Health Insurance Cover Adequacy

Find out if your current health insurance cover is adequate. Accounts for medical inflation, city hospital costs, and your family size to give a target sum insured.

Health Insurance Adequacy Calculator

Is your health cover enough? Compare against medical inflation and city costs

Current health cover Rs 5L
Rs 1LRs 1Cr
Rs
Family members covered 3 members
18
members
Medical inflation rate 14%
6%20%
%
Planning horizon 10 years
1 yr25 yr
yrs
City
Recommended cover
for your city and family
Cover gap
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additional cover needed
Cover in 10 yrs
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real value after inflation
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Major surgery cost (future)---
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Current adequacy---
Current cover vs recommended
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Medical inflation estimates based on industry data. Actual costs vary by hospital, treatment, and city. Super top-up plans can bridge large cover gaps cost-effectively.

How cover erodes vs rising medical costs over time
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ThriftRupee Insight

Medical inflation in India runs at 14% per year — far above general inflation. A procedure costing Rs 3 lakh today will cost Rs 11 lakh in 10 years. If your current health cover is Rs 5 lakh and you plan to retire in 15 years, your effective cover in retirement terms is only Rs 89,000 in today's money. Super top-up plans are the most cost-effective way to bridge this gap.

Health Insurance Adequacy — Is Rs 5 Lakh Enough?

With medical inflation at 14% per year in India, a Rs 5 lakh health cover today is effectively worth only Rs 1.3 lakh in 10 years in real purchasing power. Metro hospital room charges alone can exceed Rs 10,000–20,000 per day in ICUs. This calculator compares your current cover against actual costs in your city to tell you whether you are adequately protected — and by how much you need to top up.

Frequently asked questions

How do I know if my health insurance cover is adequate?
Key benchmark: your sum insured should cover the cost of a major surgery + 2 weeks of ICU in your city. In metros: bypass surgery Rs 3–5L, knee replacement Rs 2–4L, cancer treatment Rs 5–20L. Add a 15% annual medical inflation buffer for your planning horizon. Most financial advisors recommend Rs 10–25 lakh individual cover for metro residents.
What is a super top-up health plan?
A super top-up plan kicks in once your total hospitalisation expenses in a year exceed a threshold (deductible). Unlike a regular top-up, it aggregates all claims in a year (not just one). A Rs 15 lakh super top-up with Rs 5 lakh deductible costs Rs 3,000–5,000/year for a 30-year-old — much cheaper than increasing your base plan.
Should I include my employer health cover in adequacy calculations?
No. Employer health cover ends with your employment and often has group plan limitations (co-payment, sub-limits). Always have a personal base plan (Rs 5–10L) that is employer-independent. Use your employer cover as supplementary protection, not as your primary cover.