Health Insurance in India: How Much Cover and Which Type to Buy
Individual, family floater, or super top-up — and why ₹5 lakh cover is dangerously low for metro families.
Medical inflation in India runs at 12-14% a year — far higher than general inflation. A typical metro hospitalisation in 2026 costs ₹4-8 lakh. If your only cover is a corporate group policy of ₹5 lakh, one serious illness can wipe out years of savings.
How Much Cover Do You Need?
The cheapest way to reach ₹25 lakh is a ₹5-10 lakh base policy plus a ₹15-20 lakh super top-up. The super top-up triggers only after the base deductible — so premium stays low (~₹6,000-8,000 per year for ₹15 lakh extra cover).
- Tier 1 metros (Mumbai, Delhi, Bengaluru): ₹15-25 lakh per family
- Tier 2 cities: ₹10-15 lakh per family
- Plus a parent's policy if dependants are over 60
Individual vs Family Floater
Floater = single sum insured shared across all family members. Cheaper for young families with low claim history. Individual = separate sum insured per person. Better when someone has chronic illness or for elderly parents — keep them on a separate policy, never on the family floater.
80D Tax Deduction
- Self, spouse, kids: ₹25,000 (₹50,000 if you or spouse is 60+)
- Parents: additional ₹25,000 (₹50,000 if parent is 60+)
- Preventive health check-up: ₹5,000 (within above limits)
- Max combined: ₹1 lakh if both you and your parents are senior citizens
Check your 80D + total tax: Income Tax Calculator → https://calculatordesk.in/income-tax-calculator
Frequently Asked Questions
Is corporate health insurance enough?
No. Corporate policies typically cover ₹3-5 lakh, often disappear when you switch jobs or retire, and renewal cost at 60+ is brutal. Always buy a personal policy in your 20s-30s when premium is low and you have no exclusions.
What is the waiting period for pre-existing diseases?
Usually 2-4 years depending on insurer. Some insurers have started 1-year waiting period policies but at higher premium. Always disclose pre-existing conditions honestly — non-disclosure voids the policy at claim time.
Does health insurance cover OPD and pharmacy?
Standard policies only cover hospitalisation > 24 hours. OPD cover exists as an add-on but inflates premium 30-50% — usually not worth it unless you have ongoing OPD expenses.