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| March 18, 2024

6 Factors That Affect Your Health Insurance Premium

The rising costs of healthcare and medical treatments have made it crucial for people to have adequate health insurance coverage in place. In fact, several people are going beyond individual plans and look for family health insurance plans to ensure financial support in case of medical emergencies. Apart from financial security, buying health insurance also comes with tax benefits.

Insurance companies typically conduct thorough assessments of your health and profile before approving your insurance application and the premium for the Mediclaim policy is also set based on this assessment.

What Are the Factors that Influence the Premium of a Health Insurance Policy?

While all insurers have their own specific guidelines for assessing applicants and for calculating their premiums, there are certain factors that are common across all insurance providers, which can affect the premium of the health insurance policy. To be able to find the best health insurance in India for your requirements, it is important to understand what these factors are.

Age and Gender

Age is one of the most important factors that insurance companies take into consideration while calculating the premium. A rule of thumb that is followed by most insurance companies is that the higher the age of the applicant, the higher the health insurance premium. The reasoning behind this rule is that older people are at a higher risk of suffering from illnesses as compared to younger people. This is why it is always a good idea to buy health insurance plans when you are young, so you can avail yourself of comprehensive medical coverage and better benefits at a much more affordable premium.

Another important factor that several, but not all, insurance providers may take into account is the gender of the applicant, with women being offered lower premiums as compared to men.


The nature of your work and how many risks it exposes you to are also factors that insurers may consider for the calculation of the premium for your Mediclaim policy. For instance, applicants who work at low-risk workplaces, like schools or corporate offices may be offered lower premiums as compared to applicants who may be working in high-risk environments, like factories or construction sites.

Medical History

Your medical history and records also play a crucial role in setting health insurance premiums. Individuals who have had a history of illnesses or have a pre-existing medical condition are charged higher premiums, while people who have led a relatively healthy life with no instances of serious illnesses are offered lower premiums. For calculating the premium for the Mediclaim policy, some insurers may also take the applicant’s family medical history into account to assess their risk factors for developing medical conditions.

The Overall Health of the Applicant

Pre-policy medical assessments are required by several insurers for applicants above a certain age (generally over 45 years of age), while other insurers have a mandatory requirement for applicants to undergo a health assessment before their insurance policy is approved.

Pre-policy medical checks may include a complete blood count, diabetes tests, checking vitals, ECGs, urinalysis, lipid profile, and blood serum tests to determine the fitness of the applicant. The results of such assessments can impact the premium for both individual and family health insurance plans significantly.

Suggested Read: Selecting The Best Health Insurance Plan for Your Family

Lifestyle Habits

There are certain self-cultivated lifestyle habits that people may have, which can have a negative impact on their health insurance premiums. These include regularly participating in high-risk activities, use of tobacco, overindulging in alcohol, smoking, and other habits that are associated with different health issues.

Apart from the direct impact of lifestyle habits, one’s lifestyle can also have an indirect effect on health insurance premiums. Everyday behaviours like leading sedentary lifestyles, not getting adequate sleep, not following a nutritious diet, poor stress management, etc. can impact one’s health in the long run, translating into higher health insurance premiums.

Type of Insurance Policy Chosen

The higher the sum insured that you choose, the higher will be the premium. The premium also depends on the type of insurance plan that you choose. For instance, critical health insurance will have a different premium as compared to standard medical insurance, and in general, group health insurance plans have lower per-member premiums as compared to individual plans, and family floater insurance plans tend to have higher premiums as compared to individual or group health insurance plans.

Suggested Read: what to know about group health medical insurance plans

Another important factor is the tenure that you chose for the insurance policy. Longer durations attract lower premiums as compared to short-duration policies. Then there are the add-on covers or riders that you may choose along with your health insurance policy. Add-on covers, like a critical health insurance policy, offer extra coverage but increase the premium that you are required to pay for the health insurance policy.

With numerous insurance providers offering a range of health insurance policies, it will not be difficult for you to find the best health insurance in India that perfectly suits your requirements and budget. Just remember to do your due research into the coverage being offered before selecting an insurance policy.

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