Rs 1 crore medical health insurance – Do you actually need it? 


With healthcare costs increasing by the day, medical health insurance has turn out to be a must for everybody. Nevertheless, policy buyers often fail to make your mind up the precise amount of canopy they need to take for facing any health emergency. There are various policies now that provide health coverage of as much as Rs 1 crore. But is it really needed? 

Experts say Rs 1 crore cover might not be obligatory in all cases. But for families with a history of critical illness, such cover might be extremely helpful. 

“India has a double-digit medical inflation rate. As health insurance is a long-term product, one can consider taking a health cover of as much as Rs 1 crore. This might be extremely useful if your loved ones has a history of critical illness,” Dr. Sudha Reddy, Head, Health and Travel at Digit Insurance, told

“Treatments related to cancer or major organ transplants like kidney, liver or heart transplants can range anywhere between Rs 10-40 lakh in private hospitals, especially in metro cities. Keeping the rising medical costs in mind, one can go for a health cover of as much as Rs 1 crore. But do consider that the premiums might be relatively higher; so, go for the next sum insured only if you happen to can afford it,” she added. 

Also Read: 5% GST on hospital room rent: How will it impact medical health insurance policyholders?

In an e-mail interaction with, Dr Reddy shed more light on this issue of Rs 1 crore health cover. Edited Excerpts

Why lower sum insured might not be sufficient and what are the explanations to go for the next health cover

A lower sum insured of Rs 5-10 lakh would typically suffice for a person. Nevertheless, the identical might not be sufficient for a whole family. There might be instances of 1 member of the family getting hospitalised multiple times in the identical yr or other members also getting hospitalised through the same policy yr (as seen through the Covid pandemic).

The treatment costs of critical illness are also very high, and a lower sum insured may not fully be sufficient in such scenarios. Some medical conditions even have recurring expenses as a result of long-term care or physiotherapy or follow-up consultations. A better sum insured, hence, would also assist in catering to such post-hospitalization expenses.

Considering the rising medical inflation, it is sensible to go for the next sum insured for health insurance. 

As premiums are higher, one must also assess the affordability factor. A young couple with a child may also consider starting with a canopy of Rs 20-30 lakh after assessing individual requirements and revisit the necessity to increase the sum insured every three to 5 years.

What should one do if he can’t afford to have Rs 1 crore cover?

Buying a base cover of Rs 1 crore will be expensive. If the premium for a Rs 1 crore cover looks steep, one can consider a lower sum insured. 

A young family can start with a canopy of Rs 30-40 lakh and increase the coverage in the approaching years. A cumulative bonus under a health insurance plan may also bump up the sum insured for each non-claim yr and one can slowly increase the general insurance coverage every yr.

If I take a Rs 1 crore health plan, will it cover my family too?

One can go for a family floater plan, wherein you may cover yourself in addition to your entire family under one insurance plan. Nevertheless, if you happen to also need to cover your parents, one can consider a separate plan for them because the family floater plan premium would otherwise go up significantly. It is because the insurance premium is subject to the age of the eldest member of your loved ones (which on this case will likely be the age of your parents).

Also Read: How much sum assured you might want to face any emergency?

Does higher amount of canopy lead to higher coverage terms?

The coverage terms under a specific health insurance plan, typically, remain the identical despite the sum insured opted for. A better sum insured may not necessarily mean complete protection against any sort of hospitalization. One should rigorously undergo the policy terms and understand different waiting periods, different disease level or room rent level capping, exclusions, deductible and co-pay terms, etc before choosing a health insurance cover.


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