# How Much Health Insurance Do I Need? Cover Calculator > How much health insurance do I need? Get a suggested family floater cover from your city, family size and ages, your cover gap and a guide for parents. Source: https://trykosh.com/tools/health-insurance-cover-calculator Free tool - Budgeting and planning # How much health insurance do I need? Hospital bills depend on where you get treated, how old you are and how many people share the policy. This guide turns those into a suggested sum insured and shows how far your current cover falls short. Rules checked 25 October 2026Free - no sign-upRuns in your browser Suggested family health cover INR 15 lakh You're INR 10 lakh short of it Gap to fill**INR 10,00,000** Employer cover**INR 5,00,000** Members covered**3** Cover you have **INR 5,00,000**Gap **INR 10,00,000** Starting point for a couple under 35 (metro) INR 10,00,000 x age of eldest member (35) 1.25x x family size (3 people) 1.15x Rounded up to a standard sum insured INR 15,00,000 − Cover you have (excl. employer) INR 5,00,000 Gap INR 10,00,000 One way to get there: base policy INR 10 lakh + super top-up INR 5 lakh with a INR 10 lakh deductible INR 15,00,000 A guide, not a quote. Room-rent limits, co-payments and disease sub-limits in the policy wording can matter more than the headline sum insured. ## Upload your statement and Kosh does this for you. Upload a bank statement and Kosh builds this from your real spending: every UPI payment, EMI and subscription, sorted and priced. [Start free](/signup?via=tool-health-insurance-cover-calculator) ## How the health insurance cover calculator works The starting point is a couple under 35: INR 10 lakh in a metro or tier-1 city, INR 7.5 lakh in a tier-2 city and INR 5 lakh in a smaller town. These reflect what a serious hospitalisation such as cardiac surgery, cancer treatment or a long ICU stay can cost at a good private hospital in each place, with some room for medical inflation. The figure is then scaled by the age of the oldest member (x1.25 from 35, x1.5 from 45, x2 from 55 and x2.5 from 65), because claims rise steeply with age. Family size adds 15% for each member beyond two, since one family floater sum is shared by everyone. The result is rounded up to a standard sum insured. Your own policies are subtracted to find the gap. Employer group cover is left out by default because it ends when you change jobs or retire, which is often when you need cover most. Turn it on if you prefer to count it. For bigger sums, the calculator shows one common structure: a base policy for the city's starting amount plus a super top-up with a deductible equal to that base. A super top-up pays once total claims in a year cross the deductible, so it adds large cover at a fraction of a base policy's price. Parents are best on a separate policy, so their higher claims don't drain the floater your children rely on. Suggested cover = city base x age factor x (1 + 0.15 x (members − 2)), rounded up City base INR 10 lakh metro, INR 7.5 lakh tier-2, INR 5 lakh tier-3 Age factor 1 to 2.5 by age of the eldest member ## Worked example: The Subramanian family in Coimbatore Suresh, 42, his wife and two children live in Coimbatore. They have a INR 5 lakh family floater and INR 3 lakh through his employer. For a tier-2 city, a 42-year-old eldest member and four people, the guide suggests INR 15 lakh, so they are INR 10 lakh short without counting the employer policy. One way to fill it: keep a INR 7.5 lakh base and add a INR 7.5 lakh super top-up with a INR 7.5 lakh deductible. His parents, the elder 68, have only INR 3 lakh; the guide suggests INR 20 lakh for them, a INR 17 lakh gap. Suggested family health cover INR 15 lakh You're INR 10 lakh short of it Gap to fill**INR 10,00,000** Employer cover**INR 3,00,000** Parents' suggested cover**INR 20 lakh** Cover you have **INR 5,00,000**Gap **INR 10,00,000** Starting point for a couple under 35 (tier-2) INR 7,50,000 x age of eldest member (42) 1.25x x family size (4 people) 1.30x Rounded up to a standard sum insured INR 15,00,000 − Cover you have (excl. employer) INR 5,00,000 Gap INR 10,00,000 One way to get there: base policy INR 7.5 lakh + super top-up INR 7.5 lakh with a INR 7.5 lakh deductible INR 15,00,000 Parents (separate policy, older parent 68) INR 20,00,000 Parents' gap INR 17,00,000 A guide, not a quote. Room-rent limits, co-payments and disease sub-limits in the policy wording can matter more than the headline sum insured. [Load this example into the calculator ->](?city=tier2&kids=2&eldest=42&employer=300000&parents=1&parentsAge=68&parentsCover=300000#calculator) ## Good to know - Read the policy wording, not just the sum insured. Room-rent caps, co-payment clauses and disease-wise sub-limits can cut a claim far more than a lower cover would. - IRDAI rules issued in 2024 cap the waiting period for pre-existing diseases at three years, and after five continuous years of cover a claim can't be contested except for proven fraud. - Premiums are deductible under 80D in the old regime only: up to INR 25,000 for your family and another INR 25,000 for parents, rising to INR 50,000 each for those 60 or older. - Buy personal cover while you are young and healthy, even if your employer covers you. Waiting periods start from your first policy and carry over when you port. - You can port a policy to another insurer and keep the waiting-period credit you have built up. Apply before your renewal date. ## Frequently asked questions How much health insurance is enough for a family of four? In a metro, INR 15-25 lakh is a sensible range for a young family of four, and more as the parents get older. In smaller cities, INR 10-15 lakh is often enough. A base policy plus a super top-up is the usual way to reach these amounts affordably. Is INR 5 lakh health insurance enough? For a single young person in a small town it may be. For a family in a metro, a single major surgery or ICU stay can cost INR 5-10 lakh or more, so INR 5 lakh is usually too little. Use it as a base and add a top-up. Is employer health insurance enough? Rarely on its own. It ends when you leave the job, it is often only INR 3-5 lakh shared by the whole family, and you can't control its terms. Treat it as a bonus layer on top of a personal policy. Should parents be on my family floater? Usually not. Older members raise the floater's premium for everyone and their claims can use up the cover the rest of the family needs. A separate policy for parents, with its own sum insured, keeps the two pools apart. What is a super top-up and how does it work? It is a policy that pays only after your total hospital bills in a year cross a set amount called the deductible. Pair it with a base policy whose cover equals that deductible, and together they work like one large policy, typically for much less than a single base policy of the same size. ## Sources and assumptions - [IRDAI (Insurance Regulatory and Development Authority of India)](https://irdai.gov.in/) - [Income Tax Department](https://www.incometax.gov.in/) Rules and rates last checked on 25 October 2026. Results are estimates for planning and education, not tax, legal or investment advice. Kosh is an educational financial planning tool by Primedepth Labs. It is not a SEBI-registered investment adviser and does not offer personalised investment advice, hold your money or execute trades. Markets carry risk; read scheme documents carefully and consult a registered adviser before acting.