Deciding How Much Health Insurance You Need

The increasing expenses, along with the rising occurrence of illnesses and medical conditions, have increased the importance of health insurance. However, finding the right balance between cost-effectiveness and inclusive coverage can be a challenging endeavour among the numerous options of insurance policies and companies in the industry. In this article, we help you determine how much health coverage you might need to protect yourself and your family.

The increasing expenses, along with the rising occurrence of illnesses and medical conditions, have increased the importance of health insurance. However, finding the right balance between cost-effectiveness and inclusive coverage can be a challenging endeavour among...
The increasing expenses, along with the rising occurrence of illnesses and medical conditions,...

ACKO Health Insurance Plans starting at Rs.21/day*

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Importance of Health Insurance In India

Before you start looking for appropriate policies, you should understand why health insurance is important. To begin with, it offers financial security by taking care of a significant portion of sudden medical costs. In addition, health coverage guarantees access to a wide variety of medical services, including preventative care, tests, surgeries, and hospital stays. 

By covering preventative measures like immunisations and regular check-ups, health insurance promotes regular medical appointments and early identification of potential health problems. 

Health Insurance Plan at ACKO

ACKO Standard Health Insurance Plan

This plan provides broad coverage at affordable prices. You can choose a sum insured of Rs. 10 Lakhs, Rs. 25 Lakhs, Rs. 50 Lakhs, or Rs. 1 Crore.

ACKO Platinum Health Plan

This plan offers complete coverage with a high sum insured. It includes benefits like no deductions on claims and no waiting period, making it a great option for getting the most out of your health insurance.

ACKO Platinum Super Top-up Health Plan

This plan is ideal for adding extra coverage to your existing health insurance or saving on medical expenses. After a certain deductible, you’ll enjoy benefits like no waiting period and a high sum insured.

How Much Health Insurance Do I Need In India?

Your family and requirements are unique — your health insurance should be too. The cost of a simple heart ailment treatment might be about Rs. 5 lakhs in the present time (depending on where you reside); however, this might not be the case in another 5 or 10 years. One of the first steps to buying health insurance is by deciding how much coverage you will need. Here are some pointers before you decide on the right plan.

Understand the type of health insurance plans available in the market and then match them with your perceived healthcare requirements. An Individual plan can have less coverage and the Family health insurance plans can have more coverage since all members would be sharing the sum insured amount. You need to assess if you need Individual, Family Floater or Senior Citizen health insurance plans and zero in on the suitable plan.

Consider critical illnesses like kidney failure, heart ailments, cancer, and stroke when determining the sum insured for your health plan. Planning for such uncertainties ensures adequate coverage. Additionally, consider a critical illness plan to supplement your base policy.

Select health insurance that includes your preferred hospital in its network to access cashless treatment. Research the approximate cost of hospitalisation at your chosen facility or in your location to determine the required coverage.

If you already have a group insurance policy from your employer, evaluate its coverage to understand the additional protection needed from a personal health insurance plan.

Hereditary conditions like diabetes and hypertension may increase your risk. Choose a plan that provides benefits for hereditary illnesses, considering the health history of your family members.

Unhealthy lifestyle choices, including poor diet, lack of exercise, and stress, can lead to conditions like high cholesterol, hypertension, and diabetes. Ensure your health plan covers these lifestyle-related illnesses.

Age-related illnesses should guide your choice of coverage. For senior citizens, select a plan tailored to their health needs. For younger adults, opt for affordable plans with sufficient coverage, as the likelihood of illness is generally lower.

Choose a plan with premiums that fit your budget. A higher sum insured is beneficial only if it remains affordable without straining your finances.

If tax savings are a priority, select a health insurance plan that aligns with the tax deductions you aim to claim under applicable laws.

Ensure the sum insured is sufficient to handle expensive treatments, like artery bypass surgery, at a hospital of your choice. Adequate coverage provides peace of mind during medical emergencies.

How does health insurance work in India?

If you are trying to figure out how health insurance works in India, you should know that you will have to pay premiums to the insurer. The insurance firm commits to funding a fraction of the medical costs incurred by the policyholder. Health coverage plans in India often include the option of receiving treatment at network hospitals without the need for upfront payments. Alternatively, individuals can choose to pay for medical services themselves and later request reimbursement from the insurer.

What Measures Can I Take to Prevent Under Insurance?

Steps to Ensure Comprehensive Insurance Coverage:

Assess Your Needs Thoroughly

Take the time to evaluate your requirements before purchasing an insurance policy. Consider factors such as inflation, potential future medical costs, and unforeseen expenses. A well-thought-out analysis will help you make an informed decision that aligns with your long-term needs.

Choose an Adequate Sum Insured

Select a sum insured that sufficiently covers your anticipated healthcare expenses. While a higher premium might seem costly upfront, it’s a worthwhile investment to avoid bearing the full burden of a medical emergency in the future.

Understand Exclusions and Policy Terms

Carefully review the policy’s exclusions and conditions. Knowing what is covered and what isn’t ensures you’re not caught off guard during critical moments. Attention to these details helps you choose a policy that truly protects you.

Seek Professional Guidance

If you’re unsure, consult insurance experts or advisors. Their expertise can provide clarity and help you select the right policy that meets your needs effectively.

Minimum Health Insurance Coverage

A good rule of thumb is to have coverage that’s about 50% of your annual income. So, if you earn Rs. 20 lakhs, a Rs. 10 lakhs health insurance policy may be the right choice. However, it is recommended that the minimum coverage should be at least Rs. 5 lakhs, considering the soaring medical costs. Furthermore, purchasing insurance in your 20s can decrease the likelihood of filing a claim. This allows you to boost your coverage amount without additional expenses because you get a cumulative bonus for each year without a claim.

Health Insurance for Family

Like yourself, the significance of insurance applies to your entire family. This is crucial as a medical crisis can arise with any family member at any moment, and a single hospital stay can significantly deplete your family's finances. 

Now, you might wonder, “How much health insurance do I need for my family?” Insurance professionals recommend that a family of four obtain a minimum health insurance coverage of Rs 10 lakh.

Purchasing health insurance for your loved ones comes with a great advantage. You can choose a family floater scheme and significantly lower your insurance fees. 

In family floater schemes, a collective amount is allocated for all members of the insured family on a floating basis. This means you do not need to purchase separate health insurance policies for each family member, decreasing overall costs. Additionally, the likelihood of all family members claiming in the same year is quite minimal.

Health Insurance for Parents/ Senior Citizens

Buying health insurance for parents can get tricky if they are senior citizens. They need health insurance the most, as they are at a higher risk of developing a medical condition or needing hospitalisation. 

In today's world of rising medical costs, a major surgery like bypass surgery can cost up to Rs 2 lakh in a reputable hospital. Even a minor surgical procedure can cost up to Rs 1 lakh. Therefore, the best health insurance for parents will have a substantial sum insured.

You should look into policies that cover pre-existing conditions when buying medical insurance for parents. Moreover, they might need nursing or assisted living care in future years. So, you should try to find a long-term policy. 

Takeaway

Analyse your unique requirement with the above pointers and opt for an adequate health insurance cover to ensure you and your loved ones are well-protected with a robust health insurance plan.

Frequently asked questions

Here are some of the common queries about health insurance coverage.

The best time to purchase health insurance is when you’re young. Premiums are more affordable, and you can fulfil waiting period requirements early, ensuring comprehensive coverage when needed.

Yes, as your health, family size, or financial needs evolve, you can adjust your coverage. You might choose a plan with customisation options or purchase an additional policy to increase overall coverage.

Many health insurance plans cover pre-existing conditions, but they often include a waiting period. Coverage terms vary between insurers, so it’s crucial to review the policy details before purchasing.

Your required coverage depends on factors like age, health, lifestyle, and family medical history. A common recommendation is to select a sum insured that is 2-3 times your annual income, tailored to your personal circumstances.

For parents, especially those over 60, higher coverage is essential due to increased medical expenses. A policy with a sum insured of ₹10-20 lakh is often recommended to ensure adequate treatment.

For individuals, a cover of ₹5-10 lakh is generally sufficient to manage major illnesses and surgeries. However, if you have dependents or live in a high-cost area, consider opting for a higher sum insured.

Your health coverage should be enough to cover major illnesses and surgeries without straining your finances. A cover of ₹5-10 lakh is often sufficient for an individual, but you may want to increase this if you have dependents or live in a high-cost area.

In India, private healthcare can be expensive. A cover of ₹5-10 lakh per person is typically recommended. For larger families or residents of metropolitan areas, a higher sum insured may be more suitable.

A basic family cover of ₹5-10 lakh is a good starting point. However, if you live in a metro city or have a larger family, increasing the coverage is advisable to ensure comprehensive protection.

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Written by Roocha Kanande

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Reviewed by Rupinderjit Singh Author info Icon

I find the world of policies and premiums absolutely fascinating! Join me as I unravel health insurance with a dash of creativity and a fresh perspective.

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