Arova Investment Advisory

No Room Rent Capping and No Room Category Limit – All You Need To Know!!

What is Room Rent Capping?

Earlier most policies used to put a limit on Room Rent as 1% of the Sum Assured which means the room you can rent in a hospital cannot be more than 1% of the Sum Assured. For eg: If the policy value is Rs. 2 Lacs then you can rent a room with rent of Rs. 2000 and if the rent is higher you will have to pay the difference from your own pocket and also, the hospital bill will be settled pro-rata basis the room rent eligibility.

Imagine someone gets admitted to a hospital and gets a room with a rent of Rs. 5000 per day but his policy is only of Rs. 2 Lacs. Most earlier policies used to have a room rent capping of 1% of Sum Assured due to which this client will only get Rs. 2000 per day as room rent and additionally, all his bills would be settled pro-rata at 40% (Rs.2000/5000*100) leaving a big hole in his pocket.
This is where No Room Rent Capping is of huge benefit, where even in such a case, he will still get his bill settled as per the actual room rent and all his other hospitalization bills will be settled 100%. This is where No Room Rent Capping is a real benefit.

However, did you know that even with No Room Rent Capping, you can be at a disadvantage in many other cases. Imagine, someone has a policy of Rs. 5 Lacs in the same case with No Room Rent capping and is admitted for a treatment which might not cost him more than Rs. 1 Lac overall, can he go for the best room in the hospital? I am sure you are aware that all hospitals have rooms starting from Single private room to Deluxe to Super Deluxe to Luxury Rooms. This person cannot rent the best room despite no room rent capping because in most policies, there is a capping on Room Category where it is specified that the person can only book a Single Private Room. If he rents a room higher than Single Private Room, then he will have to bear the difference in the room rent and also the hospital bill will be settled pro rata.

So, while No Room Rent Capping is definitely a Real Benefit, you need to ensure there is no limit on the Room Category also. This helps you to customize your treatment and room category depending on what treatment you are seeking and helps you get the best treatment in the best possible way and with maximum comfort. This is very important for HNIs who want the best treatment possible with maximum comfort but end up buying a policy with No Room Rent Capping but a limit on Room Category.

So, go ahead and check if your Health Insurance has a Room Category Limit or not. If yes, then you may want to upgrade or port your existing policy to a policy with no Room Rent Capping and No Category Limit.

Domiciliary Treatment – A Saviour in Coronavirus Pandemic

The current pandemic of Coronavirus is the worst epidemic to hit mankind. We are all struggling to overcome this pandemic and have been affected by it physically, mentally and financially. Most importantly we feel helpless when we are not able to find a hospital bed for treating our family members affected by Coronavirus. Even if it drains us financially but a good health policy always saves us this making it an imperative part of our lives today. But what makes us completely helpless is when we are not able to secure the hospital bed for the affected member.

This is where a good health policy with Domiciliary Treatment comes into play.

What is Domiciliary Treatment?

Simply put it means treatment at home including setting up ICU bed if needed where a doctor is attending the patient along with nurse to monitor the patient’s health.

So what stops most people from going for Domiciliary Treatment?
Domiciliary Treatment is very expensive and in today’s world where there is a shortage of medical infrastructure, it has become all the more expensive.

So what’s the solution?

A good health policy with Domiciliary Treatment clause may be the way out. Domiciliary hospitalization is recommended in a situation where the policyholder is in such a state that he/she cannot stay in a hospital. The insured undergoes treatment at home in case the hospital room is not available. The insurer will compensate the policyholder for the medical expenses incurred during the policy term as per the advice of the doctor.

To avail of domiciliary hospitalization benefit, it is imperative for you to prove to the health insurance company that hospitalization is not possible and there is no other choice except for domiciliary treatment. Remember, that the insurer will only compensate the expenses upon satisfaction with the reason you gave to avail treatment at home. In case you chose yourself to not stay at the hospital and rather opt for treatment at home then you can be denied the claim.

5 Things to Know About Domiciliary Hospitalization Cover
1. Domiciliary hospitalization cover is not provided by every health insurance provider.
2. Domiciliary hospitalization is not a default coverage option and the insurer may ask you to pay an additional premium amount as per the coverage opted by you Some health insurance plans cover domiciliary hospitalization expenses up to the sum insured limit and offer a restricted coverage.
3. There is a waiting period criteria for domiciliary hospitalization and the illness for which domiciliary hospitalization treatment is taken Some policies only cover the allopathic domiciliary treatment costs.
4. Ayurveda or Homeopathic treatment availed at home for illness may not be covered by them.
5. Corona kavach coronavirus health insurance also covers domiciliary treatment costs if the treatment is suggested by a medical practitioner.

4 Things to Remember when Availing Domiciliary Hospitalization Benefit
1. Make sure that you go through the requirements given to check whether or not you are eligible to avail of domiciliary hospitalization benefit.
2. If you think you would need to avail domiciliary hospitalization cover in the future in case of an emergency, and find a plan that covers the benefit.
3. If your policy covers home treatment cost, remember to go through the policy inclusions and exclusions well in advance to avoid any last-minute regrets.
4. Make sure that you furnish all the necessary information when filing a claim for domiciliary hospitalization expenses

Bottom-line:

Any illness or an accident does not come with prior notice, and you cannot predict them. All you can do is stay cautious and remain financially prepared.

If you have a policy without domiciliary treatment, you may port the policy to a company which provides domiciliary treatment.

So, if you looking to buy or porting the existing one to a good health insurance policy with domiciliary treatment, you may connect with us and we will be more than happy to recommend and help you buy the best policy available.

Call 8550999631 to get the best advise on health insurance.