Room Rent Limit in Health Insurance

Health insurance plans offer coverage for most medical expenses but not all. Even if they do cover certain expenses, there would be a coverage limit. Room rent limit is one of the most common coverage limitations that you can find under medical insurance plans. Read on to know everything about the concept of room rent limit in health insurance and why you should stick to it.

Read More

Policybazaar exclusive benefits
30 minutes claim support##
(In 120+ cities)
Relationship manager
For every customer
24*7 claims assistance
In 30 mins. guaranteed*
Instant policy issuance
No medical tests~
People trust Policybazaar^
6.7 crore
Registered consumers
51
Insurance partners
3.4 crore
Policies sold
Policybazaar is one of India's leading digital insurance platform

0%

Find affordable plans with up to 25% Discount**

Select members you want to insure

  • More Members
  • Back
    Continue
    By clicking on “Continue”, you agree to our Privacy Policy and Terms of use
    Maximum child sum can be 4
    This will help us calculate the premium & discounts for your family
    Previous step
    Continue
    This will help us to find the network of Cashless Hospitals in your city

      Popular Cities

      Previous step
      Continue
      Get to plans directly next time you visit us
      Please provide your active international number
      Previous step
      Continue
      We will find you the plans that cover your condition.

      Do any member(s) have any existing illnesses for which they take regular medication?

      Get updates on WhatsApp

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step
      Advantages of
      entering a valid number
      You save time, money and effort,
      Our experts will help you choose the right plan in less than 20 minutes & save you upto 80% on your premium
      Advantages of entering an International Number
      Prompt connectivity
      Find the right plan in under 20 minutes
      Get best discounts
      Ensure smooth issuance

      What are Sub-limits?

      Sub-limits refer to a specific percentage of the sum insured amount that the insurance company will bear for different hospital expenses. The bill amount is supposed to be paid by the policyholder. It is important to keep in mind that the sub-limit in health insurance does not apply to the whole bill amount. Surgery/operation charges, doctor’s fees, medicine cost, nursing expense, and room rent all have a sub-limit applied cap applied to it. For example, the sub-limit on room rent can be capped at 1% of the sum insured and thus for coverage of Rs 1 Lakh the room-rent will be limited to Rs 1,000.

      You May Like to Read: Best Health Insurance in India

      How Does Room Rent work in Health Insurance Policy?

      Room rent is the per-day room or bed charges the hospital charges the patient to pay. With the health insurance policy, the room rent expenses of the policyholder are settled by the insurer.

      • Case Study

        If the policyholder's room rent is Rs.2,000 per day then the other charges like a doctor visit, nursing, and other diagnostic charges are respectively to the room rent. Similarly, if the policyholder chooses a private deluxe suite for Rs.8,000 per day then the other medical charges and expenditure increase respectively to the room rent. Thus, it is always advised to purchase the policy with no room-rent sub-limits.

        There are mainly four types of room rent coverage in the health insurance policy.

        • Room rent without sub-limits
        • Room rent with co-payments
        • Room rent without sub-limits as an add-on cover
        • Room rent with specified room types

      Importance of Room Rent Sub-limit

      The sub-limit on room rent is very important as far as the claim is concerned. In most of the health insurance plans, the limit on reimbursement of the claim for all the other medical cost is related to the room-rent limit. Thus, it is always advised to the policyholder to always stick to the room rent limit. If the health insurance policy sum insured amount is Rs. 3 lakh, then it is advised to select a hospital room with the rent amount equal to 1% of the sum insured i.e. Rs 3,000 per day.

      Effect of Exceeding the Sub-limit

      Not sticking to the room rent sub-limit has a negative impact on the total claim settled by the insurance company. If the policyholder exceeds the room-rent limit then the insurance company respectively reduced by the reimbursement sub-limits related to the other medical expenses. Based on the room types selected by the insured, different hospitals have different billing and room rent.

      The sub-limits for reimbursement of related medical expenses are decreased in the same proportion as the room -rent exceeds the permitted limit. So if the policyholder exceeds the room-rent limit by 33% by choosing a room which cost Rs 4,000 per day instead of choosing the mandate room which cost Rs 3,000 per day, the reimbursement sub-limits for all the other claims also get reduced by an equal percentage. In this case, the insurance company pays the partial payment of the claim and the rest of the balance expenses are needed to be taken care of by the policyholder from his/her pocket. This results into dissatisfaction and customer grievance.

      You May Like to Read: Mediclaim Policy for Senior Citizens

      What to Do?

      During hospitalization, sort out the connection between the room-rent limit and other expenses. Ask whether the third-party administration is available to the insurer itself or at the hospital. If the other expenses and room rent sub-limit is connected then it is better to stick to a room with the rent within the permitted sub-limit.

      Plans without Sub-limits

      There are some of the health insurance policies, which do not offer any sub-limit or any other medical expenses including the room-rent. Select the plan, which does not come with the sub-limit clause even though the premium amount of the policy can be higher. The benefits offered by such policies are even higher. Some of the health insurance plans also offer the option to remove the sub-limit clause by paying some extra premium.

      The Final Verdict!

      Even though most of the health insurance policy clearly states different sub-limits in the brochures, the important equal reduction of the claim amount clause is generally mentioned only in the policy document. Thus, for a good customer experience and to avoid partial settlement of the claim it is always advisable to stock to room rent sub-limit or opts for a health insurance policy without sub-limits.

      book-home-visit
      Search
      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

      Health insurance Articles

      • Recent Article
      • Popular Articles
      17 Jul 2024

      Does Care Health Insurance Cover Dengue...

      Every year, we look forward to the monsoon to escape the heat, but

      Read more
      16 Jul 2024

      Does ICICI Lombard Health Insurance Cover Dengue...

      As the monsoon season arrives, the risk of vector-borne diseases

      Read more
      15 Jul 2024

      Does Star Health Insurance Cover Dengue...

      In India, the high incidence of vector-borne diseases like dengue

      Read more
      01 Jul 2024

      Surgeries Covered Under ICICI Lombard Health...

      Life can throw unexpected medical emergencies your way, making

      Read more
      27 Jun 2024

      Is LASIK Surgery Covered by ICICI Lombard Health...

      Waking up with a clear vision is a dream for many. LASIK surgery

      Read more

      How to Apply for Ayushman Bharat Pradhan Mantri...

      Ayushman Bharat Yojana is a flagship health insurance scheme launched by the Government of India to offer universal

      Read more

      How Senior Citizens can save Tax with Medical...

      Senior citizens can save on income tax by availing tax benefits on medical expenses under Section 80D of the Income

      Read more

      10 Major Benefits of Ayushman Bharat Yojana

      Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the second component under Ayushman Bharat Scheme. PM Narendra Modi

      Read more

      Best Health Insurance Plans for Senior Citizens

      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance

      Read more

      10 New IRDAI Health Insurance Guidelines in 2024

      Health insurance penetration in India is far lower than it should be. A significant chunk of the Indian population

      Read more

      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30-minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881. Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. As per the Insurance guidelines, you are allowed to cancel the policy with-in 15 days from the date of Issuance of policy. For more details, please read the Plan Brochure carefully or talk to our advisor at the time of purchase.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

      ##On ground claim assistance is available in 114 cities

      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

      Policybazaar is a registered Composite Broker |Registration No. 742, Valid till 09/06/2024, License category- Composite Broker (Life & General)| Visitors are hereby informed that their information submitted on the website may be shared with insurers.

      Policybazaar Insurance Brokers Private Limited | CIN: U74999HR2014PTC053454 | Registered Office - Plot No.119, Sector - 44, Gurgaon, Haryana - 122001 Contact Us | Legal and Admin Policies

      © Copyright 2008-2024 policybazaar.com. All Rights Reserved.

      top
      Close
      Download the Policybazaar app
      to manage all your insurance needs.
      INSTALL