Health insurance without Room Rent Capping

There is generally a range of rooms available in hospitals to choose from when someone gets admitted for the required treatment. Under many health insurance plans, the health insurance companies give the insured a limit up to which they can pick the hospital and ICU room. For instance, there can be a double occupancy room, luxury room, deluxe room, etc which vary in terms of facilities offered and the rent paid for them.

Many health insurance companies impose restrictions on room rent, with the insurance company dictating the terms and conditions. The limit is determined regardless of the insured amount of the policy. The monetary limit, room rent capping, nursing, and boarding expenditures can all be calculated as a percentage of the total sum insured or as an exact number.For instance, room rent capping of 2% of the sum insured or of Rs. 3,000. A health insurance policy with no room rent capping is a preferred choice for policy buyers as it has no restrictions in terms of coverage.

Different insurance companies have different sets of rules when it comes to room rent and capping. But whatever the rules may be, they will be clearly specified in the policy document. In order to make the best buying decision, you must understand the common types of room rent capping in health insurance plans:

• No capping room rent: Many health insurance plans come without any limit on the room rent. The policyholders have the flexibility to choose the room of their choice and requirement.
• Co-payment on room rent: Co-payment is when the insurer and the insurance company partially pay for the claim for the treatment availed. Co-payment on room rent is when the insured and the insurance company bear the room rent expenses together.
• Room rent with capping: The amount of room rent a policyholder can claim is frequently limited by insurance providers. If the expenses exceed this amount, the insurance company will decline to cover them.
• Room rent on certain room types: Some insurance companies give policyholders the option of choosing their hospital room rent based on their needs and room rent availability.If a health insurance policy comes with a limit in room rent for specific room types, then you can either choose a room that is within the room limit or choose the one that exceeds the limit and pay for the expenses that exceed the limit, from your own pocket.
• Room rent waiver add-on cover: This is an optional feature that policyholders can add to their health insurance plans at the time of purchase for a small additional price. The limit on room rent might be removed with this benefit, allowing the insured to receive treatment without worrying about the costs.

How No Room Rent Capping Feature Affects the Hospital Bill?

Let us take an example to understand how room rent capping reflects in hospital bills:

In this case of a bill with no room rent capping, the insured will not be required to pay anything out of their own pocket. Whereas in case of bill with room rent capping, the insured will be required to pay the remaining amount i.e. Rs. 5,000 out of his own pocket.

Average Hospital Room Rent in India

To understand the average room rent charges for different hospital rooms in India, including ICU, refer to the table below:

(Source: medifee.com)

Note that the table is only for reference purposes and room rent charges may vary from hospital to hospital and city to city.

Benefits of Having No Room Rent Capping in Health Insurance

There are several benefits of having a health insurance policy without any room rent. Some of them are explained below:

1. Flexibility to choose a hospital room as per your requirement

One of the most significant advantages of purchasing a health insurance policy that does not have a room rent limit is that you can receive treatment in any hospital room of your choice. Every patient has varied needs and options, which may be limited by a health insurance plan that has a room rent cap.But with a health insurance policy without any room rent, one does not need to compromise. They can either choose to share a room or may want a private room.

2. Freedom to avail coverage benefits as per your own choice

Whether you receive necessary medical care in a basic hospital room or a deluxe hospital room, you will be covered for all expenses spent during your hospitalisation, according to your policy's terms and restrictions.Hence, it is totally up to you if and how you wish to divide the total amount. But note that the expenses will be covered only up to the sum insured limit.

3. Comfortable stay at the hospital

If you are availing of the medical treatment or are feeling sick, then you can stay in a room that offers you comfort, as per your choice.

It is important to purchase a health insurance plan with exhaustive coverage so that the policyholder is not underinsured. Therefore, it is recommended to get a health insurance policy with no room rent capping.