Cover calculators: ranges, not false precision
Everything runs on your device. Outputs are starting ranges for discussion — not personalized advice.
Health sum-insured range
General guideline, not personalized advice.
Suggested personal top-up range
₹8.1 L – ₹11.3 L
Term cover range (10–15x rule)
General guideline, not personalized advice.
Suggested cover range
₹1.10 Cr – ₹1.50 Cr
Recheck at marriage, first child, home loan, or big salary jump.
Co-pay + room-limit impact
See how a headline sum insured shrinks. Illustrative math.
You pay
₹2,01,600
Insurer pays
₹1,98,400
Room breach applies proportionate deduction on the whole bill here — that is exactly the trap Section 3 warns about.
Worked examples: cover size and hidden cuts
- Term cover: for ₹8 lakh yearly income, the 10–15× rule suggests ₹80 lakh–₹1.2 crore, plus any loans outstanding.
- Co-pay: with a 20% co-pay, a ₹3 lakh hospital bill costs you ₹60,000.
- Room rent limit: if the policy allows ₹5,000 a day and you take a ₹10,000 room, many policies cut related charges in proportion — you may pay about half of a ₹2 lakh bill.
How the Insurance cover calculators works: the rules
- IRDAI's 2024 health insurance rules cut the moratorium to 5 years and the maximum pre-existing disease waiting period to 3 years.
- Insurers must decide cashless authorisation within an hour and final discharge within three hours.
- Health premiums qualify for deduction under the old regime (₹25,000, or ₹50,000 for senior citizens).
How to choose a health sum insured
Think about the cost of one serious hospital stay in the hospital you'd actually use. In metros, a heart procedure or major surgery can cost ₹5–10 lakh or more in a private hospital. A family of four in a metro usually needs ₹10–25 lakh of cover; in smaller cities ₹5–10 lakh can be enough. A super top-up policy adds a large cover cheaply above your base policy.
How to choose a term insurance cover
Term insurance replaces your income if you die. A common rule is 10–15 times your yearly income, plus outstanding loans, plus big future goals like children's education, minus savings and existing cover. Choose a term that lasts until your youngest child is independent and your loans are paid off — usually until age 60–65.
Features worth paying for
In health insurance: no room-rent cap, no co-pay, restoration of the sum insured, and a no-claim bonus. In term insurance: a critical illness or accidental death rider if you don't have separate cover, and a claim settlement ratio of 95% or more over several years.
Room rent limits and co-pay — how they cut your claim
Some policies cap room rent at, say, 1% of the sum insured per day. If you choose a costlier room, many insurers cut the whole claim in proportion, not just the room charge. On a ₹5 lakh policy with a ₹5,000 room limit, choosing a ₹10,000 room can mean only about half of other charges (like doctor fees) are paid. Co-pay works similarly: with a 20% co-pay, you pay a fifth of every bill.
Premium examples by age (indicative)
Health premiums rise with age. A ₹10 lakh individual policy may cost a few thousand rupees a year for someone in their 20s, roughly double that in the 40s, and several times higher after 60. Term insurance follows the same pattern — a non-smoker buying ₹1 crore of cover at 30 pays much less each year, for the full term, than someone buying at 45. Buying early locks in lower premiums.
Checking an insurer before you buy
Look at the claim settlement ratio and the share of claims settled within 30 days in IRDAI's annual report, the network hospitals near you, customer complaints per 10,000 policies, and how cashless approvals work. A slightly higher premium with a strong claims record is usually worth it.
Portability, renewals and grievances
You can move a health policy to another insurer at renewal without losing waiting-period credit, by applying at least 45 days before the renewal date. Insurers can't refuse to renew a health policy because you made claims. If a claim is rejected or delayed, first complain to the insurer's grievance officer, then use IRDAI's Bima Bharosa portal, and if it's still unresolved, approach the Insurance Ombudsman — a free service for disputes up to ₹50 lakh.
For term insurance, add your nominee correctly and tell them where the policy documents are. A claim is much quicker when the nominee has the policy number, death certificate and the insured person's ID ready.
Section 80D deduction limits (old regime)
| Premium paid for | Limit |
|---|---|
| Self, spouse, children — all under 60 | ₹25,000 |
| Self or spouse aged 60+ | ₹50,000 |
| Parents under 60 | ₹25,000 (extra) |
| Parents aged 60+ | ₹50,000 (extra) |
| Maximum (you 60+ and parents 60+) | ₹1,00,000 |
| Preventive health check-up | ₹5,000 (within the limits above) |
Not available in the new tax regime.
Insurance cover calculators: frequently asked questions
How much health cover do I need?
For a family in a metro city, ₹10–20 lakh is common, with a super top-up for big bills.
How much term insurance should I buy?
A common rule is 10–15 times your yearly income, plus any outstanding loans, so your family can repay debts and replace your income.
What is co-pay?
Co-pay is the fixed share of every claim you pay yourself — with a 20% co-pay, you pay ₹20,000 of a ₹1 lakh bill. Policies with co-pay have lower premiums.
What is a room rent limit?
A daily cap on room charges; exceeding it can reduce other payouts.
What is the moratorium period?
After 5 years of continuous cover, a claim cannot be rejected for non-disclosure, except fraud.
How long is the waiting period for pre-existing diseases?
Under IRDAI's 2024 health insurance rules, the waiting period for pre-existing diseases cannot be more than 3 years; some policies offer shorter waits for a higher premium.
Official sources: IRDAI· Last reviewed 2026-10-30. Results are estimates — confirm final figures with your lender, insurer or tax adviser.