See what Star Health, Niva Bupa, HDFC ERGO, Care Health, ICICI Lombard, and Bajaj Allianz charge for your profile. Individual, family floater, and senior citizen plans. Zero GST on individual policies from September 2025.
| Insurer & Plan | Annual Premium (No GST) | Claim CSR FY 2023–24 | Network Hospitals | Key Benefit |
|---|
All premiums indicative for standard healthy profile. CSR = Claim Settlement Ratio (IRDAI Annual Report FY 2023–24). No GST on individual health insurance w.e.f. 22 Sept 2025. Verify on insurer's website before buying.
A health insurance policy is simple in principle: you pay an annual premium, and the insurer covers your hospital bills up to the Sum Insured you choose. Room charges, doctor fees, surgery costs, ICU bills, ambulance charges, pre-admission tests, and follow-up expenses for 30 to 90 days after discharge all fall within the coverage. Most people find out how valuable this is only when they actually need it. A single hospitalisation without insurance in a private hospital in a metro city today routinely crosses Rs.2 lakh to Rs.5 lakh. That wipes out most families' savings in one event.
Individual plans give each person their own Sum Insured, so one person's hospitalisation does not reduce anyone else's coverage. Family floaters pool one Sum Insured across everyone: self, spouse, and children share it. If your spouse claims Rs.3 lakh from a Rs.10 lakh floater, Rs.7 lakh is still available for the rest of the family that year. Floaters cost 30 to 40% less than buying separate individual policies for each family member. The catch: the premium is based on the eldest member's age, so adding an older parent significantly increases the cost. Senior citizen plans are built for people above 60 with conditions like domiciliary treatment and day-care procedures, reflecting the higher claim probability at that age.
Most people underestimate how much cover they actually need. The standard guidance is to keep your Sum Insured at 50 to 100% of your annual income, but that floor is rising. Individual policies in metro cities should be at least Rs.10 lakh to Rs.15 lakh. Families need Rs.20 lakh to Rs.50 lakh. Healthcare inflation in India runs at 10 to 14% per annum, which means the Rs.5 lakh policy you bought five years ago now covers what Rs.3 lakh would have covered then. A single cardiac bypass today costs Rs.5 lakh to Rs.15 lakh. Cancer treatment regularly crosses Rs.20 lakh. Plan for the bills you hope you never see, not the ones you are comfortable paying for.
As of 22 September 2025, individual health insurance premiums are fully GST-exempt following the 56th GST Council decision. New policies and renewals both qualify. You pay only the base premium, with nothing added on top. Employer-sponsored group health insurance continues to attract 18% GST, but personal policies bought directly are now exempt. For someone paying Rs.15,000 a year in premium, that translates to Rs.2,700 saved every renewal, roughly the cost of one outpatient visit.
Section 80D gives you a tax deduction on health insurance premiums, but only under the old tax regime. The self, spouse, and children bracket allows up to Rs.25,000 per year. If you are a senior citizen, your own bracket rises to Rs.50,000. Parents get a separate allowance: Rs.25,000 if they are below 60, Rs.50,000 if they are senior citizens. A family paying premiums for themselves and their senior parents, the total deduction reaches Rs.75,000 every year. That is a real saving of Rs.15,000 to Rs.22,500 annually depending on the tax bracket, over and above the protection the policy provides.
Choose plans with no room rent limit or "single private room" cover so you aren't stuck with a shared ward.
If your SI gets exhausted in a claim, this resets it — sometimes multiple times in a year. Critical for families.
Your SI increases by 10–50% for every claim-free year — effectively more cover at the same premium.
All plans have a 2–4 year wait before PED is covered. Shorter waiting periods are better.
Covers 500+ procedures done in under 24 hrs (cataract, dialysis, chemotherapy). Ensure this is included.
Larger hospital networks mean easier cashless claims. Look for 10,000+ hospitals, especially in your city.
Avoid plans with a co-pay (e.g., "you pay 10% of every claim") — it means out-of-pocket cost even with insurance.
Has a 2–4 year waiting period. Include it if you're planning a family and buy early.
The Claim Settlement Ratio tells you what percentage of claims an insurer actually paid in a given year. HDFC ERGO settled 98.6% of health claims in FY 2023-24. ICICI Lombard settled 97.4%. Bajaj Allianz settled 95.5%. These numbers matter because a policy is only useful if the claim gets paid. The CSR alone is not the complete picture, though. Also look at the Incurred Claims Ratio, which compares what the insurer paid out to what it collected in premiums. A ratio between 50% and 80% is healthy: the insurer is profitable but not aggressively so. Below 50% and the insurer is likely denying too many claims. Above 80% and it is under financial pressure, which affects future claim behaviour.
If you have diabetes, hypertension, a thyroid condition, asthma, or any prior surgery, expect a 2 to 4-year waiting period before your insurer covers claims related to those conditions. During that window, the policy works normally for everything else: accidents, infections, surgeries unrelated to the PED, and so on. Once the waiting period ends, the pre-existing condition is fully covered with no additional exclusions. Disclose every condition honestly at the time of application. Insurers investigate claim backgrounds carefully. Non-disclosure is the single most common reason for claim rejection, and a rejected claim during a serious illness is the worst possible outcome of a policy you have been paying for years.
Where you live affects your premium because hospital costs vary widely across India. Metros like Delhi, Mumbai, Bengaluru, Chennai, and Hyderabad carry a loading of 15 to 20% because private hospital treatment costs there are significantly higher. Tier-2 cities like Pune, Jaipur, Lucknow, and Nagpur are at the base rate. Tier-3 cities and rural areas tend to be 5 to 10% cheaper. The calculator applies these adjustments automatically when you select your location, so the premiums shown already reflect your geography.
Standard health insurance covers room charges, ICU bills, nursing fees, doctor and surgeon fees, pre-hospitalisation tests and consultations for up to 30 days before admission, and post-discharge follow-ups for up to 90 days. Ambulance costs, day-care procedures like cataract surgery and dialysis, and treatment at home when hospitalisation is not possible are also included. What it does not cover: OPD consultations unless you have added a rider, cosmetic procedures, dental work, and eyeglasses.
If you are 25 to 35 and living in a metro, Rs.10 lakh to Rs.15 lakh is a realistic minimum for an individual. A family of 3 to 4 needs Rs.20 lakh to Rs.30 lakh on a floater. Healthcare costs in India are rising 10 to 14% per year, so buy more than feels comfortable. One approach worth knowing: combine a Rs.5 lakh base plan with a Rs.20 lakh super top-up. The total cost is roughly what a Rs.10 lakh plan charges, but your effective coverage is Rs.25 lakh.
A family floater gives one Sum Insured to the whole family. Everyone shares it. If one member spends Rs.3 lakh from a Rs.10 lakh floater, Rs.7 lakh stays available for everyone else that year. Floaters are 30 to 40% cheaper than buying separate individual policies for each person. The premium is based on the oldest member's age, which is worth knowing if you are thinking about adding parents. Adding a restoration benefit is important on a floater because if one member exhausts the Sum Insured with a large claim, restoration rebuilds it for the rest of the family.
Not on individual policies, and not since 22 September 2025. The 56th GST Council removed GST entirely from individual health insurance premiums. Whether it is a new policy or a renewal, you pay only the base premium from that date. Employer-sponsored group health insurance still attracts 18% GST. Personal policies bought directly do not.
Every year you go without making a claim, most insurers reward you with either a higher Sum Insured at no extra cost or a reduced premium on the next renewal. Accumulate 5 claim-free years on a Rs.5 lakh policy with 50% NCB and your effective cover rises to Rs.7.5 lakh without paying anything extra. Niva Bupa has a feature called Lock the Clock that goes a step further: it freezes your premium at whatever age you joined, so it does not increase as you get older.
A super top-up sits on top of your base plan. Once your base policy's Sum Insured runs out, the super top-up takes over. A Rs.5 lakh base plan combined with a Rs.20 lakh super top-up gives you Rs.25 lakh in total effective coverage. The combined annual premium is roughly what a standalone Rs.10 lakh policy costs. This is particularly relevant for people over 40, where higher cover becomes more necessary but also more expensive. A super top-up is how you get there without the premium spike.
Section 80D gives you a deduction on health insurance premiums, but only under the old tax regime. You get up to Rs.25,000 for premiums paid for yourself, spouse, and children. Senior citizens get Rs.50,000 for their own bracket. Parents' premiums qualify for a separate deduction: Rs.25,000 if they are below 60, Rs.50,000 if they are senior citizens. Pay premiums for yourself and your senior parents and the total deduction comes to Rs.75,000 per year.
Buying early costs less and protects you better. At 25, the same Rs.10 lakh policy costs 40 to 50% less than at 35. More importantly, any condition you develop after buying the policy cannot be used by the insurer to raise your premium or exclude that condition from future coverage. Any illness you get after the policy is in place is covered once the standard waiting period ends. The worst time to buy is when you actually need it. Buy it when you are healthy, and buy it the moment you stop relying solely on your employer's group cover.
Health insurance has three types of waiting periods. The first 30 days after buying the policy, only accidents are covered. From day 31 onward, everything else starts applying normally. Pre-existing diseases have their own waiting period of 2 to 4 years before claims related to those conditions are covered. Specific illnesses like hernia, cataract, and joint replacement have a waiting period of 1 to 2 years even without a pre-existing condition. One useful rule: if you port your policy to a new insurer, the waiting period credit from your old insurer carries over. You do not restart from zero.
Premium is the starting point, not the ending point. Room rent sub-limits are the most overlooked feature: a plan that caps room rent at Rs.3,000 per day in a hospital where single rooms cost Rs.8,000 forces you to pay the difference out of pocket on every day of your stay, and this also affects how related charges are calculated. Avoid plans with sub-limits entirely. Co-payment clauses, where you pay 10 or 20% of every claim, have a similar effect: you are never fully covered. Check the restoration benefit, the network hospital count in your specific city, and whether claims are processed in-house or through a TPA. In-house processing is consistently faster. Look at the Claim Settlement Ratio to understand how reliably the insurer pays. This calculator shows you premiums across 6 insurers. Read the full policy wording on any plan before you buy.
