Why policyholders should check room rent limit while buying health insurance

Today health insurance is an essential aspect of financial planning. While most individuals primarily focus on the sum Insured or the premium they have to pay for the same, there are other important aspects that demand equal attention. The room rent limit, options of deductible, co-payment, or sub-limits are critical to look at. Before buying a health insurance policy, make sure that you understand how the room rent limit works as it may reduce your claim substantially.

Ajay Shah, Head – Distribution, Care Health Insurance said it is crucial to comprehend how hospitals classify their rooms - based on facilities and services provided such as shared rooms, single private rooms, standard or deluxe rooms, and so on. 

The room rent type is specified in policy documents and will determine the type of room a policyholder is eligible for occupying at the time of hospitalisation.

“Room rent proportionate charges comprise of certain deductions at the time of claim,” said Ajay Shah. 

These could be nursing charges, ICU expenses, Surgery charges, doctor's fees etc. These expenses are applicable for proportionate charges wherever room rent limit/type is exceeded, added Shah.

Room rent limit

Health insurance policies typically cap room rent at 1-2% of the sum insured. However, in some policies, the room rent is capped based on an absolute amount. For instance, if your sum insured is ₹5 lakh and the room rent cap is 1% of the sum insured, you can take a room in a hospital that costs ₹5,000 a day.

What happens when the room rent is exceeded?

If the policyholder opts for a higher room limit, the difference amount will be converted into percentage and this percentage of the amount will be deducted across the final bill except for medicines.

Understanding a room rent limit is hence pivotal to avoid any last-minute financial stress on policyholders. By carefully examining the policy's terms & conditions and being aware of the expenses encompassed within the predefined limit, individuals can make informed decisions and secure their finances.