This is very important to know how can you get no room rent limit in health insurance.
Group health insurance is a type of health insurance in which health coverage would be offered to a group of members under a single policy. Room rent in group health insurance is the per-day room charges or bed charges the hospital charges the insured patient in case of hospitalization.
ICU expenses are the emergency medical expenses that are incurred by the insured patient for treatment in the ICU room which would be different from the room rent. Patients would be treated in the ICU once if there is an emergency and during the recovery period, he/she would be shifted to the room.
Group Health insurance policies would mention the room rent limits and the ICU limits. In general, the room rent limit would be 1-2% of the sum insured, subject to a certain upper limit, and the ICU limit would be 2-4% of the sum insured, subject to the upper limit.
What’s on this page?
Let’s discuss those conditions that have no room rent limit in health insurance policies:
Room rent sub-limit:
The “room rent sub-limit” is the limit on the room the insured customer can opt for in case of hospitalization. The sub-limit is very important as it would decide the claim payout after the hospitalization.
Industry experts advise customers to choose their room rent and ICU limits very carefully at the time of purchasing the group health insurance plan as selecting a higher room category would reflect negatively on the overall claim amount to be paid.
The final claim amount would be deducted in the same proportion which the customer would exceed while taking the room at the time of hospitalization.
For example: if a customer has taken a group health insurance policy with a sum insured of ₹ 10 Lakhs and the room rent limit is ₹ 2000 per day, and in case of hospitalization, has taken a room with ₹ 4000 rent, then the total claim to be paid would be reduced to half as the customer has taken a room which is double the original limit.
Hence, it is very important to make sure that you stick to your room rent limit mentioned in the group health insurance plan.
No room rent limit plans:
There are certain group health insurance plans in the market that offer no room rent limit and no ICU limits which can be considered by the customer at the time of purchasing the health insurance policy.
Even though the premium would be slightly higher for these kinds of plans, it is advisable to go for these plans as there would be no hassle even if a higher rent room is chosen for hospitalization. All the costs during the hospitalization would be linked to the room rent limit.
If the room rent limit is chosen in such a way that it is less than or equal to the eligibility, it would benefit the insured during the final claim settlement as there would be no deductions done by the insurance company.
Why is Room Rent Important?
The cost of treatment varies with the number of rooms in a hospital.
For example: For a room that costs ₹ 2000 per day, the doctor’s consultation would be ₹ 1000, whereas for a room that costs ₹ 4000 per day, the doctor’s consultation would be ₹ 2000-3000 and this is where the insurance company deducts the overall claim payable to the insured as the insured is spending more than the agreed limit.
Think of it as the service provided by the hotels for different category rooms, rooms with higher costs would have luxury service whereas rooms with lower costs would have normal service.
The room rent limit is very important as it reduces the premium to be paid by the insured and at the same time decides the final claim amount.
Room rent without sub-limits is where the insured is free to choose any room for treatment. Room rent with copayments is where the insurance company offers the room on a co-payment basis. If the customer chooses a room above the limit, the extra room rent charges have to be paid by the insured.
Certain companies offer group health insurance plans without any sub-limits as an add-on cover which means that the customer can choose any room by paying an extra premium at the time of purchasing the group health insurance policy.