logo

How to Calculate Mediclaim Premium?

Posted On:4th Sep 2019
Updated On:29th Jan 2025
banner Image

A Mediclaim policy offers an easy way to bypass the skyrocketing prices of healthcare. Mediclaim is an insurance policy designed to provide financial coverage against healthcare expenses that a policyholder might incur during the policy's tenure. Simply pay a yearly premium and get protection from various medical expenses.However, the premium amount for a Mediclaim policy depends on various factors, such as age, health records, history of smoking or alcohol, etc. Therefore, the premium amount of these plans can vary from one person to the next. Now, you may be wondering how to calculate the Mediclaim premium for your policy?In this article, you will uncover various factors that insurance companies consider in calculating the premium for Mediclaim policies. Also read: Know the Difference Between Mediclaim and Health Insurance

Factors determining your Mediclaim Insurance premium

Calculating Mediclaim Insurance premiums is complex and requires technical expertise. A reputable insurance company considers multiple factors to calculate Mediclaim premiums.Following are some important aspects that insurers consider while calculating the premium amount of your Mediclaim policy:

Age

Your age is one of the most crucial factors in determining a Mediclaim Insurance premium. This is because healthcare expenses are likely to increase as you age.

Lifestyle and medical history

While assessing your insurance application, the insurer evaluates your medical history and habits such as smoking, drinking, etc. If you opt for a Family Floater plan, the insurer assesses these records for all family members. If you or any family member is a smoker, the chances of asthma, heart and pulmonary diseases, cancer, etc., increase, and so does your insurance cost.Also, if you have a pre-existing illness, the insurance company factors in the risk that you may require medical assistance at any time. Therefore, the premium charges in such cases will be higher. Also read: Best Mediclaim policy for parents in India

Sum insured

The sum insured is the maximum amount you can claim from an insurer for medical expenses under your Mediclaim policy. The amount of sum insured also affects the Mediclaim premium charges. The higher your sum insured, the more premium you must pay.You could opt for a lower sum insured to save on premiums. However, when medical bills exceed your sum insured amount, you must cover extra costs out of your pocket. Therefore, you must give thorough thought when choosing the sum insured.For instance, if you are engaged in a profession that exposes you to a health hazard, it is wise to go for a higher sum assured. And in such case, you will have to pay a higher premium.

Risk assessment

Like any other financial instrument, Mediclaim policies also need risk assessment. Insurance companies evaluate the risks associated with offering you insurance coverage. This process of due diligence to determine whether to approve your insurance is called underwriting. Every insurance company calculates medical insurance premiums through underwriting. The higher the risk associated with providing you insurance, the higher your premium.Insurance companies also consider a few other factors while calculating your Mediclaim premium. These include their marketing costs, such as commission to brokers or advertisement expenses, etc., and administrative costs, such as salaries paid to actuaries, underwriting expenses, etc.

Mediclaim policy premium calculator

As discussed above, calculating the Mediclaim premium is extremely complicated and time-consuming. The easier alternative would be to use a Mediclaim premium calculator. This online allows you to find the premium charges easily and quickly for your Mediclaim policy. However, while online calculators use sophisticated technology and advanced formula-based methodology to determine the premium amounts, remember that these are estimated figures. Your actual premium may differ depending on the policy and coverage you choose. Let’s look at some advantages of using a Mediclaim policy premium calculator:

Adjusting your coverage

By calculating Mediclaim premium beforehand with an online calculator, you get a fair idea of the policy cost and can adjust your coverage according to your budget.

Comparing multiple policies

After comparing multiple Mediclaim policies and calculating the premium, you can easily opt for the policy best suits your requirements.

Timesaving

Now that you can find the Mediclaim premium amount online within a few minutes, you can avoid the time-consuming task of physically visiting multiple insurance companies to get quotations.

Efficient financial planning

You can enjoy efficient financial planning after knowing the approximate monthly premium cost beforehand. It will help you allocate funds optimally to prevent your Mediclaim policy from lapsing. Also read: How to file a claim when you own multiple Mediclaim policies?

How to calculate premium using Mediclaim premium calculator

  • Search for an insurer with an online Mediclaim premium calculator and visit its website.
  • Click on the link that directs you to the Mediclaim premium calculator.
  • Enter the required details, such as your age, gender, location, and so on.
  • Specify how many individuals you would like to add to your policy. For Health Insurance plan , children and spouses are typical inclusions.
  • Select an appropriate coverage amount and any rider(s) if needed.
  • After filling in the required details, click ‘calculate’.
  • Based on your inputs, the calculator tool will display different premium amounts.

Remember, some of the above steps for Mediclaim premium calculators may differ depending on the insurance provider.

Key Takeaway

  • Mediclaim is Health Insurance that provides financial coverage for the medical expenses that you might have incurred during the policy term.
  • A professional insurance company considers multiple factors to determine the premium charges for a Mediclaim policy.
  • Your age, sum insured, medical history, risk profile, etc., play a role in calculating your Health Insurance premium.
  • Insurance companies assess the risk associated with offering you insurance coverage through a process called underwriting. Your coverage, policy terms and conditions, premiums, etc., depend on your risk profile.
  • Insurers also typically add their marketing or administrative expenses to the overall costs of providing you with insurance coverage. This can affect your premiums.
  • You can use online Mediclaim premium calculators to get a broad idea of the premiums you may have to pay. However, these tools only yield the best estimate of insurance premiums. Your actual premiums may vary depending on your policy.
Disclaimer

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.



Related Articles

No related articles found.

Recommended Topics


Recent in undefined

No articles found.

Recent in ABC

No articles found.

Discover Convenience Like Never Before

Unlock Financial Tools, Investment Insights, And Expert Guidance – All In One Convenient App.

Download Our Mobile App Now
QR code for downloading the mobile app
Scan the QR code to download our Mobile App

© 2025, Aditya Birla Capital Ltd. All Rights Reserved.