Health Insurance Calculator Premium & Coverage India 2025
Calculate health insurance premium and coverage needs based on your age, family size, city, and health conditions. Compare family floater vs individual plans for optimal protection.
Recommended Coverage
₹18.00 L
Premium Comparison
Estimated Annual Premium
₹13.00 K
For ₹5.00 L coverage (family-floater)
Coverage Benefits
Metro cities have higher medical costs. Consider 50% higher coverage than tier-2 cities.
Start early for lower premiums and no waiting periods for pre-existing conditions.
Types of Health Insurance Plans
Choose the right health insurance plan for your family's needs
Individual Plans
Separate coverage
- • Dedicated sum insured per person
- • Higher premium but guaranteed coverage
- • No sharing of sum insured
- • Best for senior citizens
Family Floater
Shared coverage
- • Shared sum insured among family
- • Cost-effective for families
- • One premium for entire family
- • Suitable for young families
Critical Illness
Specific diseases
- • Covers specific critical illnesses
- • Lump sum payout on diagnosis
- • Covers cancer, heart attack, stroke
- • Additional to regular health plan
What's Covered vs What's Not
Understanding your health insurance coverage and exclusions
What's Typically Covered
Hospitalization Expenses
Room rent, doctor fees, medicines
Day Care Procedures
Surgeries not requiring 24-hour stay
Pre & Post Hospitalization
30-60 days before and after
Ambulance Charges
Emergency transportation costs
What's Usually Excluded
Pre-existing Diseases
2-4 year waiting period applies
Cosmetic Treatments
Plastic surgery, dental cosmetics
Alternative Treatments
Ayurveda, homeopathy (unless covered)
Self-Inflicted Injuries
Substance abuse, suicide attempts
Hidden Charges to Watch Out For
Be aware of these additional costs beyond your premium
Co-payment Clause
Room Rent Limits
Waiting Periods
⚠️ Important Note
Always read the policy document carefully. Look for sub-limits, waiting periods, and exclusions. Choose a policy with minimal restrictions and maximum coverage for your needs.
Health Insurance Calculation Formulas
Understand the mathematical formulas used to calculate health insurance premiums and coverage.
Health Insurance Premium
Calculate health insurance premium based on age and coverage.
Premium = Base Premium × Age Factor × Coverage FactorExample:
Base ₹5K, Age factor 1.5, Coverage factor 2.0
Variables:
Claim Settlement
Calculate claim amount after deductibles and co-payment.
Claim Amount = (Medical Expense - Deductible) × (1 - Co-payment%)Example:
Medical ₹2L, Deductible ₹10K, Co-payment 10%
Variables:
These formulas provide the mathematical foundation for the calculations. Actual results may vary based on rounding, compounding frequency, and specific lender policies.
Health Insurance Calculator FAQs
Everything you need to know about health insurance premiums, coverage, and medical protection
Why do I need health insurance?
Health insurance protects you from high medical costs and ensures quality healthcare access. Medical expenses have inflated dramatically, making insurance essential for financial security.
Reality Check: A single hospitalization can cost ₹2-5 lakhs, and critical illness treatments can exceed ₹15-20 lakhs. Health insurance prevents these costs from destroying your savings.
How much health insurance coverage do I need?
Coverage should be based on family size, city, age, and medical inflation:
Minimum Coverage Guidelines:
- Individual: ₹5-10 lakhs
- Family of 4: ₹10-20 lakhs
- Metro cities: ₹15-25 lakhs
- Senior citizens: ₹10-15 lakhs each
Factors to Consider:
- Family medical history
- City's healthcare costs
- Preferred hospital network
- Age and health status
Family floater vs individual health plans - which is better?
| Aspect | Family Floater | Individual Plans |
|---|---|---|
| Cost | Lower overall premium | Higher combined premium |
| Coverage | Shared among family members | Dedicated coverage per person |
| Age Impact | Premium based on eldest member | Age-appropriate premium |
Recommendation: Family floater works well for young families. Consider individual plans as family members age or if anyone has chronic conditions.
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