier-2 cities.
Methodology. Base cover per person by city: metro ₹7L, tier-1 ₹5L, tier-2 ₹3.5L, tier-3 ₹2L. Multi-family adjustments: discount 20-30% because not all family members need coverage at the same time. Age loading: +30% for 45+, +60% for 55+, +100% for 65+. Pre-existing: +25% mild / +75% major. Medical inflation in India runs 12-14% annually — future cover needed projected forward. Minimum recommended: always include one top-up / super top-up plan above base. Consult an independent insurance advisor for specific product selection.
What drives the cover you need
- City: a week in a private hospital in a metro can cost ₹3–6 lakh for a major procedure; tier-2 costs are lower.
- Family size and ages: a family floater is shared, so one big claim can use up the cover for everyone.
- Medical inflation: commonly estimated at 12–14% a year in India, so a cover that feels big today shrinks quickly in real terms.
Worked example
A family of four in a metro: a ₹10 lakh base floater plus a ₹25–50 lakh super top-up with a ₹10 lakh deductible. The super top-up adds large cover cheaply because it pays only after the base policy is used up. Parents over 60 are better covered by a separate policy so their claims and premiums do not affect yours.
Features worth checking
- No room-rent cap, or a single private room
- Restoration of sum insured and a no-claim bonus
- Pre-existing disease waiting period (36 months is now the maximum allowed) and specific-illness waiting periods
- Network hospitals near you for cashless claims
Individual health insurance premiums have been exempt from GST since 22 September 2025, making cover cheaper than before. Premiums qualify for deduction under Section 80D in the old regime — up to ₹25,000 for self and family and ₹50,000 for senior-citizen parents.
For a full walkthrough, see the health insurance buyer’s guide and family floater vs individual cover.
FAQs
Is employer cover enough?
Rarely. It ends with the job and is often ₹3–5 lakh; buy a personal policy while young and healthy.
How often should I review my cover?
Every 3–4 years, or after marriage, a child or a move to a bigger city.
Figures last checked October 2026. Calculator results are estimates; actual lender, fund or tax outcomes can differ.