When you are discharged from the hospital after treatment, you are usually handed a long and hefty bill. This hospital bill includes all the services that are provided to the patient during their treatment. This also includes room rent, which is quite a hit to the pocket. If the patient has health insurance, then the hospital bill will be settled by the insurance company. Sometimes, it can be a bit difficult to understand how the room rent will be calculated for the claim. The article below states all that you need to know about room rent in health insurance.

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  1. Room rent capping in health insurance
  2. ‘No Room Rent Capping’ in health insurance
  3. Need for room rent capping in health insurance
  4. Why does room rent affect health insurance

Room rent capping means that a certain percentage of the room rent during hospitalization will be paid by the insurance company. If an insured person needs to be hospitalised, they have to pay all the medical bills as well as the room rent, which is part of the hospital bill. Room rent capping refers to a condition of the policy where the insurance company pays the room rent up to a certain limit.

Suppose a person has taken health insurance of Rs 3 lakhs and the policy bond will cover up to 1% of the sum insured on the room rent. According to this condition, the insurance company will cover the room rented up to Rs 3,000 per day. However, some insurance companies may even cover more than 1% of the sum insured. In myUpchar Bima Plus, 1% of the sum insured is covered for room rent.

In case of ICU admission, the insurance company can give double cover. That is, where up to 1% of the sum-insured was being covered in common rooms, in ICU rooms, instead of 1, 2% or more can be covered.

What will happen if the room rent is outside the specified limit in the policy bond? In such cases, the insured will have to pay the additional charges out of their own pocket. How much will be covered under room rent camping should be clarified at the time of taking the health insurance policy.

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You may have heard the term ‘no room capping’. Simply put, no room capping means that ther is no limit on the room rent. It can go up to the sum insured, which means if the room rent in the hospital is equal to or less than the sum insured amount, the insurance company will cover it. So, whether the room is Rs 2,000 or 20,000 per day, you can choose the room as per your wish, without worrying about the rent, provided it is within the sum-insured amount.

There is also another method of capping room rent, in which the insurance company will make it clear to you that it will only cover the rent for a certain room. You know that there are many types of rooms in a hospital, such as personal wards (in which only one person stays), semi-sharing wards (in which there is an arrangement for 2 patients to stay) and sharing wards (in which 4 to 6 patients can be admitted). If sharing ward is covered in your health insurance policy, then you can get admitted to that type of room without worrying about its rent. It is also worth noting here that even if the rent of a private room or private ward in another hospital is less than the semi-sharing of another hospital, the insurance company will not pay you the rent for the private ward.

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Usually, some general preparations and necessary tests are required before a surgery. The patient is required to be admitted a day before so that the doctor can perform the necessary tests and health checks to determine whether they are ready for that surgery or not. There are also some surgeries or operations, after which the patient needs to stay in the hospital for several days, during which the patient is monitored. After this, when it is time to be discharged, the relevant medical bills are handed over to you.

If capping is imposed on the room rent in health insurance, then the insurance company will cover the room rent to a certain extent. If there is no capping on the room rent in the policy, then you do not need to worry about the room rent as the insurance company pays the full rent under the terms and conditions. Either way, your financial problems will be reduced. That is why people taking health insurance should understand conditions like capping thoroughly before opting for the policy.

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There are often a variety of rooms available when being hospitalized in India. These include General Ward, Semi-Private (AC/Non AC), Private (AC/Non AC), Deluxe and Super Deluxe, in addition to the above-mentioned rooms/wards. Not only this, these rooms have facilities like fridge, air conditioning, television, sofa, geyser, etc. The charges for other facilities may also increase as the room rent does. This could have a serious impact on your final hospital bill and become quite a burden if you have to pay it out of your own pocket.

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