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Understanding room rent limits in health insurance

Understanding room rent limits in health insurance

. 1 min read

How much difference do you think there exists between these two policies?


Policy 1:
Sum-insured: 3 Lakhs
Room-rent limit: INR 3,000 for normal room and INR 6,000 for ICU room

Policy 2:
Sum-insured: 3 Lakhs
Room-rent limit: No room-rent limits

The answer is A LOT. The difference can be whether 50% of your medical bill is paid or 100%! 🤯

Let’s understand why.

All medical expenses in a hospital are linked to room rates. (Similar to how your food bill increases when you go to the AC section of a restaurant 🙋🏻‍♂️)

Now let's assume you have Policy 1, which a sum-insured of 3L and room-rent limit of 3k

At the hospital, the charges could be as follows

Room rent: 3k per day, Total medical bill: 1.5L
Room rent: 6k per day, Total medical bill: 3L

Now, if you opt for the 6k room (twice your room-rent limit) , only 1.5 L would be covered under insurance.

This is because 3k/6k = 50% and 50%* 3L (actual medical bill) = 1.5 L (what insurance will cover)

The remaining 1.5L would be payable out-of-pocket when you opt for the higher room category, even though the sum-insured is 3L.

Read your company's health policy today to understand what the room rent limits are! 👍🏼 If it's low speak to your HR about it since they will be deciding on your team's financial wellbeing.