What is Room Rent Capping in Health Insurance?
Capping or a “cap” on something refers to its limit. Talking about the room rent capping in health insurance, it is the limit up to which your insurance company will bear the room rent. If you decide to stay in a hospital room that costs more than the cap, you will have to bear the additional money during the claim settlement.
The insurance company mentions the room rent cap in a health insurance policy document for your reference. It can either be a specific amount, for example, Rs. 15000, or in percentage, i.e. 3% of the sum insured. It can also be capped at a certain number for each day of hospitalization
It works on the principle of proportionate deductions. It is calculated as the percentage of room rent allowed upon actual room rent.
Proportionate Deductions = Room Rent Allowed / Actual Room Rent * 100
the percentage difference in the room rent limit and the actual room rent is 50%, his overall bill will also be affected by 50% for applicable items. He has to bear approximately Rs.300000 from his pocket excluding other deductions.
Non-associated expenses mean items like medicines as they are sold on MRP. Hence, no deductions. However, based on the room you select, other charges like doctor visits also vary. Due to this, the differential price structure is proportionately deducted.
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