Health Insurance Calculator

Health insurance is a type of insurance that covers medical expenses incurred due to hospitalization, surgery, and treatment. It protects your savings from being depleted by medical emergencies. Medical costs in India are rising at 10-12% annually, making health insurance essential for everyone, regardless of age. A single hospitalization can cost ₹2-10 Lakhs or more, which can wipe out years of savings without adequate insurance coverage.

Coverage needs depend on multiple factors: (1) Individual: ₹5-10 Lakhs minimum, ₹10-25 Lakhs recommended, (2) Family: ₹10-25 Lakhs minimum, ₹25-50 Lakhs recommended, (3) Age: Older individuals need more coverage due to higher medical costs, (4) City tier: Tier 1 cities have 30-50% higher medical costs, (5) Family size: More family members require higher coverage. Our calculator considers all these factors to recommend appropriate coverage. Generally, coverage should be 20-40% of annual income for individuals and families respectively.

The best time to buy health insurance is NOW, regardless of age. Buy as early as possible (ideally in your 20s-30s) when premiums are lowest. Premiums increase significantly with age (3-5x higher after age 50), and pre-existing conditions can lead to rejection or much higher premiums. Don't wait for health issues to arise - secure coverage early when you're healthy and premiums are affordable. Waiting can make you uninsurable or result in exclusions for pre-existing conditions.

No, employer health insurance is not sufficient as primary coverage. Limitations include: (1) Coverage ends when you change jobs, (2) May be insufficient for family needs or major medical expenses, (3) Doesn't cover you after retirement, (4) Group policies may have sub-limits on room rent, specific treatments, etc., (5) Limited choice of hospitals and treatments. We recommend having a personal health insurance policy as primary coverage, with employer insurance as supplementary protection. Personal health insurance provides continuity and portability.

Base health plan is your primary coverage (typically ₹5-10 Lakhs for individuals, ₹10-25 Lakhs for families) that covers day-to-day hospitalization expenses. Super top-up is additional coverage that kicks in only after your base plan sum insured is exhausted. For example, if you have ₹5 Lakh base + ₹20 Lakh super top-up, the super top-up covers expenses above ₹5 Lakhs. Strategy: Base plan + Super top-up = Comprehensive coverage at lower cost. Super top-up premiums are ~70% cheaper than base plan premiums for the same coverage amount, making this a cost-effective strategy for high coverage needs.

Medical inflation is the rate at which healthcare costs increase annually. In India, medical inflation is 10-12% per year (vs. general inflation of 4-6%), meaning medical costs double every 6-7 years. This means coverage that seems adequate today (e.g., ₹5 Lakhs) may be insufficient in 10 years when the same treatment costs ₹15-20 Lakhs. You need to review and increase your health insurance coverage periodically (every 3-5 years) to keep pace with medical inflation. The calculator shows how your coverage needs increase over time.

For most families, family floater health insurance is more economical. Family floater covers the entire family under one sum insured (e.g., ₹10 Lakhs for spouse + 2 children), while individual plans provide separate coverage for each member. Family floater is typically 30% cheaper per person than individual plans. However, if family members have significant age differences or one member has pre-existing conditions, individual plans may be better. Family floater works best when all members are relatively healthy and similar in age.

Pre-existing conditions are medical conditions (diabetes, hypertension, heart disease, etc.) that existed before buying health insurance. Most health insurance policies have a waiting period of 2-4 years before pre-existing conditions are covered. During this period, treatment for pre-existing conditions is not covered. Some policies offer shorter waiting periods (1-2 years) at higher premiums. It's crucial to disclose all pre-existing conditions honestly - non-disclosure can lead to claim rejection. Buy health insurance early when healthy to avoid waiting periods.

Yes, health insurance premiums qualify for tax deduction under Section 80D: (1) Self/Spouse/Children: Up to ₹25,000 deduction, (2) Parents (below 60): Up to ₹25,000 additional deduction, (3) Parents (60+): Up to ₹50,000 additional deduction (instead of ₹25,000), (4) Total: Up to ₹1 Lakh deduction possible if you cover yourself, spouse, children, and senior citizen parents. Premiums must be paid by cashless payment or cheque/online transfer (not cash above ₹10,000).

No-claim bonus (NCB) is a reward for not making claims during a policy year. If you don't make any claims, your sum insured increases by 20-50% each year (varies by insurer), up to a maximum of 200% of the base sum insured. For example, ₹5 Lakh base coverage can grow to ₹10-15 Lakhs over 3-5 claim-free years. NCB encourages using health insurance only for major expenses, not minor treatments. However, NCB is lost if you switch insurers, so consider this when changing policies.

Critical illness cover is different from health insurance. Health insurance covers hospitalization expenses, while critical illness provides a lump-sum payout on diagnosis of specified diseases (cancer, heart attack, stroke, etc.). Critical illness cover is recommended as a supplement to health insurance for major diseases. The lump sum can cover: treatment costs beyond health insurance, loss of income during recovery, lifestyle maintenance, and alternative treatments. Consider critical illness cover of ₹10-25 Lakhs in addition to health insurance, especially if you have family history of critical illnesses.

Review your health insurance coverage: (1) Annually - to account for medical inflation and increasing healthcare costs, (2) When life changes occur - marriage, child birth, job change, salary increase, relocation to different city tier, (3) When family members age - older family members need more coverage, (4) When you develop new health conditions - may need to increase coverage or add riders, (5) Every 3-5 years - to ensure coverage keeps pace with medical inflation. Consider increasing sum insured or adding super top-up coverage as your needs grow.