Health Insurance Coverage Estimator
How much cover you actually need, city by city. ₹5 lakh sounds like a lot. In a Mumbai cardiac case it isn't.
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Your result
For a family of 4 in Metro (Mumbai/Delhi/Bangalore/Chennai) with the oldest member at 40, you should carry at least ₹17.4 lakh of health insurance cover. This sizes for a serious hospitalisation (cardiac / oncology / ICU stay) at a top-tier private hospital, factoring age-related cost inflation and the wider risk surface of more dependants.
- Base ICU cost in your city
- ₹12 lakh
- Age multiplier
- 1.00x
- Family size multiplier
- 1.45x
- Recommended cover
- ₹17.4 lakh
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The other insurance you need: term life
Health insurance protects your family while you are alive. Term life protects them if you are not. Both are non-optional for earners with dependants.
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What to look for in a policy
- No sub-limits on room rent: many policies cap "room rent" to ₹5,000-10,000/day. ICU in a private metro hospital starts at ₹25,000/day. Sub-limits kill you exactly when you need cover most.
- No co-pay clause: 10-20% co-pay on a ₹15 lakh bill is ₹1.5-3 lakh out of pocket.
- Day-1 cover for pre-existing conditions if you have any. Standard policies have 2-4 year waiting periods.
- Restoration benefit: cover refills mid-year if you exhaust it. Critical for families with multiple potential claims.
- No claim bonus: cover increases each claim-free year. Some policies double cover after 5 claim-free years.
The super top-up strategy
A super top-up policy kicks in only above a deductible (usually equal to your base policy cover). Premium-wise, ₹15 lakh super top-up costs roughly the same as ₹3-4 lakh of base cover. The combined effect: base policy ₹10L + super top-up ₹40L gives you ₹50L of effective cover at maybe 60-70% of the premium of buying ₹50L base outright.