ET Wealth | How much health cover do you need?

A 46-year-old Gurugram-based marketing consultant, Gagan Kapoor, took inspiration from his acquaintance's family who faced a medical emergency that left them with a hospital bill of over Rs.55 lakh. This incident prompted Kapoor to reassess his own health insurance. Kapoor now has a health insurance sum insured of Rs.1 crore, which has been further enhanced by cumulative bonuses.

He emphasizes that rising healthcare costs necessitate a large cover, stating that smaller covers of Rs.5-10 lakh can quickly be exhausted by certain illnesses and procedures.

Similarly, 48-year-old Delhi-based Anoop Kumar Madan has a health cover of nearly Rs.3 crore. Madan attributes this high cover to the rising medical inflation in the country, which necessitates a large sum insured to protect against unexpected medical expenses.

Industry estimates suggest that annual medical inflation in the country ranges from 12-14%. Estimates indicate that a Rs.5-10 lakh independent health cover, once considered adequate in the pre-Covid-19 era, is no longer sufficient. Amarnath Saxena, the Chief Technical Officer, Commercial, at Bajaj General Insurance, notes that a single cardiac procedure or cancer treatment cycle in a metro hospital can exceed Rs.15-25 lakh.

Saxena also points out that cancers and heart ailments account for a significant portion of claim costs, with an average claim size of Rs.5.55 lakh for cancer and Rs.2.08 lakh for heart diseases, hypertension, and stroke treatments.

Experts advise that the ideal health insurance cover depends on individual circumstances rather than income alone. Two people with the same income may have different insurance needs based on their current hospitalization costs, potential future costs, and medical inflation. Factors such as age, family size, health history, and current health status should also be considered when determining the appropriate health insurance cover.