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HealAssist

Room-rent limits and proportionate deductions

Quick answer

Most health policies cap what they will pay per day for your room. Go above that cap and many insurers reduce every other charge — surgeon, theatre, nursing — by the same proportion. So a nicer room can cost far more than the room. HealAssist matches your room choice to your policy’s limit.

This is the most expensive misunderstanding in Indian health insurance, and almost nobody is told about it until the bill arrives.

Your policy sets a limit on how much it will pay per day for your hospital room. If you take a room that costs more than that limit, most insurers do not simply pay the limit and let you cover the difference. They reduce everything else in the claim — the surgeon’s fee, the operating theatre, nursing, investigations — by the same proportion that your room exceeded the cap. It is called a proportionate deduction.

What HealAssist does about it

Your HealAssistant reads your policy’s room-rent limit and matches your room choice to it before you are admitted. The goal is simple: keep you inside the limit, so the proportionate deduction never gets triggered in the first place. If you want a room above your limit anyway, you should hear what it will really cost you across the whole claim before you decide — not afterwards.

How to find out your limit

Ask your HealAssistant. Your room-rent limit is a term of your own insurance policy, and it varies from policy to policy — there is no room-rent screen in your HealAssist account, and any number quoted to you as "the usual limit" is a guess about somebody else’s policy. Your HealAssistant reads yours.

Room-rent questions

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