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.
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
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: ₹5-7LMore 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 seniorsFamily 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 historyMedical 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 costsCity-wise Coverage Recommendations
Delhi NCR
Highest medical costs in IndiaMumbai
High corporate hospital ratesBangalore
Growing healthcare costsChennai
Good hospital networkPune/Hyderabad
Moderate costsTier-2 Cities
Lower facility costsCommon Treatment Costs in India
| Treatment | Metro Cities | Tier-2 Cities | Tier-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.
Frequently Asked Questions
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Calculate Your Ideal Coverage
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