Owing to ever-rising inflation, a huge sum of money that appears sufficient today may prove inadequate for the smallest of your needs in the future. In India, everything is becoming more and more expensive, whether it is groceries or the cost of treating minor ailments. In such a scenario, insurance products come in handy.

However, purchasing medical insurance without first assessing your needs is pointless. You must account for today's doctor consultation fees, critical illness treatment costs, and more. How much health insurance do I need? is a valid question and today, we will look into it in detail.

Importance of health insurance in India

Healthcare expenses in India have been rising steadily, making health insurance plans essential. Medical emergencies can deplete savings, and treatments for critical illnesses can be costly. A well-chosen health insurance policy:

• Provides financial protection against medical expenses.
• Covers hospitalisation, surgeries, and critical illnesses.
• Ensures access to quality healthcare without financial worries.
• Reduces tax liability under Section 80D of the Income Tax Act.

What is the ideal health insurance coverage in India?

 The answer majorly depends on your age. Most adolescents are free of major or minor illnesses. If you are young and work for a company that offers group health insurance, you may choose to insure yourself for a lower sum.

However, if you are over 40 years, your sum insured should be at least 3-5 times your annual income. It means that if you earn ₹6 lakhs per year, coverage ranging from ₹18 lakhs to ₹30 lakhs is ideal.

How to choose your ideal health insurance coverage amount?

You should decide on coverage after considering your age and the number of dependent members. If you have a spouse over the age of 40 years, dependent children, and dependent parents, the total sum insured should be on the higher side. Other factors to consider include:

• Determine potential medical risks. For example, if you have diabetes, you are more prone to heart disease, strokes, and other complications. Always factor in these uncertainties before deciding on the best coverage.
• Check to see if the insurer you are considering has network hospitals in your city.
• Evaluate the benefits provided by the group health insurance through which you are covered.
• Check with your insurance company to see if advanced medical treatments are covered. Read the fine print in the policy brochure to see the provisions relating to the policy's inclusions and exclusions.

All of these parameters not only aid in the selection of the best sum insured, but also in the selection of the best insurer.

How much health insurance is enough in India?

The ideal health insurance plan should cover hospitalisation, doctor fees, pre- and post-hospitalisation expenses, and critical illnesses. Here’s a breakdown:

• For individuals: ₹5-10 lakh
• For families: ₹10-20 lakh (family floater plans)
• For senior citizens: ₹10-25 lakh (including critical illness cover)

Factors to consider while choosing the right health insurance coverage amount

• Rising medical inflation: Medical costs increase yearly, so select a relevant plan.
• Critical illness coverage: Ensure coverage for diseases like cancer, kidney failure, and heart ailments.
• Hospital network: Choose a plan with a wide cashless hospital network.
• Co-payment and sub-limits: Check if the plan restricts claims or co-payment clauses.
• Waiting period for pre-existing diseases: Look for a plan with a shorter waiting period.

How much health insurance do you need in India for family?

If you are your family's sole breadwinner, it is your responsibility to look after your loved ones. If your family consists of your spouse and two children, you can choose a family floater plan with a sum insured of 3-5%. If you have family group health insurance, you may choose lower coverage if you are on a tight budget.

How much health insurance do you need for parents/senior citizens?

People in their old age are more vulnerable to illness. There is also a chance that they have a pre-existing disease or have had major surgery such as a heart bypass in the past. Consider their medical history, current lifestyle, and personal income when deciding on the amount of coverage in a health insurance for senior citizen. Remember, the premium for senior citizens is slightly higher than for young people.

Health insurance plan at ICICI Lombard

ICICI Lombard offers comprehensive health insurance policies with the following:

• High-sum insured options.
• Cashless hospitalisation in a vast network of hospitals.
• Coverage for critical illnesses, pre- and post-hospitalisation expenses.
• There is no co-payment for senior citizens in select plans.

FAQs

1. When is the best time to purchase health insurance?

Buying health insurance early is advisable when premiums are lower and you are less likely to have pre-existing conditions. This ensures continuous coverage and financial security in case of future medical emergencies.

2. Can I modify my health insurance coverage later?

You can adjust your health insurance plan according to your financial situation, family size, or healthcare needs change. Many insurers offer the flexibility to enhance coverage, add riders, or switch plans to suit your evolving requirements.

3. Do health insurance plans cover pre-existing medical conditions?

Most health insurance policies cover pre-existing conditions, but there is usually a waiting period before you can claim these ailments. The duration of this period varies by insurer and policy type.

4. What is the ideal health insurance coverage amount in India?

The right coverage depends on age, lifestyle, medical history, and location. For individuals, a sum insured of ₹5-10 lakh is generally recommended. Families, especially those in metro cities, may require higher coverage to accommodate rising healthcare costs.

5. How much health insurance is necessary for parents and senior citizens?

Given the increased medical expenses associated with ageing, a minimum coverage of ₹10-20 lakh is advisable for senior citizens. A comprehensive plan that includes pre-existing disease coverage and critical illness benefits is an ideal health insurance for senior citizen.

6. What is the recommended health insurance coverage for families in India?

A family health plan with a coverage of ₹5-10 lakh is a good starting point. However, larger families or those in metro cities should opt for higher coverage to ensure complete financial protection against medical emergencies.

7. Is one crore health insurance a good option?

A high-coverage health insurance plan, such as one crore, can benefit individuals seeking extensive medical protection, particularly against critical illnesses or advanced treatments. While it may not be necessary for everyone, it provides financial security against major medical expenses.

Conclusion

Opting for the right health insurance plan depends on factors like your needs, lifestyle, and family structure. A minimum coverage of ₹5-10 lakh for individuals, ₹10-20 lakh for families, and ₹10-25 lakh for senior citizens is advisable. Investing in a comprehensive policy ensures financial security against medical emergencies. Always compare plans, check inclusions, and opt for adequate coverage to safeguard your health and finances effectively.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.