Know the Difference between Network and Non-Network Hospital

HEALTH INSURANCE PLANS



In the present age, having a health insurance policy is the need of the hour. The right health insurance comes with numerous benefits. In addition to this, many health insurers such as Care Health Insurance(Formerly known as Religare Health Insurance) have tie-ups with hospitals that allow the insured to go for cashless treatment. The more there will be many network hospitals on the list, it will be easier for you to find one in your proximity. To lessen the burden of expenses, most health insurers assess profiles and negotiate with selected hospitals. With this, the selected hospital is partnered with the insurer and gets the name of ‘network hospital’. Let us discuss how network hospital and non-network hospitals affect the insured.

Network Hospital

Every health insurer ties-ups with hospitals where they appoint a network of hospitals for cashless hospitalisation. Through this, these hospitals get more patients who are connected to them through the network of the health insurer. The insured file claims against their medical bills, and the insurers bear the expenses on behalf of the insured. The insurer bears the expenses on behalf of the insured, as per the policy terms and conditions.

Let us explain you with an example. Suppose, Jyoti is admitted to a network hospital that is in her area. She has got treatment in the network hospital and has opted for cashless treatment. She is not supposed to pay the medical expenses from her pocket. She needs to present her health card to get admission in the hospital and submit the pre-authorisation form at the hospital’s insurance desk. If she has chosen for a health cover from Care Health Insurance; then, the company’s in-house team will help in this process. The company will raise a query if required and will process the claim after documents verification.

Non-Network Hospital

This type of hospital is not included in the panel of the health insurer. In case if you go to a non-network hospital, then you will have to bear the hospitalisation expenses from your pocket. The health insurer will check the documents and approve them. The amount is refunded to the patient within a few days. It is essential to know that hospitals with no cashless treatment have to go through the complete process, involving submission of bills and paperwork.

For better clarity, look at this example. Jyoti is admitted to a non-network hospital for treatment. The health insurer does not offer cashless treatment to her. In this case, she has to provide necessary documents to the insurer. It should only be an option in case of emergencies.

Conclusion

It is always a better idea to get treatment at a network hospital. In the event of pre-planned hospitalisation, you can speak to the company’s in-house team, in case you have a bought a policy from Care Health Insurance. The company has tie-up with more than 7900 network hospitals in India. In case of sudden hospitalisation, you must refer to the list of network hospitals where you can go for affordable treatment. You must keep the list handy with you for quick reference.

If you have opted for health insurance policy, then choosing cashless treatment at network hospital definitely makes sense. It is advisable to have a list of best cashless network hospitals that have tie-ups the health insurer. It is advisable to go for non-network hospitals only in case of an unavoidable situation or if treatment is not possible in a network hospital.