Capping on Room Rent Under Health Insurance Policy

During the COVID-19 pandemic, health insurance has come up as one of the most required investments made by an individual as soon as he/she starts working. The reason for the same is, it enables the policyholders to opt for the most suitable form of treatment without thinking much about its cost.

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    Health issues can occur to anyone and protecting ourselves against them in all possible ways is our priority. From a healthy lifestyle to opting for an appropriate health insurance plan is all that we need. While a health insurance plan is one of the wise decisions that we can make, it is always recommended to read all the terms and conditions carefully to ensure that the claims are not rejected.

    One of the things that we all should thoroughly check in our health insurance policy is capping on room rent while hospitalized.

    What is Room Rent Capping?

    Room rent capping is the limit of hospital room cost that is borne by our insurance provider. This capping can either be a whole figure that states how much room rent expenses are paid by the insurer or as a specific percentage of the sum assured. Before a hospitalization, we all should check the room rent capping under our health insurance policy.

    Generally, our health insurance policy explicitly mentions the capping on room rent in the policy documents. For example, if the capping on room rent set by the insurer is Rs. 5000, then we can claim only Rs 5000 as room expenses.

    The average cost of Hospital Room Rent in India

    Check out the below table to understand the average room rent costs for different hospitals rooms in India, including rent for ICU rooms:

    Types of Hospital Rooms

    Average Cost in Zone A

    Average Cost in Zone B

    Average Cost in Zone C

    Semiprivate Ward (2 or more sharing)

    Rs 4000

    Rs 3000

    Rs 1500

    Private Ward

    Rs 5200

    Rs 4800

    Rs 2300

    General Ward

    Rs 1400

    Rs 1200

    Rs 800

    ICU

    Rs 8800

    Rs 8400

    Rs 6800

    Note – The above costs are for reference purposes only and the costs may differ from one hospital to another and from one city to another. 

    Here is an illustrative example to make it simple for you to understand. Assuming that your basic health insurance sum insured is Rs 5 lakh and you get hospitalized for 4-days in Bangalore (Zone B City) and policy has a room rent capping of up to 1% of your sum insured i.e. Rs 3,000 per day.

    Health Insurance with No Room Rent Capping

    Sum Insured

    Rs 3 Lakh

    Room rent cap

    No capping

    No of days Hospitalized

    4

    Room rent for the private ward (per day)

    Rs 6000

    Hospital room rent for 4 days

    Rs 24000

    Room rent to be paid by the Insurer

    Rs 24000

    You pay

    Rs 0

     As given in the above table here, with room rent capping, you will be paying Rs 4,000 more due to the room rent cap.

    But if your medical insurance policy doesn’t have capping on room rent, then you are not required to pay any extra amount and save any additional out-of-the-pocket expenses! 

    Health insurance without Room Rent Capping

    Buying health insurance with no room rent capping makes it possible for you to pick any hospital room while undergoing treatment. As there is no capping on the room rent limit you can select a hospital room of your choice during hospitalization or for the ICU as long as the total claim amount is up to the policy sum insured.

    Here is some context to help you understand better

    When you get admitted into a hospital for treatment you can select from a range of hospital rooms available at the time of admission. Mostly, health insurers keep a limit up to which you can select the hospital room and ICU room.

    For example, you can pick from a double hospital room, luxury room, deluxe room, etc. and the room rent of each room is different. However, many health insurance companies have a room rent capping clause in your policy, which can be ICU room rent capping as well.

    Benefits of having No Room Rent Capping in your Health Insurance

    Check out the benefits of buying health insurance without room rent capping:

    1. Choose a hospital room as per your requirement: One of the major benefits of no room rent capping in your health insurance is that your room rent choice doesn’t get limited. The preferences of every customer are different and if you can pick a hospital room of your choice then you can make your experience at the hospital much better. It is up to you if you want to share your hospital room with one other patient or want a private room.
    2. Freedom to benefit from health insurance as per your choice: Whether you stay in a deluxe room or a basic hospital room, your claim is registered based on the total amount of your hospitalization and treatment expenses put together. With no limit on room rent capping, you can decide if you want to divide the expenses or spend it on the total treatment. And this is self-understood that the coverage limit or the total claim amount can only be up to the sum insured.
    3. Comfortable stay at the hospital: If you feel sick or being treated, then you must stay in a room that offers you comfort. You can decide on a room as you like and feel comfortable while undergoing the treatment.  

    Summing it up!

    This was all about room-rent capping, and if you are planning to buy health insurance or already have a health cover then do check the room rent cap. Nowadays a lot of health plans come with no room rent cap and you can avail of the treatment with ease.

     

     

    Written By: PolicyBazaar - Updated: 26 July 2021

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