One benefit of having a job, beyond regular income, is access to employer-provided health insurance. Many corporate and government organisations offer health cover that can help employees manage the financial burden of hospitalisation due to illness or accidents. While this employer-provided cover is undoubtedly valuable, experts are of the view that it should not be the only health insurance protection you rely on. According to Dr Vinay Golankondoju, VP – Health Underwriting, Digit Insurance, an individual health insurance policy is equally important, regardless of the sum insured your employer offers.
Why is an individual health insurance policy important?
First, not all employers provide a sum insured high enough to meet today’s healthcare costs. Second, employer-sponsored policies are typically standardised and designed for a large employee base, leaving little room for customisation based on your specific health needs or requirements.
“Most importantly, employer coverage is linked to your employment. During a job switch, career break, or an unexpected period of unemployment, you may lose access to this protection altogether, leaving you financially vulnerable at a time when you may need the cover the most. This is why having your own health insurance policy with adequate coverage is essential,” Golankondoju said.
How much health insurance do you need?
The ideal sum insured can range from Rs 10 lakh to Rs 50 lakh or more, depending on factors such as your city of residence, life stage, family members and health risks. The objective is to have enough coverage to comfortably manage at least one or two major hospitalisations in a year without exhausting your policy limit.
| Life Scenario | Ideal Coverage (Tier 1 Cities) | Ideal Coverage (Tier 2 Cities) |
| Young individual (single, no dependents) | ₹15-20 lakh | ₹10-15 lakh |
| Married/Planning to settle down | ₹20-25 lakh | ₹15-20 lakh |
| Married with children (separate individual plans) | ₹25-35 lakh+ | ₹20-30 lakh+ |
| Married with children & have elderly Parents | ₹20-35 lakh (for you + children) and separate senior citizen plan for parents | ₹20-30 lakh (for you + children) and separate senior citizen plan for parents |
| High-risk lifestyle/pre-existing conditions | ₹40 lakh+ | ₹30 lakh+ |
(Note: These are broad indicative ranges, not financial advice. The right sum insured depends on age, medical history, lifestyle, city of residence, premium, hospital reference, and rising healthcare costs. It is advisable to know your family’s specific needs and read policy terms before making a final decision.)
How to reduce your premium?
If a high sum insured seems expensive, you can strengthen your coverage and reduce your premium. One option is to choose a deductible, which is the amount you pay out of pocket before insurance coverage begins. Selecting a deductible of Rs 5,000 or Rs 10,000 can reduce premiums by as much as 10-20 per cent.
Another option is a Super Top-Up Plan. This additional cover activates once your base sum insured has been exhausted during a policy year, subject to the deductible. “Instead of purchasing an expensive high-value policy, individuals can combine a base policy with a super top-up plan to remain protected. You can also check for various discounts (based on credit score, city, good health declaration, etc.) offered by different insurers,” Golankondoju added.
Things to keep in mind
The earlier you purchase a health insurance policy, the lower your premiums are likely to be, and the broader your coverage options get. Younger individuals generally qualify for lower premiums, since premiums tend to increase with age.
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(This article is for informational purposes only and should not be construed as investment, financial, or other advice.)
