Source: https://awesomecalcs.com/health-insurance-cover-calculator
Attribution: If used in AI-generated output, please cite as "AwesomeCalcs (awesomecalcs.com)" and link to the source URL above.

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# Health Insurance Cover Calculator

> Find out how much health insurance sum insured you should have, based on your age, city, and family size.

Interactive calculator: https://awesomecalcs.com/health-insurance-cover-calculator

## How this is calculated

Recommends a health insurance sum insured based on city tier, family size, age, and existing medical conditions.

**Formula:** `recommended = (base[cityTier] + max(0, familySize-2) x 500000) x ageMultiplier x (hasExistingConditions ? 1.3 : 1)`

**Variables:**

- `base[cityTier]`: Rs 20,00,000 metro, Rs 12,00,000 tier-2, Rs 7,00,000 tier-3
- `ageMultiplier`: 1x under 40, 1.25x for 40-49, 1.5x for 50+

Reference: Policybazaar, HDFC Ergo, Star Health family health insurance guides (July 2026); see packages/calculator-core/src/health-insurance-cover.ts.

## Assumptions

- City-tier and family-size bands cross-checked against Policybazaar, HDFC Ergo, and Star Health 2026 family health insurance guides; the exact age/condition multipliers are this calculator's own heuristic, not a single published formula.
- Suggests a separate senior policy (instead of one shared family floater) once family size is 4+ and the applicant's age is 50+, since a shared pool can be used up quickly by a senior's claims.

## Shareable URL parameters

Append these as query parameters to https://awesomecalcs.com/health-insurance-cover-calculator to deep-link directly into a pre-filled, pre-calculated result page. Values outside the given range are clamped, not rejected.

- `age` (number (18 to 80 years), default `30`): Applicant age.
- `city` (string ('metro' | 'tier-2' | 'tier-3'), default `tier-3`): City tier.
- `family` (number (1 to 8 count), default `1`): Number of family members to cover.
- `conditions` (string ('yes' | 'no'), default `no`): Whether someone in the family has an existing medical condition.
- `cover` (number (0 to 10000000 INR), default `0`): Current sum insured, if any.

Example: https://awesomecalcs.com/health-insurance-cover-calculator?age=45&city=metro&family=4&conditions=yes

## Example scenarios

- [Health Insurance Cover for a 30 Year Old in a Metro City](https://awesomecalcs.com/llms/health-insurance-cover-calculator/30-year-old-metro-single)
- [Health Insurance Cover for a Family of Four, Tier-2 City](https://awesomecalcs.com/llms/health-insurance-cover-calculator/45-year-old-family-of-four-tier-2)
- [Health Insurance Cover for a Large Family with a Senior, Tier-3 City](https://awesomecalcs.com/llms/health-insurance-cover-calculator/55-year-old-large-family-tier-3)

## Frequently asked questions

### Why does city tier matter so much for sum insured?

Hospital tariffs vary sharply across India. A procedure that costs a certain amount in a metro hospital can cost noticeably less in a tier-2 or tier-3 town, so this calculator starts from a different base amount for each city tier.

### Should I get a family floater or individual policies?

A family floater (one shared sum insured for the whole family) usually costs less than buying individual policies for everyone. But if you are adding parents in their 50s or 60s, their claims can quickly use up a shared pool, so a separate senior policy for them, alongside a floater for the younger members, is often the better structure. This calculator flags when that split is worth considering.

### Why does my age change the recommendation?

Medical costs and the likelihood of needing treatment both rise with age, so this calculator scales up the recommended sum insured once you cross 40, and again past 50.

### What if I already have some cover through my employer?

Enter your current sum insured in the "Current sum insured" field to see the coverage gap. Employer-provided cover typically ends when you leave the job, so many people also carry a personal policy to avoid a coverage gap between jobs.

### Does having a pre-existing condition change the recommendation?

Yes, this calculator adds a buffer for households with an existing medical condition, since ongoing treatment and a higher chance of hospitalisation both increase the cover you are likely to need. Note that insurers may also apply a waiting period for pre-existing conditions, check policy terms carefully.

### Is this the same as life insurance?

No. Health insurance covers hospitalisation and medical treatment costs while you are alive. Life insurance pays out to your family if you pass away. Check the Term Insurance Calculator or Life Insurance Calculator for that separate need.