Loading article content...
A health insurance plan acts as a financial shield when medical emergencies strike. In tough times, it protects your hard-earned savings by paying for most of your healthcare costs. Going well beyond basic hospital stays and medical treatments, a well-rounded policy also covers the costs you face right before and after your hospital visit. Read on to discover why having pre- and post-hospitalisation coverage is so essential.
What are the benefits of Pre- and Post-Hospitalisation Coverage?
Many people think that a health insurance policy or a family mediclaim plan only kicks in once you are actually admitted to a hospital bed. Because of this common misunderstanding, many people miss out on the full value of their coverage. In this quick guide, we will break down exactly what pre- and post-hospitalisation coverages are and why you definitely want them in your plan.
Think about how a typical illness plays out. If you start feeling unwell or notice something isn't right, your first step is usually to visit your regular doctor. They examine you and give you some medicine to help you feel better. But what happens if you finish the medicine and still feel sick? At that point, your doctor will likely tell you it's time to go to the hospital for more detailed tests and treatment.
This entire journey comes with two distinct sets of bills: the ones from before you check into the hospital, and the ones from after you get discharged. Let’s look at the difference between the two:
Pre-Hospitalisation Expenses
Expenses that are incurred before you get admitted to the hospital for further treatment are known as pre-hospitalisation expenses. Investigation tests, routine medication, etc., are pre-hospitalisation expenses covered by a health insurance policy.
Pre-hospitalisation expenses incurred within 30 days before hospitalisation are admissible for reimbursement under the policy.
Post-Hospitalisation Expenses
Medical expenses that are incurred after you get discharged from the hospital are known as post-hospitalisation expenses. Doctor's consultation, diagnostic tests, medication, etc., are considered post-hospitalisation expenses covered under a policy.
Post-hospitalisation expenses incurred within 60 days of discharge from the hospital are admissible for reimbursement under the policy.
How to Claim Pre- and Post-Hospitalisation Expenses?
Filing a claim for medical costs incurred before and after a hospital stay is a straightforward process. Here is a step-by-step guide on how to do it with most health insurance providers:
Step 1: Notify Your Insurance Company
As soon as you are admitted to the hospital (or even before, if it is a planned surgery), let your insurance company know. You can usually do this by calling their customer care helpline, using their mobile app, or visiting the insurance desk at the hospital.
- Pre-hospitalisation timeline: Most policies allow you to claim expenses incurred 30 to 60 days before you were admitted.
- Post-hospitalisation timeline: You can generally claim recovery expenses incurred within 45 to 90 days after your discharge date, depending on your specific policy.
Step 2: Gather and Submit Your Documents
Next, you will need to fill out a claim form and attach all original medical records and bills. Make sure you keep every single receipt organised.
- For Pre-Hospitalisation Claims: Gather the original doctor's prescriptions, pharmacy bills, diagnostic test reports (like blood tests or scans), and ambulance receipts that led to your hospital stay.
- For Post-Hospitalisation Claims: Keep your official hospital discharge summary, follow-up prescriptions, new medical test results, bills for recovery medicines, and physiotherapy or alternative treatment charges.
Step 3: Document Verification
Once you submit the paperwork, the insurance company's medical team will review your bills. They will verify that the tests, consultations, and medicines you are claiming are directly related to the specific illness or injury you were hospitalised for.
Step 4: Claim Settlement
After your documents are verified and approved, the claim is settled in one of two ways:
- Reimbursement Claim: If you paid these medical bills out of your own pocket, the approved amount will be transferred directly back into your bank account.
- Cashless Claim: If you are using a network hospital that offers this feature, the insurer may settle these specific expenses directly with the hospital's billing desk on your behalf.
Reasons to Buy Insurance with Pre- and Post-Hospitalisation Coverage
Comprehensive health insurance plans should cover pre- and post-hospitalisation expenses. Read the five reasons to buy insurance withpre-e and post-hospitalisation coverage. Pre- and post-hospitalisation expenses will be reimbursed, reducing your additional financial burden.
With this cover, you can carry out your treatment without worrying about your medical expenses.
It will help you face any unexpected medical emergency that can arise at any time.
Your savings will not be drained, and you can keep them for your family's future while taking good care of your health.
The Takeaway
Life is completely unpredictable. One day, everything is smooth sailing, and the next, you are dealing with a sudden curveball. Between stressful routines, poor eating habits, and rising pollution levels, anyone can face a sudden medical emergency.
But you don’t have to handle it alone. Care Health Insurance is here to back you up with comprehensive plans that feature built-in pre- and post-hospitalisation coverage. This means we don't just pay for your hospital bed; we also cover the medical bills that pile up before you're admitted and the recovery costs after you come home. With our plans, including family floater options that cover your entire household under a single shield, you can focus entirely on getting better instead of stressing over heavy medical bills.
Disclaimer: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.
