Most people fear ending up in a sterile room with several beeping machines right next to them. Suddenly, they find themselves in the Intensive Care Unit (ICU).
Their next concern is the estimated cost of the bill. Well, it's not just you! Many patients share this common financial concern. This blog covers information about a health insurance policy that covers ICU charges and the different types of coverage offered.
Types of Room Rent Coverage
Lets break down the rent charges for ICU room in India:
Health care insurance with no cap on room rent
Health insurance with a sub-limit and co-payment of room rent
Health insurance with coverage for specific room types
Health insurance with riders for no capping on room rent
It is one of the most desirable coverage offerings, as it allows you to pick any room based on your preference without worrying about the cost associated with it.
This coverage includes a cap on the amount of room rent and a co-payment clause. This implies that the company will only cover a specified amount, and you are responsible for contributing the remaining amount.
Some insurance policies clearly mention the room types they cover under their policy. However, if you choose a room that does not fall under the policy's coverage, you will be responsible for paying the entire cost.
Many insurance policies place a cap on the room rent charges; in this case, you can pay a premium to remove the cap.
Average Daily ICU Charges in Private Hospitals
The intensive care unit (ICU) of private hospitals is used to treat critical patients who have life-threatening diseases; hence, treatment in an ICU is considered one of the most expensive parts of hospitalisation.
Moreover, ICUs contain high-tech life-saving facilities and basic equipment like bed charges, nursing care, doctor visits, common ICU medications such as emergency drugs, sedatives, antibiotics, and painkillers; cardiac monitors; ventilators; infusion pumps; oxygen cylinders; and consumables like syringes, gloves, catheters, and IV fluids, which contribute to the high cost of medical care.
In India, the ICU cost per day in a private hospital varies based on the treatment the patient is to receive. However, generally, the amount for ICU charges per day in a private hospital ranges from Rs 15,000 to Rs 30,000.
Insurance Coverage for ICU
Most insurance companies in India cover ICU charges in their insurance policies; however, the extent of coverage may differ based on the insurance provider.
Inpatient treatment
Room rent coverage
Pre-existing conditions
Critical illness
Generally covers expenses like basic medications administered during your stay, medical procedures, X-rays, blood tests, monitoring charges, etc.
When selecting a policy, ensure that you carefully evaluate the coverage offering for each policy. Some policies have room rent coverage, and if the ICU charges exceed that, the remaining charges have to be paid by the policyholder. There are several premium plans available that have no cap on the room rent, meaning the entire amount is covered under the insurance policy.
Generally, most insurance companies have a waiting period of 1 to 3 years for individuals with pre-existing conditions. If you have a pre-existing condition and have not completed your waiting period, you must pay for the expenses incurred during your ICU stay.
If you’re suffering from a critical illness that requires a prolonged stay in the ICU, you should consider looking for a critical illness insurance policy that will provide lump-sum compensation upon diagnosis. The amount can then be used to pay for related expenditures.
Conclusion
Dealing with an ICU visit is stressful enough without the added burden of skyrocketing medical bills. Understanding how ICU charges are structured and what your health insurance covers can make a huge difference during such critical moments. Whether it's the type of room you're eligible for or waiting periods for pre-existing conditions, every detail counts when you're trying to avoid unexpected out-of-pocket expenses.
Before you or your loved ones face an emergency, it’s essential to find a plan that provides comprehensive coverage. Coverfox is a fantastic starting point if you're searching for a health insurance plan that covers intensive care unit expenses! Moreover, Coverfox is an IRDAI-approved platform that offers a user-friendly interface, allowing you to compare various policies from leading insurers and providing expert guidance on the most suitable policy for your needs!
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Frequently Asked Questions
Does health insurance cover ICU charges?
While the coverage offered by insurance companies varies, most of them do cover intensive care unit (ICU) charges under their policies. Reviewing the policy’s terms and conditions before purchasing one is a wise decision to choose the perfect policy for your needs.
What is room rent capping?
Room rent cap refers to the maximum amount an insurer will pay the hospital per day for a stay in a hospital ICU room. For example, if your policy has a room rent cap of Rs 4000 per day, the insurer will only pay that amount, and the policyholder must pay the difference if the room costs more. Hence, choose your policies wisely!
Does group health insurance cover ICU charges?
Yes, most insurance companies do cover ICU charges under group health insurance. While some policies come with room rent limits, others may have flexible options. Reading the terms and conditions properly helps make a wise decision when choosing a policy!
