The Financial Case for Health Insurance

Healthcare inflation in India runs at 10–14% per year — faster than general inflation. A cardiac procedure that cost ₹3 lakh in 2015 costs ₹7+ lakh today.

Without health insurance, one serious illness can wipe out years of savings. With a comprehensive plan, your out-of-pocket expense is capped at the deductible or co-pay.

Types of Health Insurance

Individual plan: Covers one person. Best for singles with no dependents.

Family floater: One sum insured shared among all family members (typically spouse + children). More cost-effective than individual plans for each member. Risk: if one member exhausts the cover, others have no protection.

Top-up / Super top-up plan: Activates after your base cover (or a deductible) is exhausted. Highly cost-effective way to increase total cover.

How to Choose the Right Plan

1. Sum Insured

  • Metro cities: ₹10–25 lakh minimum (₹50 lakh if affordable).
  • Smaller cities: ₹5–10 lakh.
  • Family floater: Increase sum insured since it's shared.

    • 2. Check the Hospital Network

    Ensure major hospitals in your city are in the insurer's cashless network. Check both private and public hospitals.

    3. Read the Exclusions

  • Pre-existing diseases: Most plans have a 2–4 year waiting period.
  • Specific illnesses (e.g., cataracts, joint replacements) often have sub-limits.
  • Maternity cover has a waiting period of 2–4 years.

    • 4. Claim Settlement Ratio

    IRDAI publishes annual claim settlement ratios. Choose insurers with >90% ratio.

    5. No-Claim Bonus

    Plans that increase your sum insured by 10–50% for every claim-free year offer significant long-term value.

    Key Mistakes to Avoid

  • Relying solely on employer-provided group insurance (it disappears when you leave the job).
  • Buying the cheapest plan and missing critical covers.
  • Delaying purchase — premiums rise with age and pre-existing conditions may be excluded.

    • > Altius Tip: Buy a personal health insurance plan independent of your employer. Start early (before 30) when premiums are low and health is good. Portability rules allow switching insurers without losing waiting period credit.