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Coverage Guide

How Much Health Insurance Cover Do You Need?

Medical costs can spiral into lakhs. Calculate the right coverage amount based on your city, family size, and health risks. Don't be under-insured when you need it most.

Quick Coverage Estimate

Recommended Coverage = Base Need × Family Factor × Risk Factor

Metro City

₹10-15L

Base Coverage

Family of 4

× 1.5

Family Factor

With Seniors

₹20-25L

Total Coverage

Key Factors That Determine Your Coverage Need

Your City of Residence

Healthcare costs vary significantly by location. A heart surgery costs ₹3-4 lakhs in a tier-2 city but ₹5-7 lakhs in Mumbai or Delhi. Metro cities have 40-60% higher medical costs. If you live in a metro, budget for higher coverage.

Metro: ₹10-15L minimum | Tier-2: ₹7-10L | Tier-3: ₹5-7L
Family Size & Ages

More family members mean more coverage needs. Elderly members have higher health risks and costs. A family of 4 with elderly parents needs significantly more coverage than a young couple. Factor in ages when deciding sum insured.

Add ₹3-5L per adult member, ₹5-7L for seniors
Medical History

Family history of chronic diseases like diabetes, heart conditions, or cancer increases your risk. Pre-existing conditions may require higher coverage for potential complications. Consider critical illness add-on if family history exists.

Add 30-50% buffer for high-risk medical history
Healthcare Inflation

Medical inflation in India is 10-15% annually - higher than general inflation. What costs ₹5 lakhs today will cost ₹12-15 lakhs in 10 years. Your coverage needs to account for future cost escalation, not just current prices.

Build 50-70% inflation buffer over current costs

City-wise Coverage Recommendations

Delhi NCR

Highest medical costs in India
Recommended Cover₹10-15 Lakh
Est. Annual Premium₹8,000-15,000/year

Mumbai

High corporate hospital rates
Recommended Cover₹10-15 Lakh
Est. Annual Premium₹8,000-15,000/year

Bangalore

Growing healthcare costs
Recommended Cover₹8-12 Lakh
Est. Annual Premium₹7,000-12,000/year

Chennai

Good hospital network
Recommended Cover₹8-12 Lakh
Est. Annual Premium₹6,000-12,000/year

Pune/Hyderabad

Moderate costs
Recommended Cover₹8-10 Lakh
Est. Annual Premium₹6,000-10,000/year

Tier-2 Cities

Lower facility costs
Recommended Cover₹5-8 Lakh
Est. Annual Premium₹4,000-8,000/year

Common Treatment Costs in India

TreatmentMetro CitiesTier-2 CitiesTier-3 Cities
Heart Bypass Surgery₹4-6 L₹3-4 L₹2-3 L
Knee Replacement₹3-5 L₹2-3 L₹1.5-2 L
Cancer Treatment₹10-20 L₹8-15 L₹5-10 L
Kidney Transplant₹6-10 L₹5-8 L₹4-6 L
ICU (per day)₹25,000-50,000₹15,000-30,000₹10,000-20,000
Normal Delivery₹50,000-1 L₹30,000-60,000₹20,000-40,000

Costs are approximate and vary by hospital, treatment complexity, and room category

Warning: Under-Insurance Risk

Many Indians are under-insured with just ₹2-5 lakh coverage. A single serious illness can exhaust this and more. When coverage falls short, you dip into savings, take loans, or compromise on treatment quality. Don't let inadequate coverage put your family's financial future at risk.

68% Indians under-insuredMedical inflation: 15%/yearCancer costs: ₹10-20L

Frequently Asked Questions

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