How Much Mediclaim is Enough?

How Much Mediclaim is Enough?| HealthSoul

A mediclaim policy is a kind of health insurance plan that offers coverage for various health-related expenses such as hospitalisation costs, accident-related treatment and pre as well as post hospitalisation expenses. The coverage offered under a mediclaim policy is typically only up to a predetermined limit. 

Purchasing a mediclaim policy can help you save potentially lakhs of rupees in case you are hospitalised later, when the policy is active. However, before buying this kind of health insurance plan, you need to compare your options, assess your requirements and make an informed choice. 

One of the most important aspects to give some thought to is the amount of coverage you need. The question you should aim to answer is this — How much mediclaim coverage should you purchase? Let’s find out. 

How to Determine the Right Amount of Mediclaim Coverage You Need?

To identify the right amount of health insurance coverage, you need to account for the following factors before you decide how much of a sum assured you require.

1. Your Age

Your age is one of the most important factors that determine your ideal health insurance coverage. If you are younger, a more general and basic cover should be sufficient to protect you from medical contingencies, since the chances of you falling sick are slightly lower. 

On the other hand, for older people, a higher amount of coverage may be justified. This is because with age, the likelihood of developing various illnesses like diabetes, heart disease and other critical illnesses goes up. So, a higher mediclaim coverage can ensure that in case of such a diagnosis, you are adequately protected. 

2. Your Medical History

Your medical history also influences the ideal amount of mediclaim coverage you require. If you are young and healthy, a basic cover amounting to a few lakhs of rupees could be sufficient for you at this stage of life. But if you have any pre-existing health conditions, your mediclaim coverage requirements will be quite different. 

For instance, if you have been diagnosed with diabetes, hypertension or any autoimmune disease, you will need regular medical care and attention depending on the seriousness of the condition. To meet these healthcare costs, a higher mediclaim policy coverage may be required. So, factor in your medical history before making a decision about the amount of coverage necessary. 

3. Your Financial Affordability 

Another important aspect to factor in is your budget and how much of a premium you can afford. In other words, your budget. Despite your age and your pre-existing health conditions, if you can only afford a smaller cover, you need to keep your budget constraints in mind.  

For example, say you determine that you require a coverage of ₹50 lakhs based on your age and your medical history. And say the premium for the same comes up to around ₹2,000 per month. However, if you can only afford to pay a monthly premium of ₹1,000, you will have to settle for a lower cover for the time being. 

4. The Kind of Hospital you Prefer to be Treated in

Treatment at private hospitals, particularly those belonging to reputed chains, costs more than healthcare at government hospitals. So, if you are keen on being treated in the former in case of any illness, you will need to purchase a mediclaim policy that offers a higher amount of coverage. 

The premiums will also be correspondingly higher, but you can offset this by opting for a higher deductible if you can afford it. 

5. The Number of People to be Covered Under the Plan

Mediclaim policies can be purchased for one individual or for an entire family. Policies belonging to the latter kind are known as family floater plans, and they offer health insurance coverage to all the members in a family. With this kind of a plan, you can cover your spouse, children, and even dependent parents. 

In case you decide to get a family floater plan, you need to opt for higher coverage since several people will be covered under one policy. That said, it is advisable to purchase a separate policy for your parents if they are senior citizens, since the kind of coverage they require will be different. 


Keep these factors in mind before you decide to purchase a mediclaim policy for yourself or for your family. By factoring in all the parameters outlined above, you can make an informed decision about the amount of mediclaim coverage you need. Being underinsured can cost you in the long run, while being overinsured could mean you spend unnecessarily on coverage you don’t actually need. So, striking the right balance is crucial.