What are Pre & Post Hospitalization Expenses?
Pre-hospitalization expenses are medical costs incurred by the insured before getting admitted to a hospital. Post-hospitalization expenses are medical costs incurred after discharge from the hospital. These are covered by most health insurers. Health insurance is mandatory in case of medical emergencies. During difficult situations, lots of insurance policies will help you to save your finances by paying most of your financial bills.
Having said that, medical bills are not only limited to hospitalization. Medical expenses also include in pre-hospitalization as well as post-hospitalization. A good health insurance plan provides financial coverage for expenses like pre-hospitalization tests and post-hospitalization treatments.
The pre-hospitalization as well as post-hospitalization coverage in health insurance is basically a policy inclusion which covers the expenses that are incurred after and before the hospitalization of the insured patient. A health insurance policy containing this type of coverage is known to be wide ranging because it provides financial coverage to select expenses before and after hospitalization along with providing coverage during hospitalization.
As already mentioned above, these expenses can consume all your savings if your health insurance policy does not have these facilities. Thus, pre and post hospitalization coverage acts as a protecting shield to your lifetime savings by providing financial support to pay all your medical bills during financial emergencies.
What are Pre Hospitalization Expenses?
- Medical bills that are incurred before getting admitted into a hospital is known as pre hospitalisation expenses. Most of the time, people prefer consulting to their family doctors if they feel sick. The doctor will suggest required scans and tests for proper diagnosis. If the outcome is severe, the doctor will suggest the patient to get admitted into hospital.
- In general, various medical tests that are conducted before admitting patients to the hospital such as CT scan, X-ray, blood sugar, angiography, and MRI which find out the medical condition of the patient. Expenses for these tests will be paid under pre hospitalisation coverage according to the terms and conditions of the plan.
- The majority of insurance companies provide pre-hospitalization cover for up to 30 days before the date of hospitalization. Having said that, this duration can vary from company to company. Note that insurance companies will provide coverage for the same illness for which the policyholder is admitted in the hospital.
What are Post Hospitalisation Expenses?
- The medical expenses paid after getting discharged from a hospital are known as post hospitalization expenses. When it comes to hospitalization, treatment does not end after getting discharged from a hospital. A patient needs to under post discharge care which comprises care and proper medication. This is where post hospitalization coverage comes to rescue.
- Post hospitalization coverage incurs the medical expenses required for the follow up treatment after a patient gets discharged from the hospital. The majority of health insurance companies incurs these costs between 45 to 90 days after the discharge date from the hospital.
How to Claim Pre Hospitalization and Post Hospitalization Expenses?
When it comes to claiming pre hospitalization and post hospitalization expenses, timing plays an important role. This is because insurance companies follow the strict timeframe for providing settlement of these types of claims. For instance, the claim application as well as document submission process for post hospitalization expenses has to be finished within the given timeframe after getting discharged from the hospital. If the policyholder fails to do so, the insurance company might reject the request on the grounds of non-compliance. Hence, it is important for the policyholders to know the duration for such claims and follow the rules for claim settlement.
You have to submit the following documents for verification purposes to file a claim:
- Original medical bills and receipts
- Medical certificates
- Discharge reports
- Original doctor’s prescriptions
- Medicine bills
- Other documents as requested by the insurance company
After the documents are turned in, the claim verification/validation process gets started. The insurer will determine whether the costs are connected to the same medical issue that led to the patient's admission or not. If the expenses are unrelated, the claim may be rejected. The claim amount will be paid out in accordance with the policy's terms and conditions after verification.
Benefits of Pre & Post Hospitalization Coverage
When you have a health insurance which pre and post hospitalization expenses coverage, there are various benefits. Some of them are mentioned below:
Pre & Post Hospitalization Coverage Benefits
- Superior Coverage: A health insurance policy has pre-hospitalization as well as post-hospitalization coverage which helps you face the financial challenges that may arise right from diagnosing the disease till its recovery. All health insurance plans will not be providing this coverage. Hence, it is important to go through policy inclusions as well as exclusions to know about the policy coverage before purchasing the plan.
- The Convenience of Network Hospitals: Insurance companies comprises a list of hospitals for your treatment. In these hospitals, you are free to select your preferred hospital from the given list according to your convenience. With this coverage, you can select a hospital in your area and settle your claim in a smooth way.
- Includes Treatment Cost: There are times when the cost of post-hospitalization treatment can be more expensive as compared to the initial hospitalization. Post-hospitalization insurance comprises the cost of the treatment cost of surgeries, day care treatment, and dialysis which reduce the financial burden.
Documents Required
The following are the documents which are required to be submitted:
- Original hospital bills
- Original prescriptions
- Medical certificates
- Medicine and drugs bills
- Discharge summary
- Other documents given by the insurance company
FAQs on Pre & Post Hospitalization Expenses
- What is usually covered under pre hospitalization expenses?
In a pre hospitalization cover, the insurance companies bear expenses for the tests before the patient gets admitted into the hospital such as CT scans, MRI, X-rays, and consultation free for physicians.
- How to claim post hospitalization expenses?
You can claim both pre and post hospitalization expenses for consulting fees, diagnostic charges, and medicine expenses by submitting the required documents like discharge summary and doctor’s certificate to your insurer while getting the health insurance.
- When are pre and post hospitalization claims not accepted?
Pre and post hospitalization claims will not be made if claim is not made after the mandated period or if you don’t submit the proper bills or documents.
- Do you have to get a pre and post hospitalization cover separately?
For the majority of the health insurance plans, these types of expenses are generally covered. It is advisable to check the policy documents. On the other hand, in case of the other policies, you need to purchase separate add on covers to get these facilities.
- Are ayurvedic treatments covered under post hospitalization?
Depending on the chosen insurance and the policy, some insurers might pay these costs and others would not. Please review the health insurance policy's provisions and exclusions to determine whether or not ayurvedic therapies are covered under post-hospitalization charges.
- Can I purchase pre-hospitalization and post hospitalization cover online?
Yes, you can purchase pre-hospitalization and post hospitalization cover online.
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