Imagine you fall sick and choose a hospital room that costs ₹10,000 per day, but your health insurance policy has a room rent cap of only ₹5,000 (1% of your ₹5 lakh sum insured). You might think you just need to pay the extra ₹5,000 per day yourself, so it’s worth picking the nicer room.
However, here’s the catch: your insurer won't just charge you the difference for the room rent. They’ll apply that cap to many other charges during your stay—such as surgeon fees, consultant fees, tests, and diagnostics.
For example, if your surgery costs ₹50,000, your insurer will pay only half (₹25,000) because you chose a room that exceeded the rent limit. The rest comes out of your pocket.
This can mean a shockingly large bill after discharge, much higher than your simple plan of paying the extra room rent.
The best advice: avoid policies that have strict room rent caps. They may seem cheaper upfront but can leave you facing heavy out-of-pocket expenses later.
If you must stick with a policy with room rent limits, always choose a hospital room well within the allowed rent to avoid unexpected charges.
Making smart choices about room rent caps can save you stress, money, and surprises at a difficult time