How to Determine the Right Amount of Health Insurance Coverage in India

Why Coverage Matters More Than You Think

While buying a health insurance policy, many people focus only on premiums. But the real value lies in the coverage amount, or the “sum insured.” A low premium with inadequate coverage might save you a few bucks now but can cost you dearly during a medical crisis.

According to industry data, a single hospitalization in a private hospital in a metro city can cost anywhere between ₹1.5 to ₹7 lakhs depending on the condition. For critical illnesses, the costs can cross ₹20 lakhs or more.

Evaluate Your City and Lifestyle

Healthcare costs vary across cities. If you live in a metro like Mumbai, Delhi, Bengaluru, or Hyderabad, the average cost of treatment is significantly higher than in Tier 2 or Tier 3 cities.

Tip: If you're in a metro city, start with a minimum base cover of ₹10–15 lakhs for an individual. For families, consider a floater policy starting at ₹20 lakhs.

Assess Your Age and Health Status

Your age and current medical condition directly influence the right coverage amount:

• Young adults (20–35): Lower risk of illnesses, but early investment in a higher sum insured means lower premiums long-term.
• Mid-age adults (35–50): Higher risk of lifestyle diseases like hypertension or diabetes. A ₹15–20 lakh cover is advisable.
• Senior citizens (60+): With rising risks and limited income sources, aim for comprehensive senior-specific plans or top-ups of ₹25 lakhs or more.

Jio Insurance Broking offers personalized assistance in choosing age-appropriate plans with maximum value.

Consider Your Family Structure

A family floater health insurance plan is ideal for nuclear families. But the sum insured must reflect the number of people covered.

For example:

• Family of 2 (husband and wife): ₹15–20 lakh
• Family of 4 (with kids or parents): ₹25–30 lakh or more

Remember, if two family members fall sick in the same year, a lower sum insured can get exhausted quickly.

Look at Future Medical Inflation

Medical inflation in India is currently around 12–15% per year, meaning a ₹10 lakh cover today could be insufficient 5 years down the line.

Solution:

• Choose plans with automatic recharge and no-claim bonus (NCB) benefits.
• Opt for super top-up plans from Jio Insurance Broking to increase your total cover without increasing the base premium significantly.

Review Coverage for Critical Illnesses

Critical illnesses like cancer, heart surgeries, kidney failure, and organ transplants can cost anywhere between ₹15–50 lakhs. Standard health policies might fall short here.

That’s why experts recommend:

• A base policy of ₹10–15 lakhs
• Plus, a critical illness rider or separate policy of ₹20–30 lakhs

Jio Insurance Broking offers tailored solutions combining base plans and riders for full protection.

Factor in Additional Benefits

The “right” coverage isn’t just about the rupee value. Look for:

• Pre & post-hospitalization benefits
• Daycare procedures
• Domiciliary treatment
• Organ donor expenses
• Mental health coverage
• OPD expenses (if applicable)

More comprehensive coverage = less out-of-pocket expense during emergencies.

Use the 50/20 Rule

As a thumb rule:

• 50% of your annual income should be the base health insurance coverage.
• So, if your yearly income is ₹10 lakhs, opt for at least ₹5 lakhs coverage, ideally with a super top-up plan of ₹10–15 lakhs more.

Why Choose Jio Insurance Broking?

At Jio Insurance Broking, we don’t just sell policies—we help you make informed decisions based on data, health trends, and your individual needs. Here's what makes us different:

• Expert consultation for policy selection
• Comparison of multiple insurers & benefits
• Support in claim settlement
• Custom family and critical illness plans
• Super top-up options at competitive prices

Health insurance is not an expense—it’s an investment in your peace of mind. The right coverage ensures that your savings and lifestyle are protected, no matter what life throws at you.

With Jio Insurance Broking, you can be sure of choosing the health insurance coverage that fits your life, your goals, and your future.

Don’t wait for a scare to get covered. Plan smart. Insure early. Stay protected.