Health Insurance Cover Calculator (India)
Calculate the right health insurance sum insured for you and your family, in rupees, based on age, city, family size and existing conditions.
How to Size Your Health-Insurance Cover
Insurers project medical costs rising about 10% a year globally in 2026 (8–14% by region) — faster than wage or general inflation. A hospital bill that looks survivable today can wipe out years of savings five years from now. Your cover needs to be sized for tomorrow's prices, not today's.
The four drivers of recommended cover
- Age — Lifetime healthcare spend rises sharply after 45. Heart, joint, and cancer treatments concentrate in this window.
- City tier — Metro / Tier-1 hospitals charge 1.5-3x what Tier-3 hospitals do for the same procedure. Pick the tier you would actually be treated in.
- Family size — Family floaters share one sum-assured, so the recommended floor scales with members but not linearly.
- Pre-existing conditions — Diabetes, hypertension, and cardiac history all push lifetime claims higher and warrant a 20-100% larger sum-assured.
Why a base + super top-up is usually optimal
Once your base policy meets the recommended cover, adding a super top-up with a deductible equal to your base sum-assured is one of the cheapest ways to push total cover to 2-3x. The deductible is automatically met by the base policy, so you almost never see it.
Sources & assumptions
Checked on 11 October 2026. The calculator is built for Indian sum-insured health policies and works in rupees. US major-medical plans can’t put yearly or lifetime dollar limits on essential benefits, so this sizing doesn’t apply to them.
- WTW 2026 Global Medical Trends Survey (consultancy survey of insurers) — medical costs projected to rise about 10% globally in 2026, 8–14% by region.
- HealthCare.gov: lifetime and yearly limits — US plans can’t cap essential health benefits.
- IRDAI Master Circular on Health Insurance Business, 2024 (copy hosted by the Institute of Actuaries of India) — the regulatory framework for Indian health policies.
- Hindustan Times (news report) — IRDAI cut the maximum waiting period for pre-existing diseases from 48 to 36 months.
- ClearTax: GST on health insurance — individual and family-floater health policies carry no GST from 22 September 2025, so none is added to the premium here. Group policies still attract 18%.
Our assumptions: the age-based base amounts (₹3–10 lakh), city and condition factors, the 30% loading per family member, the income cap and the 1.2% premium rate are illustrative figures we chose, not insurer or IRDAI figures.