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Health Insurance Sum-Insured

Hospitalisation costs in metros routinely cross ₹5–10 lakh. Tier-1: ₹10–20L individual; Tier-2: ₹5–10L; Tier-3: ₹3–7L. Family floater: 1.5–2× individual cover.

Tier 1: metros (Mumbai, Delhi, Bangalore...). Tier 2: state capitals. Tier 3: smaller towns.

3 people
40 yrs
Recommended cover
₹15,00,000
Minimum (avoid below)₹10,50,000
Optimal (super-top-up)₹22,50,000

Tip: ₹10L base + ₹15L super-top-up is often cheaper than ₹25L base — same effective cover.

How we size the cover

The right sum-insured is set by the cost of a 5-7 day hospital stay for a critical illness in your city. We anchor to typical room rates × 7 + ICU + procedure costs + post-hospitalisation. Metros (Mumbai, Delhi NCR, Bengaluru, Hyderabad, Chennai, Pune) — premium hospital bypass surgery runs ₹4-7 lakh. Add 30-40% headroom for medical inflation (~10%/yr in India).

Worked example

A 35-year-old couple in Bengaluru with one child and one set of parents (62 + 60) needs: ₹15 lakh floater for the nuclear family + separate ₹10 lakh × 2 for parents (premium loads triple after 60, so individual policies beat adding them to the floater). Premium: ~₹18k floater + ~₹30k each for parents = ~₹78k/year. Section 80D deduction up to ₹25,000 (self/family) + ₹50,000 (senior parents) = ₹75,000 tax saving slot used efficiently.

Cover floor by city tier

  • Tier-1 metros — ₹10-20L individual, ₹20-50L family floater
  • Tier-2 cities (Jaipur, Indore, Kochi, Lucknow) — ₹5-10L individual, ₹15-25L floater
  • Tier-3 — ₹3-7L individual; consider a super top-up to ₹15L
  • Parents 60+ — always separate policy with no co-pay restriction

Use a super top-up (kicks in above a deductible) for cheap cover above ₹15L. See our term insurance calculator for the life cover side of the family protection plan.

FAQ

Family floater or individual policies?

Floater is cheaper for healthy young families. Individual makes sense for elderly (premiums rise sharply with age). Many split — floater for self+spouse+kids, separate cover for parents.

What is super top-up vs top-up?

Both kick in above a deductible. Top-up resets per claim. Super top-up is annual aggregate — once you cross the deductible in total claims, it covers everything else. Always pick super top-up.

Are pre-existing diseases covered?

After 2-4 year waiting period (varies by insurer). Disclose them honestly — non-disclosure = claim denial. Look for "day-1 PED cover" plans if you have pre-existing conditions.