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Know Your Hospital Room Rent Limit In Mediclaim

The following factors related to room rent will help you understand how it affects your insurance policy

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Hospitalisation for most common illnesses like the ‘flu or cough is not uncommon these days. Since most of us are covered with health insurance, we think the cost might not be too prohibitive. The shocker presents itself at the time of billing when you realise that the costs that are not covered or considered will burn a hole in your wallet. 

There are many factors such as ambulance cost, food, unexpected medicines, etc., that we do not consider while choosing a health policy. Room rent is one such example.  Every policy has something called sub-limit on hospital rooms that can be claimed during hospitalisation. This means if the room rent exceeds the sub-limit as per the policy, the additional expense will have to be borne by the policyholder. 

What is sub-limit in room rent and how does it affect you

Sub-limits on room rent in lay words mean the maximum amount your policy will cover your room for.

So, for example, if your health policy caps your room rent limit to a few thousand that only can get you a general ward bed, then you can either choose that bed and your stay at the hospital is covered or you can take a private room and pay the additional expense from your pocket. 

If you choose a room with a higher cost, the treatment costs, facilities and services associated with it will also increase. In most cases, the max limit on the room rent is only 10% of the total sum insured. Since the room rent sub-limit directly affects your claim, you should be careful while choosing a health insurance plan. 

Even though most health insurance policies have a sub-limit attached to room rent, there are new-age general insurance companies that provide policies with no limits. Alternatively, you can also choose a comprehensive cover that does not have limits on the other additional costs. 

The following factors related to room rent will help you understand how it affects your insurance policy:

Room rent is not linked to NCB (No claim bonus) -

NCB is a bonus added to the claim amount every year for not claiming. It is like a bonus or reward that an insured person gets for not making any claims. Even if your total cover increases, the room rent will remain constant as it is linked to the base sum insured. Since room rent is not linked to NCB there won't be an increase in total cover for room rent during the claim.

Medical inflation, which changes the room rent in hospitals

Inflation in medical expenses is something that needs to be considered while opting for health insurance premiums. For instance, the room rent limit of your insurance that looks affordable today, will not be reasonable if there is a 10 per cent inflation on the medical expenses when you claim after five years. Due to medical inflation, all the expenses will increase the total cost including your room rent. Hence, it is important to choose a plan which doesn’t have room rent limits.

Top-up plans don’t cover room rent

It is not possible to depend on the top-up option for all the expenses that your base health insurance does not cover. For instance, if the base policy has room rent capping and your claim amount is more than the maximum limit, the top-up feature will not help, and there will be a large deduction in the claim as it will be taken from the base cover.

Generally, people choose a policy with low premium with sub-limits on room rent as they are more affordable.  However, the whole process of being hospitalised itself can be extremely exhausting. In such a situation, if you have to compromise on your comfort because of capping on room rent in your health insurance policy, it will add to the stress. 

Hence, check for room rent capping in health insurance so that it will not harm your wallet during billing. One of the primary reasons for opting for a health insurance is to relieve oneself from the financial burdens and stress associated with unexpected medical expenses. Thus, it is always preferable to opt for a cover that is comprehensive and includes all additional costs in the policy. Today, with the new-age insurance companies providing personalised and customised sachet insurance policies, there are plenty of smart options that you can choose. 

Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.


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medical cover health insurance

Vivek Chaturvedi

The author is Head of Marketing, Digit Insurance

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