How much health cover does your family really need?
Five questions. See your gap today, if your employer's cover ends, and as medical costs rise.
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Health Insurance Calculator
Other points to check before taking a policy
The cover amount is only half the story. These terms decide how much of a hospital bill actually gets paid.
| Point | What it means | What to look for |
|---|---|---|
| Room-rent limit | Some policies cut doctor, nursing and OT charges in the same ratio if your room costs more than the limit. A ₹5,000/day limit with a ₹10,000 room can mean those bills are paid at about half. | No room-rent limit |
| Co-pay | You pay a fixed share of every claim yourself. | 0% co-pay. Watch for extra co-pay when treated in a costlier city than your policy zone. |
| Restore / recharge / refill | Your cover is refilled after it is used up during the year. | Check when it kicks in, and whether it works for the same illness, for every member, and more than once a year |
| No-claim / super bonus | Your cover grows for every claim-free year. | Check how the bonus builds up and whether a claim reduces it |
| Super top-up | Extra cover that starts after a deductible. Usually cheaper than a bigger base policy. | Super top-up (deductible on the year's total bills), not a plain top-up (deductible per claim) |
| Waiting periods | Time before some illnesses are covered. For existing illnesses, up to 3 years. | Shorter waits, or waiver options |
| Disease sub-limits | Caps on specific treatments such as cataract or knee replacement. | No sub-limits |
| Consumables | Gloves, PPE kits and similar items are not paid by default. | Consumables cover add-on |
| Network hospitals | Cashless treatment works only at the insurer's tie-up hospitals. | Good hospitals near you and in your treatment city |
| Portability | You can switch insurer at renewal. | Eligible credit for waiting periods already served carries over |
| Claim settlement ratios | Check two numbers: claims settled out of claims received, and amount paid out of amount claimed. | High on both, alongside clear policy terms and good service. A high first number with a low second can mean big claims get trimmed. |
Questions people ask before buying health cover
Plain answers to what most buyers want to know. This is general information, so always read the policy document before you buy.
How much health cover should I buy?
It depends on where you would be treated, your family's size and ages, and what your employer already covers. The calculator above gives an estimate for your family. Medical costs keep rising, so review the number every few years and whenever your family changes.
Is my employer's health cover enough?
Usually not on its own. It ends if you change jobs, are laid off or retire, and the sum insured is often shared across the family. Many people keep a personal policy as well, so cover stays with them whatever happens to the job.
What is a super top-up, and is it cheaper?
A super top-up gives extra cover that starts only after your bills in the year pass a deductible, usually the sum insured of your base policy. It generally costs less than raising the base cover by the same amount. A plain top-up applies its deductible to each claim, while a super top-up adds up all claims in the year.
What is a room-rent limit, and why does it matter?
Some policies cap the daily room rent. If your room costs more, other charges such as doctor and nursing fees can be cut in the same proportion. A limit of ₹5,000 a day with a ₹10,000 room can mean those bills are paid at about half. Look for no room-rent limit, or a high one.
How long are waiting periods?
Most policies have a short initial wait, often 30 days except for accidents, and longer waits for specific illnesses and for conditions you already have. IRDAI caps the wait for pre-existing conditions at 3 years, and the wait for specific illnesses at 3 years too. Shorter waits or waiver options are worth looking for.
Can the insurer reject my claim?
Yes, if the treatment is not covered or health details were hidden. After five years of continuous cover, called the moratorium period, an insurer generally cannot reject a claim for not disclosing a pre-existing condition, except in cases of fraud. Disclose your health history honestly and do not let the policy lapse.
Can I switch insurers without losing waiting-period credit?
Yes. You can port your policy to another insurer at renewal, and credit for waiting periods you have already served carries over, along with your moratorium count. Apply before the renewal date and compare the new policy's terms, not just the premium.
Will my premium go up as I get older?
Usually yes. Premiums are generally set by age band and step up as you move into an older band, and they can rise as medical costs rise. Compare renewal premiums as well as the first-year premium before you choose.
Do I need a separate policy for my parents?
Often it works better. Cover for parents is priced and underwritten differently from cover for a younger family, and adding them to a family policy can raise the premium sharply. Many families buy a separate policy for parents. This calculator is for you, your spouse and children, so talk to us if you would like to plan parents' cover.
What should I check besides the sum insured?
Look at room-rent limits, co-pay, sub-limits on specific treatments, consumables, restore benefits, network hospitals near you, waiting periods and the insurer's claim settlement record. The checklist above shows what each one means and what to look for.
Not sure how your policy scores on these points?
Send us your numbers or policy details on WhatsApp and we'll talk you through them using this checklist.
- A plain-language check of your current policy against this list
- Whether a base upgrade or a super top-up suits you
- Planning separate cover for your parents
- Switching at renewal without losing waiting-period credit
Talk to us before you renew or buy
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