Room type Single AC Private room confusion and future claim issue Optima secure
I have taken HDFC Ergo Optima Secure new policy with no rent capping but there is specifically mentioned SA below 50L the room type would be single AC private room and for SA >50L the eligibility as actual.
Should I opt for such high SA 50L with much high premium or should I take 10L SA with room type capped to stand room. Please suggest and advice
Hi Bijan Deb,
For health insurance to be actually worthwhile, always opt for a fuss free cover with minimum restrictions and sub limits.
As mentioned earlier, all service charges are pegged to your room category, the same treatment in a general ward will cost different from that of a suite room. So understand and make a purchase.
To understand more, book a free consultation call
Dear Deb
Single AC private room will suffice for all practical purposes. But sometimes it will be a bottle neck. I will tell my experience. My father in law was admitted to a private hospital in Thiruvananthapuram due to stroke two years back (During Covid outbreak ). It was an emergency hospitalisation and admitted to ICU. After few days in ICU he was shifted to room. During that time only suite room was available and we have taken it. He was having a group policy with no capping on room rent and hence there was no issue. Discharged after two weeks. In such situations, Comprehensive health insurance policy without room cap will be helpful. After this experience, I have migrated my Care insurance policy with 20 Lakh cover(having single pvt. room eligibility upgradable to next level) to Care Advantage with Rs 50 Lakh cover without any room type /room rent capping with slight increase in premium.
If affordable (in the long term) go for policy without any capping. While comparing premium please check the difference in premium at the age of 45 years and 60 years where exponential increase will be visible.
There is an update to the policy terms and conditions which will make you happy. As of 21 Oct, HDFC Optima Secure has removed room cappings. So now all room types are included irrespective of your sum assured.
The latter is always better as you'll be able to make your plan comprehensive, room rent restriction is a major dampener as in a hospital all service charges are pegged to the room category.