Room Rent Limit In Health Insurance Explained
Updated On Nov 18, 2020
When buying your health insurance policy, you must have come across many features such as renewal, portability, claim settlement, pre & post hospitalization, OPD expenses, etc. In case, you forget to notice the room rent limit at that time, learn that it is one of the most important elements of your policy.
What Is the Room Rent Limit?
Room rent limit is the limit imposed on room rent coverage and other boarding expenses of the hospital. Determined in the form of percentage of the insured amount or the exact amount of the sum insured, room rent limit has an impact on the health insurance claims.
Room Rent Coverage Types
Your health insurance policy may have room rent feature in any of the following types:
1. Room rent without sub-limits: In this feature type, the health insurance company does not put any limit or restrictions on the room rents. Policyholders are free to choose any room of their choice.
2. Room rents without sub-limits as add on cover: In certain health insurance policies, the policyholder does not get any room rent sub-limits as add on cover. The policyholder may be required to pay an additional amount to get the feature covered.
3. Room rent co-payment: In this feature, the policyholder has to share the room rent expenses with the health insurance company. In case, the policy has a specific limit to the room rent, then the insurer pays any amount spent above the specified limit.
4. Room rent with specified room types: There are health insurance policies that provide coverage for specific types of rooms. In case of room rent with specified room types present, the patient is admitted to only a pre-specified room.
How Does The Room Rent Limit Impact the Claims?
To understand the impact of room rent limits on the health insurance claims, let us take the help of an example.
Let us suppose that you are eligible for a hospital room worth Rs.2,000. However, you choose a room worth Rs.4,000. In this case, your health insurance company will settle your claim partially. Remember, your health insurance company will not perform comparison of the costs of each charge in two different rooms. It will simply reduce the total bill on a pro-rata basis.
Keep in mind that if you are eligible for a room that costs Rs.1,000, however, you choose a room that is worth Rs.2,000, Rs.3,000 or Rs.4,000, your claim will be decreased to 50%, 33% and 25%, respectively, of the total bill.
Room rent limit is a feature that you simply cannot afford to miss while going through a health insurance policy.
So, the next time you opt for a policy, make sure you check the policy for this significant feature by all means.
Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.