If you're in Kerala, chances are you're already familiar with government-backed health insurance schemes like Karunya Arogya Suraksha Padhat (KASP) or Rashtriya Swasthya Bima Yojana (RSBY). And you probably know someone who had a smooth experience at a government hospital too.
However, the state still reports the highest out-of-pocket health expenditure in the country. As one of the leading insurance intermediaries in India, we know this happens mainly because government schemes often fall short on coverage or flexibility.
What makes things trickier is the brand familiarity that legacy insurers like Star Health, New India, and National Insurance enjoy in Kerala. With their strong agent presence and aggressive marketing, it's easy to assume their policies are the best choice, but that's not always the case.
If you’re unsure whether government schemes or familiar private brands are enough, this guide will help you make the right call. We'll help you cut through the noise and show you which private insurers actually perform better on key metrics like claim settlement, complaint volume, and hospital network, and which plans are really worth your money in Kerala.
Still unsure which health insurance plan is suitable for you or your family? WhatsApp us or book a free call with a Ditto advisor to get unbiased guidance. Our advisors will help you find the best protection based on your healthcare needs.
Are Kerala’s Government Health Insurance Schemes Enough?
About 30% of Kerala’s population is covered under schemes like KASP or RSBY. If you're enrolled in one, that's a great starting point for basic medical expenses.
As one of our senior advisors at Ditto recalls,
“എന്റെ അച്ഛൻ കേരത്തിലെ ഒരു സർക്കാർ ആശുപത്രിയിൽ നട്ടെല്ല് ശസ്ത്രക്രിയക്ക് വിധേയനായിരുന്നു. പ്രവേശനം മുതൽ ഡിസ്ചാർജ് വരെയുള്ള മുഴുവൻ പ്രക്രിയയും അത്യന്തം സുഗമമായി നടന്നു എന്ന് മാത്രമല്ല, ഈ ചികിത്സയുടെ 90% ചെലവും പൂർണ്ണമായും സൗജന്യമായിരുന്നു!”
(“My father underwent a complex spinal surgery at a government facility in Kerala. What left me amazed was that the entire procedure, from admission to recovery, was completed smoothly, and 90% of it was completely free!”)
But before you decide to rely solely on them, here are a few things to keep in mind:
- Coverage is capped at ₹5 lakh per family per year, which may fall short for major surgeries or ICU stays.
- Hospital access is limited to public and empanelled semi-private facilities. Many top cancer care centers and multispeciality hospitals restrict KASP usage for high-cost treatments.
- Room upgrades aren’t covered; most schemes include only general ward admissions.
- Advanced care, including robotic surgeries, branded implants, or specialized critical care procedures, are often excluded.
- Portability outside Kerala is hit or miss, with many migrants or students living in metros like Bangalore or Mumbai often finding their scheme invalid or unusable.
- Public hospital wait times can be long for non-urgent surgeries or specialist consults due to high patient volumes.
That’s why many Keralites, especially those working in metro cities or abroad, opt for a personal health insurance plan alongside public coverage. It fills the gaps seen in government schemes by providing:
- Access to premium private hospitals
- A choice of doctors, rooms, and advanced treatment plans
- Add-ons like maternity cover, durable equipment covers, and wellness benefits
- Digital claims tracking, app-based consultation, and second opinions
| Ditto’s Take: Put simply, if you are someone who travels, works outside the state, prefers private care, or simply wants peace of mind beyond public schemes, then a comprehensive personal health insurance policy is a smart choice. |
Now that we’ve addressed the importance of personal health insurance in Kerala, let’s see how the state fares compared to others in terms of insurance adoption and affordability.
Why Most Keralites Buy Star or National and Should You?
In Kerala, most people end up buying health insurance from companies like Star Health, Care Health, National Insurance, or Oriental. These brands dominate the market here, and it’s not hard to see why.
They’ve built deep offline agent networks, especially in tier-2 towns and semi-urban regions. Their names are familiar, their agents are easily accessible, and they’ve been around for decades. For many buyers, this offline trust is enough to seal the deal.
But brand familiarity doesn't always translate to better protection.
Where Star, Oriental, and National Fall Short
While companies like Star or National are household names, their policies come with some trade-offs you should be aware of:
- Smaller hospital networks: National Insurance and Oriental cover fewer hospitals (3,700 and 4,000 respectively), compared to private players that go up to 10,000+.
- Lower claim settlement ratios: Star Health, one of the most bought plans in Kerala, has an average CSR (across FY 2021 to FY 2024) of 83%. Ideally, this should be more than 90%.
- Higher customer complaints: Brands like Star (56 per 10,000 claims) and Manipal Cigna (26 per 10,000 claims) often receive more service or claim-related complaints than peers, who have complaint volumes in the single digit.
- Hidden restrictions: An ideal policy does not have any room rent restrictions, co-payments, or disease-wise sub-limits. Insurers like Star, Oriental, and New India Health Insurance often have these restrictions, meaning they do not provide comprehensive coverage.
- Premium hikes at renewal: Some insurers offer low initial premiums to attract customers, but may significantly increase them at renewal based on claims and costs.
So, even if you’ve heard good things or know someone who’s bought one of these policies, it’s worth asking: Is it really the best choice for you?
| Did You Know? Because Kerala falls in Zone 2 or 3 in most insurer pricing models, you actually pay less than someone in Mumbai or Delhi for the same ₹10–15 lakh policy. A 35-year-old in Thiruvananthapuram could pay ₹8,500 annually, while the same policy might cost ₹12,000+ in Mumbai. |
Best Health Insurance Plans for Kerala in 2025
Based on key parameters, here are our top picks:
| Plan Name | Restoration | Renewal Bonus | Network Hospitals | CSR | ICR |
|---|---|---|---|---|---|
| HDFC ERGO Optima Secure | 100% of base SI, once/year (addon: unlimited) | 50% pa, up to 100% (irrespective of claims) | 13k+ | 98% | 86% |
| Care Supreme | Up to base SI, unlimited times | 50% pa, up to 100% (addon: 100% p.a up to 500% or unlimited accumulation) | 11.4k+ | 90% | 59% |
| Aditya Birla Activ One Max | 100% of base SI, unlimited times | 100% pa, up to 500% (irrespective of claims) | 12k+ | 95% | 68% |
| Niva Bupa Aspire Titanium+ | Unlimited restoration after the first claim | Booster+: Carry forward unused cover up to 10x | 10k+ | 91% | 58% |
| ICICI Elevate | Unlimited restoration of base cover | 20% pa up to 100% (Addon: 100% p.a up to unlimited accumulation) | 10.2k+ | 85% | 83% |
Wondering what these plans might actually cost you? Here’s a premium estimate for a ₹15 lakh cover across different family structures in the capital city, Thiruvananthapuram:
| Structure | Premium Range (including GST) |
|---|---|
| 1 Adult (Individual, 25 years) | ₹9,820 to ₹15,547 |
| 2 Adults (Floater 30 and 32 years) | ₹15,405 to ₹24,628 |
| 2 Adults + 1 Child (Floater 35, 33, and 5 years) | ₹19,260 to ₹30,348 |
| 2 Adults + 2 Children (Floater 40, 38, 7, and 3 years) | ₹25,098 to ₹37,172 |
| 2 Adults (Floater 63 and 62 years) | ₹64,350 to ₹85,999 |
*Note: Premiums are subject to the insurer’s underwriting process.
Want help figuring out which of these suits your needs? Book a free call and our advisors will help you compare them and choose the plan that best suits your needs.
Network Hospitals in Kerala Covered by Leading Insurers
Many top hospitals in Kerala, including Aster Medcity, Amrita Institute of Medical Sciences (AIMS), KIMS, Baby Memorial Hospital, and Jubilee Mission Medical College, have tie-ups with leading private insurers like HDFC ERGO, Niva Bupa, and Care.
Before you buy a plan, it’s smart to check if your preferred hospital is part of the insurer’s cashless network. You can find this information on the insurer’s website or talk to a Ditto advisor for guidance.
A Ditto Advisor’s Recommendation for Keralites
We spoke with Riyas, a senior advisor at Ditto, to get his insights on health insurance advice for Keralites. He says,
“ആരോഗ്യ ഇൻഷുറൻസ് തിരഞ്ഞെടുക്കുമ്പോൾ എപ്പോഴും നിങ്ങളുടെ ഭാവിയിലെ ആരോഗ്യപരമായ ആവശ്യങ്ങളും സാമ്പത്തികപരിധികളും പരിഗണിച്ച് കൊണ്ടായിരിക്കണം സമീപനം. വിവിധ പോളിസികളെ താരതമ്യം ചെയ്യുന്നതിനും അതിന്റെതായ നിബന്ധനകളും വിശദാംശങ്ങളും മനസ്സിലാക്കുന്നതിനും നിങ്ങൾക്ക് ഞങ്ങളുമായി ബന്ധപ്പെടാവുന്നതാണ്.
നിങ്ങൾ ഇന്ത്യയിലെ മറ്റു നഗരങ്ങളിലോ യുഎഇ പോലുള്ള രാജ്യങ്ങളിലോ ജോലി ചെയ്യുന്ന ഒരു തൊഴിൽപ്രവർത്തകനാണെങ്കിൽ, തദ്ദേശ സംസ്ഥാനത്തിന് പുറത്തുള്ള വൈദ്യസഹായം ഉൾപ്പെടെ ആശ്വാസകരമായ കവർേജ് നൽകുന്ന സമഗ്രമായ ആരോഗ്യ ഇൻഷുറൻസ് പോളിസി സ്വീകരിക്കുന്നത് ഉചിതമാണ്. അടിയന്തരസാഹചര്യങ്ങളിൽ അത്യാവശ്യമായ സുരക്ഷ ഉറപ്പാക്കാനും മാനസികമായി ഒരു തരത്തിൽ സമാധാനം നിലനിർത്താനും ഇത് സഹായിക്കും.”
(“Always analyze your future healthcare needs and budgetary constraints in terms of health insurance. You can reach out to us to compare different policies to understand the terms and conditions, exclusions, and policy riders.
If you’re a working professional employed in other Indian cities or countries like the UAE, consider a comprehensive policy that covers your medical needs away from your home state. This will provide peace of mind and ensure that you have the necessary coverage in case of emergencies.”)
| Heads Up: Look for policies that match Ditto's checklist - no copay, no room rent limit, no disease-wise limit, comprehensive bonus and restoration, and consumables cover. |
Why Talk to Ditto for Your Health Insurance?
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Health Insurance in Kerala: Key Takeaways
If you are a resident of Kerala planning to buy health insurance, here are the things to keep in mind:
- The state has excellent public health schemes, but they may not provide you with comprehensive coverage, especially for major surgeries or critical illnesses.
- A personal health insurance plan gives you access to advanced healthcare along with valuable add-ons like consumables coverage, higher sum insured, and more.
Still unsure which health insurance plan is suitable for you or your family? WhatsApp us or book a free call with a Ditto advisor to get unbiased guidance. Our advisors will help you find the best protection based on your healthcare needs.
FAQs on Health Insurance in Kerala
How can I calculate health insurance quotes in Kerala?
You can seek help from online insurance aggregators or visit the official websites of insurance providers to calculate health insurance quotes in Kerala. Provide key details such as your age, coverage requirements, medical history, and preferred policy options to receive personalized quotes.
How much health coverage do I need in Kerala?
We usually recommend a coverage amount ranging between Rs. 15,00,000 to Rs. 25,00,000 due to three reasons. The first is a black swan event (an unpredictable and serious medical emergency) that can turn your life upside down. Another reason is the rising medical inflation rate of 10-14% every year.
Moreover, you cannot ask for an increase in your sum insured mid-term, especially if you’ve already made a claim or developed a serious health condition like a heart ailment or cancer. That’s why it’s smart to opt for a high coverage policy before health issues arise, so you’re always protected.
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