August 19, 2025
What is the Ideal Coverage for Health Insurance?

What is the Ideal Coverage for Health Insurance?

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Health insurance coverage should be tailored to individual medical needs and circumstances. An ideal health insurance plan is usually suggested to have a sum insured equal to at least half of your annual income. You must check if it is sufficient to meet your medical expenses. Experts suggest buying a health cover of at least ₹10 lakhs to combat rising healthcare costs easily.

You must consider the following three factors to decide the ideal coverage for your health insurance plan:

  1. City of residence (i.e., tier-1, tier-2, or tier-3 city)
  2. Age or life stage of the insured
  3. Future healthcare costs (while considering medical inflation)

For instance, if you have no pre-existing diseases and live in a tier-3 city, where the living cost is less than in metropolitan areas, health insurance of ₹5 lakh may be enough to provide financial protection against medical expenses. Similarly, if you are residing in a tier-1 city where the living costs are high or have a critical illness, you may have to increase the coverage to ₹10 or 20 lakhs for better financial protection.

To know your ideal medical insurance coverage amount, check out the table given below:

Types of PlansIdeal Health Insurance Sum Insured
Tier-1 CityTier-2 CityTier-3 City
Individual Health Insurance Plan₹10 lakh & above₹5-10 lakh₹5 lakh
Family Floater Health Insurance Plan₹30 lakh & above₹20 lakh & above₹10 lakh & above
Senior Citizen Health Insurance Plan₹20 lakh & above₹15 lakh & above₹10 lakh & above

*Disclaimer: The above sum insured is suggestive and may vary as per the age and medical needs of the people.

Alternatively, you can also opt for a ₹1 crore health insurance policy that has become extremely affordable these days. A ₹1 crore health policy can come in handy for treating a disease that requires long-term care or for medical procedures taken abroad. You can easily get a ₹1 crore health cover by paying an extra premium of approximately ₹1500.

You also have a more affordable option of purchasing a base health insurance policy with a low sum insured and buying a top-up cover with a high sum insured.

Courtsey To : Policybazaar

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