Home / Health Insurance / Articles / Health Insurance Coverage / Is Rs. 10 Lakhs Medical Coverage Enough?

Is Rs. 10 Lakhs Medical Coverage Enough?

Team AckoMay 13, 2024

The cost of medical treatment for hospitalisation due to serious illnesses can reach high amounts, causing financial strain for individuals. Without proper health insurance, it can be challenging to manage the expenses for medical treatment. For those with limited health insurance coverage, the amount may not be sufficient to cover the full cost of hospitalisation.

It is crucial to have adequate health insurance coverage for oneself and family members to avoid having to use personal funds to pay for medical bills. The effectiveness of your health insurance coverage largely depends on the sum insured by the insurance policy. Therefore, a health insurance plan with a sum insured of ₹10 lakhs can provide ample coverage for medical expenses throughout the policy period.

At first, you may think that Rs. 10 lakhs medical coverage might sound a lot more. So, what is the right or perfect health insurance coverage amount?

In this article, we’ll go through the basics of health insurance and understand if an Rs.10 lakhs health policy can provide adequate protection in case of a medical emergency.

Contents

Is Rs. 10 lakhs health insurance adequate?
Benefits of having an insurance policy of Rs 10 lakh
What is the right amount of coverage that one needs to opt for?
Consider including riders and top-ups
How much does a Rs. 10 lakh health insurance policy cost?
Who should consider a Rs 10 lakh health insurance policy?
Frequently asked questions

Is Rs. 10 lakhs health insurance adequate?

Rs. 10 lakhs is an amount so massive that it feels like a huge sum insured to many of us at first glance. But, once you understand your requirements and do the math, Rs. 10 lakhs may feel a whole lot smaller.

Medical costs have skyrocketed over the years, especially after the deadly COVID-19 pandemic. Individuals without any health insurance might have borne the brunt of high medical expenses from their pockets. Even for those who did have health insurance, the coverage amount (sum insured) might have been insufficient to meet high medical costs.

Securing your family with comprehensive health insurance is a significant step while buying a well-balanced health insurance policy. You can choose between the Individual and Family Floater plans based on your requirements to protect yourself and your loved ones from unforeseen medical emergencies.

One of the thumb rules while accessing the sum insured amount (coverage amount) is that the coverage should be 50% of your annual income. Additionally, the sum insured amount should cover the cost of expensive treatments such as coronary artery bypass graft. This way, you can balance between higher coverage and mitigate medical costs that may arise due to costly medical treatments.

Benefits of having an insurance policy of Rs 10 lakh

The perks of having such a high sum insured are as follows:

Comprehensive coverage: A health insurance plan of ten lakh covers a range of medical costs, such as hospital stays, operations, tests, prescription drugs, and more. It helps guarantee that you won't have to worry about unforeseen medical costs.
Financial security: In the event of a medical emergency, a 10 lakh health insurance coverage offers financial stability. You can be certain that your medical bills will be paid, and you won't need to take out loans or drain your assets to cover the expenses.
Critical illness cover: The policyholder may be eligible for critical illness coverage under a 10 lakh medical insurance policy. It pays out in full in the event that the policyholder is found to have a critical illness that is covered by the policy. A 10 lakh medical insurance policy may cover a number of critical ailments, such as kidney failure, cancer, heart attacks, strokes, major organ transplants, and more. The coverage amount for the diseases will be detailed in the policy.
Access to high-quality healthcare: By obtaining a Rs 10 lakh health insurance policy, you will have the opportunity to receive top-notch medical care. You have the freedom to choose private hospitals and specialized treatments without any concerns about the high expenses.
Cashless facility: A medical insurance policy worth Rs 10 lakh can provide policyholders with the convenience of cashless treatment. Therefore, the insurance provider will handle the payment of medical expenses directly with the healthcare facility. This allows policyholders to concentrate on their well-being and recovery without having to worry about upfront payments for medical services.
Peace of mind: You can feel secure knowing that you have enough coverage in case of an emergency. It can enhance your general well-being by lowering stress and anxiety.
Tax benefits: It is common knowledge that there are tax advantages associated with health insurance in India. By paying a premium of 10 lakhs for medical insurance, you can qualify for a greater deduction, which will assist in minimizing your tax obligations.

What is the right amount of coverage that one needs to opt for?

The ideal sum insured or coverage in health insurance depends on several important factors. You must consider these factors before finalising the sum insured amount.

Location
Health care expenses in your locality
Type of hospital you prefer
Current age
Health conditions of the beneficiaries
Your affordability
Your income and lifestyle

Consider including riders and top-ups

The rising healthcare costs and expensive treatments may leave your base health insurance plan inadequate to cover all medical expenses. The primary plan may not cover pre- and post-hospitalisation expenses such as nursing care, rehabilitation, counselling sessions, etc. However, you can enhance the plan with riders and top-ups with a slightly higher premium.

Riders are add-on covers that provide coverage for specific treatments or medical care. You can also opt for top-ups when you think that a higher coverage amount is required to mitigate higher expenses for critical illnesses such as heart surgery.

How much does a Rs. 10 lakh health insurance policy cost?

Several factors determine the cost of a health insurance plan.

The type of policy: The type of plan you choose impacts the insurance premium you pay. A family floater plan, which provides coverage for multiple family members, typically has a higher premium than an individual plan.
Age: As we grow older, our health insurance premiums increase because insurance companies perceive us as having a greater likelihood of experiencing medical problems.
Location: The cost of healthcare varies depending on where you live. For instance, tier-1 cities will have much higher expenses than semi-urban areas.
Lifestyle: Insurance companies might adjust their premium costs based on your lifestyle choices, such as smoking, alcohol consumption, and weight since these habits raise your chances of having health issues.
Medical history: People with past health problems or existing medical conditions could be required to pay a greater premium because they are viewed as being at a higher risk of filing a claim.
Deductible: Choosing a plan with a higher deductible, which is the amount you pay out-of-pocket before insurance coverage kicks in, can reduce the monthly premium. This is because you agree to take on more financial responsibility for your healthcare expenses.
Policy term: The cost could change depending on the duration of the policy. Long-term policies might provide a reduced rate compared to yearly plans.

Go online and use the internet to compare and review the benefits and features of the policy along with the inclusions and exclusions before you finalize the Best Health Insurance Plans for Family.

Who should consider a Rs 10 lakh health insurance policy?

It is highly recommended for individuals to consider a health insurance policy with coverage of 10 lakh to protect themselves from unexpected medical expenses. Certain demographics may find a 10 lakh health insurance plan particularly advantageous:

People with dependent family members: A 10 lakh health insurance coverage can offer financial protection if you have dependents, such as elderly parents or small children.
People with pre-existing health conditions: You might require a greater coverage amount if you already have a medical issue to guarantee that your medical costs are sufficiently covered.
Self-employed individuals: Self-employed people might have to buy individual health insurance policies since they might not be able to enrol in the group health insurance plans offered by their employers. A 10 lakh health insurance plan can offer adequate coverage to self-employed people for medical emergencies.
People with high net worth: High-net-worth individuals may have higher medical costs because of their lifestyle. So, they require higher coverage amounts to ensure they are protected in an emergency.
People with a family history of diseases: Your risk of getting certain diseases is high if they are hereditary or genetic. A 10 lakh medical insurance will offer peace of mind in such scenarios.

Frequently asked questions

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

What does it mean to be underinsured in health insurance?

Underinsured means that you lack enough protection provided by your health insurance policy. This means that you may have a lower sum insured amount when you need it the most. It also means that your policy does not have enough coverage, and it may not cover specific ailments or treatments you may need in the future.

How do I avoid the risks of underinsurance?

Here are some tips to avoid the risks of under insurance.

Make an effort to assess your needs.
Choose an adequate sum insured amount.
Understand the exclusions and inclusions of the plan.
Seek professional help when you are in doubt.

Why is choosing the correct sum insured amount important?

Here are the reasons why you should choose a sufficient or a higher sum insured amount.

It increases the amount you have to pay in case of medical emergencies.
It keeps your savings intact.
It reduces your stress in medical emergencies.
In the case of a Family Floater plan, a higher sum insured is essential since the entire family shares it, beneficial when you raise multiple claims during the policy period.