Why Your Health Insurance Premium Goes Up Every Year — and What You Can Do About It

By Rahul Narang
Why Your Health Insurance Premium Goes Up Every Year — and What You Can Do About It

Renewal time arrives. Your health insurance premium is ₹4,000 higher than last year. Nobody asked. Nobody warned you. The insurer just revised it.

This is one of the most common and most frustrating experiences of owning health insurance in India. And unlike many financial surprises, the premium increase isn't arbitrary — there are specific, identifiable reasons behind it. Understanding them helps you predict future increases, negotiate where possible, and make better decisions at renewal.


The Primary Reason: Medical Inflation

Healthcare in India has been inflating at 12–15% per year — significantly faster than general consumer price inflation. Hospital room rates, surgery fees, diagnostic costs, and medicine prices all increase annually.

A cardiac angioplasty that cost ₹2.2 lakh at a Noida private hospital in 2019 might cost ₹3.5–4 lakh in 2025. An ICU day that was ₹8,000 might now be ₹14,000–18,000.

Insurers pay claims at current prices. If hospitalisation costs rise 13% per year, and claim frequency stays constant, the insurer's costs go up 13%. That cost goes somewhere — it goes into your premium.

Health insurance in India is repriced annually specifically because medical inflation makes multi-year fixed pricing financially unviable for most insurers.


Age-Based Premium Bands

Health insurance premiums in India are structured in age bands. As you move from one band to the next, your premium jumps — not gradually, but in a step change.

Common age band transitions that trigger significant increases:

  • Crossing 35
  • Crossing 40
  • Crossing 45
  • Crossing 50
  • Crossing 55 and beyond (increases become steeper)

The logic: older policyholders statistically use healthcare more frequently and generate larger average claims. The insurer prices this statistical risk into the premium for your age band.

If your premium increased more than usual in a particular year, check whether you crossed an age band. The increase isn't punitive — it reflects your actuarially-assessed risk moving into a higher category.


Insurer-Wide Premium Revisions

Insurers don't just reprice individual policyholders — they revise premiums across their entire policy portfolio, sometimes affecting specific products or all products across the board.

These revisions happen when:

1. Claims experience is worse than projected

If the insurer's actual claim costs exceeded their actuarial projections for the year — because hospitalisation volumes were higher than expected, or because medical costs ran above projections — they need to reprice to remain viable.

2. Portfolio mix changes

If older or higher-risk policyholders renew at higher rates while younger policyholders leave, the insurer's average risk profile worsens, requiring a portfolio-wide repricing.

3. Regulatory changes

IRDAI's standardisation requirements (like mandatory coverage for mental health, daycare procedures, and home healthcare) add covered expenses that weren't previously included. This expands the insurer's liability, which increases premiums.

4. Reinsurance costs

Insurers themselves purchase reinsurance. If reinsurance costs increase (due to global claims trends, catastrophic events), this flows through to policyholder premiums.

IRDAI must approve premium revision applications from insurers — it's not entirely unchecked — but revisions are approved routinely when adequately justified.


Your Individual Claims History

For individual and family floater policies, your claims history can influence your premium. Insurers typically build this into renewal pricing in two ways:

Loading for high claims. If your claims in a previous year were very high relative to premium paid, some insurers apply a premium loading at renewal.

Loss of No Claim Bonus (NCB). Many health policies provide an NCB — an increase in sum insured (not a premium reduction) for claim-free years. Typically, the sum insured increases by 10–50% with each claim-free year. If you filed a claim, you may lose the accumulated NCB sum insured increase.

Note: Unlike motor insurance NCB, health NCB is typically a sum insured bonus, not a premium discount. So you don't "pay more" directly for filing a claim — but you lose the extra cover you would have accumulated claim-free.

Some policies do include premium loading on claims. Check your policy's renewal terms specifically.


What You Can and Cannot Do

What you can't change:

  • Medical inflation — it's structural and will continue
  • Age-band transitions — they happen as you age
  • Insurer-wide portfolio revisions — they apply to all policyholders

What you can influence:

1. Port to a different insurer

Under IRDAI's portability rules, you can switch health insurers at renewal while retaining credit for time served under your previous policy (including waiting period completion and continuity for pre-existing conditions).

Porting makes sense if:

  • Your insurer's premium revision is significantly above market rates for equivalent cover
  • Another insurer offers genuinely better coverage terms for similar or lower premium
  • You've had poor claims service and want to move before you need a claim

Important: Port before your policy expires. Portability must be initiated before the renewal date. Missing this window forfeits the option for that year.

2. Increase your deductible or co-pay

Some policies allow you to choose a higher deductible or co-payment in exchange for a lower premium. If you have sufficient savings to absorb smaller claims, this can meaningfully reduce premiums — especially as policies age and base premiums rise.

3. Reduce sum insured and add a super top-up

If your existing policy's premium has become expensive as you've aged, consider reducing the base sum insured to a lower, more affordable amount, and adding a super top-up policy to cover above that level. The combined premium may be lower than the full-cover premium.

4. Review add-ons that are no longer valuable

If you added riders or benefits years ago that you no longer need (maternity cover after you've completed your family, for example), removing them at renewal reduces your premium.

5. Annual versus multi-year policies

A small number of health insurance products offer 2-year or 3-year terms with a premium lock for the duration. These insulate you from annual repricing for the lock-in period — though the insurer typically prices in some inflation buffer upfront.


The Honest Projection

If you're 35 today paying ₹15,000 per year for a family floater, here's a realistic projection:

  • At 40: ₹22,000–₹28,000 per year (age-band increase + medical inflation)
  • At 45: ₹32,000–₹42,000 per year
  • At 50: ₹48,000–₹65,000 per year
  • At 55+: ₹70,000–₹1,00,000+ per year for a family cover

These are rough estimates. The trajectory is real — premiums increase faster as you age. This is why health insurance is significantly cheaper to buy young, and why switching to a better policy is easiest before pre-existing conditions accumulate.


One More Thing: Don't Let Premium Pressure Make You Lapse

The worst outcome of premium increases is letting the policy lapse because renewal feels expensive. Starting over means a fresh waiting period, no continuity credit for pre-existing conditions, and starting your NCB from zero.

If the premium has become difficult, the right response is to restructure (different plan, different insurer, adjusted sum insured) — not to go without cover. Being uninsured at 50 in India, facing medical costs that have been rising at 12–15% per year, is a serious financial risk.


For a renewal review that helps you understand your options and potentially reduce your premium without losing meaningful cover, call Policywings at +91-98111-67809.


Policywings Insurance Broking Pvt. Ltd. | IRDAI License No. DB 835 | A-57, 5th Floor, Sector-136, Noida | +91-98111-67809

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