ICU Charges in India: Daily Cost, Factors & Insurance

Posted on: Nov 21, 2024 | 3 mins | Written by: HDFC ERGO Team

ICU Charges in India: Daily Cost, Factors & Insurance

An Incentive Care Unit (ICU) stay is one of the most financially demanding aspects of healthcare, often leaving individuals unprepared for the substantial costs involved. ICU charges can consume 20% to 30% of total hospitalisation expense. For families facing medical emergencies, this sudden financial burden can be overwhelming. However, you can cover ICU bills and afford advanced healthcare facilities with suitable health insurance. This blog explores what ICU care involves, factors influencing costs, average rates, and how proper health insurance planning can shield you in such critical times.

What is an ICU?

ICU or Intensive Care Unit is an ultra-sterile hospital ward with specilaised healthcare providers, nurses, hi-tech equipment, and exceptional care standards. It is designed to handle critical and potentially life-threatening cases.

Some scenarios include traumatic accidents, brain damage, cardio-pulmonary arrest, post-complicated surgery, sepsis, stroke, acute organ failure, respiratory blockage, rapidly declining health, repeated seizures, pulse rate below 40, cancer-related care, and a comatose condition.

Patients’ vital organs, like heart rate, blood pressure, blood oxygen level, urinary output, respiratory rate, and temperature, are monitored by healthcare professionals round-the-clock.

ICU is also referred to as Critical Care Unit, Intensive Treatment Unit, Intensive Therapy Unit, Neonatal Intensive Care Unit (NICU), or Intensive Care Nursery.

Average Daily ICU Rates

ICU treatment is the most expensive part of hospitalisation, accounting for 20-30% of the total costs. In India, the average ICU charges in a private hospital can range between INR 15,000 and INR 30,000 per day.

The cost generally covers ICU bed charges, nursing care, doctor visits, common ICU medications such as emergency drugs, sedatives, antibiotics, and painkillers, basic medical equipment like cardiac monitors, ventilators, infusion pumps, oxygen cylinders, consumables like syringes, gloves, catheters, IV fluids, round-the-clock monitoring, and routine investigations.

Factors Influencing Cost

ICU charges are influenced by clinical, operational, and infrastructural elements, such as:

1. Length of ICU Stay

The single biggest factor influencing the overall cost is the duration, because the longer a patient stays, the more resources they consume, like staff, monitoring machinery, and general overheads for upkeep and maintenance.

2. Severity of Illness and Comorbidities

Critically ill conditions (cancer, liver damage, or sepsis), complex cases, or people with underlying health conditions, like heart failure, kidney disease, or diabetes, typically require prolonged and more intensive care. Aggressive treatments, urgent surgeries, and diagnostic frequency further drive costs upward.

3. Type and Level of Support Required

Costs shoot up when patients need life-support interventions, like mechanical ventilation, high-flow oxygen therapy, non-invasive ventilation, ECMO support, and continuous renal replacement therapy or dialysis.

These support treatments increase the costs.

4. Medical Consumables and Drugs

ICU patients use a high volume of single-use medical supplies, like syringes, gloves, IV sets, catheters, and disinfectants. They also need a wide range of drugs in the form of antibiotics, antivirals, sedatives, and emergency medications. These costs fluctuate based on the treatment plan and patient response.

5. Hospital Infrastructural Maintenance

Premium private hospitals provide high-end ICU facilities with imported ventilators, infusion pumps, beds, patient monitors, and additional care provisions. The cost of maintaining and replacing these tools, electricity, heating, ventilation, and air conditioning (HVAC systems), and sterilisation units is factored into daily ICU rates.

6. Type and Location of Healthcare Facility

ICU charges widely differ between public, private, and charitable hospitals. Government-affiliated hospitals often offer lower or subsidised rates, while private hospitals typically charge higher fees due to advanced infrastructure. Specialised hospitals may charge higher rates.

In addition, ICU bed charges in metro cities might be higher than in tier II or tier III cities and towns.

Importance of Insurance Coverage for ICU Stays

Health insurance coverage financially protects you during emergencies and critical illnesses, ensuring your life savings stay intact and you don’t resort to borrowing at a high interest rate.

Similarly, health insurance for senior citizens with critical illness coverage gives your parents access to the entire sum insured upon the diagnosis of a critical illness that may require an ICU stay.

A good health insurance gives access to premium and well-equipped hospitals that have readily available advanced ICU facilities.

Family health insurance plans are particularly valuable in India’s joint family system, where multiple generations live together. These plans cover all family members under a single plan.

Why is HDFC ERGO a Good Choice for ICU Coverage?

When it comes to handling the high cost of intensive care, HDFC ERGO’s health insurance plans offer comprehensive and dependable benefits, such as:

1. No Limits on ICU Rent

HDFC ERGO’s specific health insurance plans, like Optima Secure, do not impose any cap on the sum insured on ICU charges. This means even if a patient is admitted to a high-end ICU room, they are covered without any prorated deductions. This plan also comes with zero co-payment, which means the insurer will cover 100% of admissible ICU expenses.

2. Huge Network of Cashless Hospitals

HDFC ERGO has a huge network of 15000+ cashless healthcare facilities across India. This is crucial in situations where immediate admission is required in a special facility.

3. Rapid Claim Settlement Process

To ensure you get the proper financial assistance at the right time, HDFC ERGO ensures seamless claim settlement with a record of settling one claim every three minutes.

HDFC ERGO also demonstrates a high claim settlement ratio (CSR) of around 98%, which is well above the industry average of 90%.

4. Secure Benefits that Enhance ICU Readiness

HDFC ERGO offers secure benefits on its customised plans that enhance the ICU coverage layer. These include:

• Optima Secure:

Doubles the coverage from day 1.

• Optima Lite:

Instant addition of 100% of the base sum insured upon partial or complete utilisation of the amount.

• Optima Restore:

Get 100% of your cover restored after the first claim.

• Optima Secure Global:

Covers emergency ICU stays overseas.

5. Floater Plans

Family health insurance ensures that any family member requiring ICU care is covered without policy limitations for each individual. Furthermore, HDFC ERGO’s critical illness plan offers coverage for 51 critical illnesses where an ICU stay is a common occurrence. It is available as both standalone policies and add-on riders.

6. Tax Benefits

All HDFC ERGO health insurance plans are eligible for tax deductions of up to INR 100,000 under Section 80D of the Income Tax Act. It includes INR 25,000 for individuals below 60 years and INR 50,000 for premiums paid on parents’ health insurance.

Managing Unexpected Bills

Some practical ways to prepare for and manage ICU expenses are:

1. Choose a comprehensive health insurance policy with a higher sum insured and critical illness coverage, especially if you have ailing parents and family members at home.

2. Learn about what your policy covers, waiting periods, sub-limits, mandatory deductibles, room rent restrictions, inclusions, and exclusions.

3. Maintain an emergency fund covering 3–6 months of expenses. It will help manage co-payments and costs beyond hospitalisations.

4. Choose hospitals that use structured or fixed cost methodology for calculating ICU stays.

5. Maintain detailed records of medical expenses for quick and seamless claim approval and settlement.

Conclusion

ICU charges cost a lot more than general wards or regular rooms in hospitals. A prolonged stay can mean a significant amount of money, leading to financial and emotional stress. Therefore, make sure you understand the cost involved, have an emergency fund ready, and choose a health insurance plan that covers ICU stays extensively.

Getting HDFC ERGO health insurance coverage will provide a financial cushion against expensive ICU bills and other medical costs.

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

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