Knowledge Centre

Health Insurance Plans and Implications Of Room Rent Limit

What is Health Insurance?

Health insurance is a type of insurance which helps an insured person cover the cost of medical, healthcare and surgical expenses. A health insurance is also popularly known as mediclaim or medical insurance.

What is room rent limit?

Most health insurance policies provide a comprehensive coverage. Hence, it is important that when you choose a health insurance policy, you go with the one that offers maximum coverage.

The limit imposed on the coverage of boarding expenses or room rent in the hospital is called as room rent limit. In simpler terms, it is the maximum amount of per day room charges that you can claim in case you get admitted to a hospital.

Your entire claim for health insurance coverage depends on the room rent limit. Not only would it cap the coverage, but also doctor’s fee and treatment cost would be affected in case you go overboard.

Have you heard of sub limit?

Sub Limit is the limit to which an insurer will pay for claims that arise out of an associated medical expense. Hence, the expenses like the cost of medicine or surgery will be limited to an amount specified in the sub limit. So, let us say you have a medical coverage of two lakh but the doctor’s fee could be limited to only 2%. In such a scenario, the insurer will pay only INR 4000 even if the doctor’s fee was INR10000.

Sub limit can be on medicine cost, doctor’s fee, pre-hospitalization charges but the most common sub limit is the one applied on room rent. It is mostly limited to a maximum of 1.5% of the sum insured.

What happens when you exceed the sub – limit?

Exceeding your sub limit may have adverse implications on policy holder’s claim. Exceeding your sub limit may lead your insurer to reduce your sub limit for other expenses too.

While a policy with sub limit might come cheap, it is advisable to buy a health care plan that comes with no sub limits. You may need to pay a higher premium, but it results in fewer hassles in case of a medical emergency. HDFC ERGO provides numerous comprehensive health care plans that suit your budget and needs and at the same time provide a hassle free experience when you need it the most.

Additional benefit of health insurance

There is no question on the benefits of a medical insurance for you and your family. But besides providing a safety net it also lets you claim a deduction in your tax. As per section 80D of income tax act, you can claim as much as INR25000 per year for medical insurance premium instalments. Health insurance 80D limit is government’s way of promoting public to buy health insurance and safeguard themselves and their families against medical emergencies.

Disclaimer:The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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