Room rent in health insurance is the maximum amount of hospital room charges that are covered under the insurance policy. While there is no standard limit in insurance, the room rent limit may vary from one plan to another.

The exact amount of room rent is largely dependent on the hospital and the type of room chosen by the insured. For example, the room rent for a private/single room may be higher than that for a twin-sharing room.

Thus, if an individual opts for a room with a rent higher than the room rent limit, he will have to bear the extra charges from his pocket. For example, if the room rent limit of a health policy is ₹2500 per day and you choose a room with rent of ₹3000 per day, you will have to bear the extra room charges (₹500 per day) from your pocket.

Impacts the Choice of Hospital Room

The health insurance room rent limit impacts the choice of your hospital room. Based on the rent limit, you may have to choose a shared, deluxe or private room. Thus, the rent limit determines the level of your comfort and may also restrict your choice. For example, if the room rent limit is ₹3000, you may have to choose a room with rent up to ₹3000 only, as any excess charge will have to be paid by you.

May Increase Out-of-Pocket Expenses

Since the room rent is limited to a specific amount, any excess charges incurred will be excluded from the insurance coverage. Therefore, if you choose a room with higher rent, it may lead to out-of-pocket expenses. Thus, it is wiser to choose a room within the limits specified.

Affects the Claim Amount

The room rent is a crucial part of your hospital expenditure and exceeding the room rent limit can affect the overall claim amount to be paid. In case of excess room rent, the insurer may proportionately reduce the claim amount, as all the medical services are linked to your room category.

Thus, it is evident that TATA AIG’s health policy allows you to choose hospital rooms without any sub-limits and capping with some of its insurance plans. Even the insurance plans with a capping allow you to choose a single private room category, ensuring you can be comfortable and get the desired privacy during hospitalisation.

If you want to opt for a higher category of room than the one mentioned in the policy, you can opt for the room eligibility modification rider. It is an add-on that allows you to increase the room rent limit and bring it under the insurance blanket. By paying a nominal premium, you can enhance the room rent limit and enjoy the added financial benefits.

Also Read: Add-On Covers: Comprehensive Guide

Here are some types of room rent limits in health insurance that you must be aware of

Hospital Type

It is usually observed that private hospitals charge a higher room rent than government hospitals. Thus, if you decide to get treated in a private hospital, the room charges will be higher.

Type of Room

Hospitals offer various categories of rooms, such as private, semi-private, deluxe, suite, general, etc. Depending on the type of room that you select, the rent may be high or low. For example, the rent for a private room will be higher than that for a semi-private or general category room.

City Location

Metropolitan and tier-1 cities have a high cost of living. Thus, the hospital room rent in such cities is more than in tier-2 and tier-3 cities.

Amenities Provided

Hospital rooms that offer personalised amenities and services are likely to charge a higher room rent than others. Thus, when choosing a hospital room, opt for amenities and services that are necessary to avoid exceeding the rent limit in your insurance plan.

While the room rent limit may restrict your choice of room during hospitalisation, here are some ways to navigate the limit. These tips can help you reduce the impact of the room rent limit on your overall claim.

Choose the Right Insurance Policy

Getting the right health policy can be an effective way to manage the room rent limitation. When you set out to buy health insurance, choose a plan that has a higher rent limit. The choice of the plan can be made based on the insurance zone you fall into or the city tier you live in.

For example, hospital room rent is higher in Zone A and Tier 1 cities. So, if you fall into any of these categories, it is better to choose a plan with a higher room rent limit to match the hospital room rent in your city.

Understand the Policy Terms for Room Rent

Insurance plans have different terms regarding hospital room rent. Some plans may have a percentage-based room rent limit, while others may have a fixed amount. Depending on the policy term, you can make the most appropriate choice.

For example, if your room rent is a percentage of the sum insured, you can opt for a higher sum insured and increase the room rent limit.

Consider Add-On Riders

Many insurance plans allow you to get rid of the room rent limit with the help of an add-on rider. By paying an additional premium amount, you can waive the room rent limit and select a room category based on your preference and comfort.

Be Aware of the Proportionate Deductions

A primary risk associated with exceeding the room rent limit is the proportionate deduction of medical expenses from the overall claim amount. For example, if the room rent is ₹3000 and you select a room worth ₹4000, the percentage difference is 25% (4000-3000=1000) (1000/4000*100). While settling the claim, the insurance company will deduct 25% of the amount and pay the remaining.

The room rent limit in health insurance is a two-sided coin with advantages and disadvantages. It helps you to make thoughtful decisions when it comes to the hospital room, saving you from spending a lot.

While many insurers cap the room rent to a basic category, TATA AIG’s medical health insurance stands out from the rest. Some of its plans do not have any cap or sub-limit on the hospital room rent, while the others allow you to opt for a single private room, ensuring comfort and privacy during recovery.

Whether you choose health insurance plans for a family or individual, TATA AIG offers you some of the most efficient features, such as premium affordability, lifelong renewability, cashless hospitalisation and a lot more.

Find out more about TATA AIG health policy and room rent by connecting with the 24.7 customer support team.