Understand Sub-limits In Your Health Insurance Policy

Fwd: Beware Of Sub-limits In Your Health Insurance Policy

Understand Sub-limits In Your Health Insurance Policy Dear Mr.subhash wadhwa I hope you have some sort of health insurance policy(also called medical policy, hospitalization policy, etc). Do you know if your policy comes ‘with sub-limits’ or ‘without sub-limits’? What does ‘with sub-limits’ mean? This means that if you are hospitalized, the insurance company has set a limit of how much they would pay for room rent, ICU care, etc. Most of the times, the limit applies to ‘per day’ room rent which would be restricted to 1% or 2% of sum insured. What does it mean? Say, your sum insured is Rs 2,00,000, and your room rent is restricted to 2% of sum insured. This means that the insurance company would pay only Rs 4,000 (2% of Rs 2 lakhs) per day for room rent. So, if you opt for a room that costs Rs 5,000 per day and you stay 10 days at the hospital, the insurance company would pay only Rs 4000 per day, ie, Rs 40,000 totally and you have to pay the remaining (5000 – 4000) X 10 = Rs 10,000 yourself. Similarly, if there are sub-limits for other category of expenses, they also have to be calculated like this. Therefore, please go through your policy and find out what is the maximum limit you are allowed for various expense categories. Understand this BEFORE you get admitted so that when the hospital asks you which type of room you want, you know which one you should choose. The hospital would NOT tell you which room you are eligible for because they DO NOT know anything about the policy you have. There are policies that don’t have any sub limits. If you have one of these policies, then you don’t have such limits to think about. The insurance company would pay for hospitalization expenses up to sum insured in a year. The policies ‘with sub-limits’ costs less than the policies ‘without sub-limits’. If you don’t know what type of policy you have, please click here for help. If you don’t have any health insurance and would like to purchase one, click here. Thank you Sincerely Kalyani Narayanan

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