Reviewed by Finin2min Editorial Desk · Last reviewed 11 August 2026
Estimate family health-cover need from hospital-cost assumptions, medical inflation, employer cover, deductible and contingency buffer.
Estimate health-cover need
Projected base medical cost
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Additional personal cover need
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Insurance need is not the same as policy eligibility or claim settlement.
How This Is Calculated
This calculator estimates the health insurance cover you need based on factors like your city (medical costs vary significantly by location), family size, age, and any existing coverage — aiming for a sum insured that can realistically absorb a major hospitalization without depleting savings.
Frequently Asked Questions
How much health insurance cover do I need?
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It depends heavily on where you live (metro hospital costs are far higher than smaller cities), your family size, and existing coverage (employer group insurance often isn't enough on its own). A common guideline is at least ₹5-10 lakh per person in metro cities, more if you want cover for serious illnesses without financial strain.
Is employer-provided health insurance enough on its own?
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Often not. Employer group policies typically have lower sum-insured limits, end when you leave the job, and may not cover pre-existing conditions for dependents from day one. A personal/family floater policy alongside employer cover is generally recommended for continuity and adequacy.
Does a higher deductible reduce the cover I need?
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A higher deductible (via a super top-up plan, for instance) reduces your regular premium but means you pay more out-of-pocket before the top-up kicks in — see the site's Health Super Top-Up Deductible Calculator to model that trade-off specifically.
Source and review trail
Use the current official instrument, portal or regulator publication before acting.
Scope: Estimates the recommended health (mediclaim) insurance sum insured, based on the family's composition, city-tier healthcare costs, and existing coverage (employer group cover, if any).
Calculation logic
Estimate a baseline sum-insured range using illustrative current hospitalisation cost benchmarks for the family's city tier (metro/tier-2/tier-3, since treatment costs vary materially by location) and family size/composition (age of members, since older members and larger families generally need higher cover).
Adjust for specific risk factors entered by the user (e.g., pre-existing conditions, family history of major illness, preference for private/high-end hospitals), which increase the recommended cover.
Net off existing employer-provided group health cover (which is a supplementary, not fully reliable, source since it typically ends with employment) against the recommended baseline, to suggest an independent/family floater policy sum insured that isn't solely dependent on continued employment.
Inputs and assumptions
Baseline cost benchmarks are illustrative planning ranges, not live/current hospital pricing data — actual healthcare costs vary significantly by city, hospital and specific treatment/procedure.
The calculator recommends treating employer group cover as supplementary rather than a sole safety net, per common personal-finance planning guidance, since group cover typically ends at employment separation/retirement, which the user should independently plan around.
Exclusions and edge cases
This is a needs-estimation tool, not insurance advice — specific policy features (room-rent sub-limits, co-payment, disease-wise caps, waiting periods for pre-existing conditions) vary significantly by insurer and materially affect real-world adequacy, and must be checked in the specific policy wording before purchase.
Does not itself recommend a specific insurer or policy — the output is a sum-insured estimate to use when comparing health insurance plans.
Sources
No single official source applies — this is a needs-based planning estimate, not a statutory computation.
Review status: reviewed and approved by CA Nikhil Gupta on 17 July 2026.
Guides that use this calculator
Background, worked examples and the rules behind these numbers.