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06 Apr, 2022 by  Bhavna Khatri

i don't understand the concept of a single private ac room in terms of a health insurance policy. is it supposed to be the lowest category in a single room.? because sometimes hospitals say that they don't have the lowest category available so they shift you to next category of single room (no suite) available. will those expenses be pro rated while claim settlement? its not the patients fault if the room is not avaiable

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Yes it is supposed to be the lowest category amongst the single pvt AC rooms, to simply answer your question.


If you're moved to a bigger category you'll proportionately bear the expenses inspite of non availability.

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08 Apr, 2022
CEO, Insurance Samadhan

Dear Bhavna

It means basic single room .

You can go for higher category but you are also liable for higher charges whoch compsmy may refuse on probation basis .

Hope this clarifies

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08 Apr, 2022
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Dear Bhavna,


Hospitals have different type of rooms

General Ward

Shared Room

Single Pvt AC Room (Standard)

Single Pvt AC Room (Deluxe)

Suite


In many plans the limit for room is specified as Upto Single Pvt AC Room. If one reads the policy details carefully a single room (in most plans) would mean the most economical single pvt AC room or the cheapest single pvt AC room in the hospital.


Incase one uses a room of higher category then proportionate cost will have to be borne by the policy holder. Incase policy holder is not willing to share expenses towards higher category room then he/she can opt for a shared room.


There are plans available without room rent restrictions as well however they generally will have premium on higher side.


I hope your query is answered now.


Regards

Rohit Dhingra







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08 Apr, 2022
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Hi Bhavna khatri,

If you have policy saying single pvt room please go through the terms and conditions and check with your advisor is deluxe room covered or not.


Go for a plan which covers deluxe room you can PORT with all the benefits of continuity

If interested schedule a free appointment with me.


My suggestion: If you have a policy that is not clearly saying which pvt room is covered then it's better you choose sharing rooms so you don't have to spend anything because of room limit proportionate charges.


Eg of Room rent expenses

Dengue disease stay in hospital for 7 days

General ward - 70000

3 sharing room - 100000

2 sharing room - 130000

Single pvt room : 150000

Single pvt room deluxe : 200000

Suite room : 230000


Same treatment but cost changes according to the room you choose.


Hospital will tell just Rs1000 difference in Pvt room and deluxe room if that room is choosen by insured


Health insurance company will settle claim according to the highest room category and you have to incur the proportionate amount.


Hope you liked my detailed answer regarding to room rent limit and expenses .


Regards

Vikram Aralikatty, CFP





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