A sudden illness requiring extensive hospitalisation and the rising medical costs in India can often leave you with a hefty financial burden.
But does that mean you should not seek medical support? No, you have a solution, and that is a health insurance policy covering pre- and post-hospitalisation expenses.
From doctor consultations and medicines to room rent and ambulance charges, health insurance with pre-post-hospitalisation expenses offers the necessary financial protection to save your finances. How? Let's find out.
What are Pre-Hospitalisation Expenses in Health Insurance?
Pre-hospitalisation expenses meaning in health insurance, refer to the medical expenses you pay for before hospital treatment begins. Let's look at an example to understand.
Mr Satish had a very high fever and a constant cough. He had to visit the doctor for a check-up but could not walk. So, he called for an ambulance to the hospital and had to undergo a list of medical tests to ensure an accurate diagnosis. He was in the hospital for a day. Finally, he was prescribed some medicines to treat his health condition.
All the expenses he incurred throughout this are called pre-hospitalisation expenses. The list includes -
In health insurance, the coverage for pre-hospitalisation expenses is available for a pre-determined period, usually a maximum of 30 days, before hospitalisation. However, this period can vary depending on the insurer you choose.
What are Post-Hospitalisation Expenses in Health Insurance?
Post-hospitalisation expenses in health insurance refer to the medical expenses you pay for after your hospital treatment is over for recovery. Let's continue Mr Satish's example to understand this better.
After completing his medical course for 3-5 days as advised, Mr Satish's fever was still very high. So, he scheduled a follow-up consultation with the doctor for further investigation. The doctor advised him to undergo another round of blood tests to detect the cause, and based on these reports, changed his medication.
Here, the post-hospitalisation medical expenses covered by a health insurance policy include -
In addition to these, depending on the medical condition, other inclusions under post-hospitalisation expenses covered in the health insurance plan include domiciliary treatment and assistance, physiotherapy, and other alternative out-of-hospital treatments if suggested by the doctor for recovery.
In health insurance, the coverage for post-hospitalisation expenses is available for a pre-determined period, usually a maximum of 30 days, before hospitalisation. However, this period can vary depending on the insurer you choose.
Benefits of Coverage for Pre- and Postthesepitalisation Expenses
Better Coverage
A health insurance plan that covers pre- and post-hospitalisation expenses offers a more extensive financial safety net that protects you from start to end.
Additional Financial Security
With coverage for these expenses, your out-of-pocket expenses are reduced to a bare minimum. This is because you get coverage not only for treatment expenses but also for costs you need to cover before and after the treatment.
Improved Accessibility to Health
A comprehensive health insurance plan ensures everyone has better access to the necessary medical support and assistance, regardless of their budget constraints.
Network Hospitals
Most health insurance providers that offer coverage for these expenses also have a network of authorised hospitals. These hospitals have a streamlined process for any pre-post hospitalisation claim and provide quality medical support.
Everything You Need to Know About Claims For Pre-Post Hospitalisation Expenses
To file a post- or pre-hospitalisation claim, you must remember these important points.
The time of filing the claim directly impacts the timeline of the claim settlement.
You must collect and submit all the required claim documents for pre-post hospitalisation expenses. The list includes -
A duly signed and filled claim form
All the original hospital bills
All doctor prescriptions (first and follow-up ones) Hospital discharge summary All medical certificates and reports Medicine bills Health insurance document Any other supporting documents for the incurred medical expenses
You can file two types of claims: reimbursement and cashless.
In a reimbursement claim, you need to pay all the medical bills and then get the applicable reimbursement.
In a cashless claim, your medical bills are settled directly between the insurer and the hospital. You can file a cashless claim at any hospital in India using the “Cashless Everywhere" facility.
To start the claim settlement process, your insurer verifies all the expenses incurred against the bills and documents you submitted. Then, they approve a claim amount based on your policy terms and limits.
You can only file a claim for pre-post-hospitalisation expenses for the same disease for which you got treatment at the hospital. No other expenses will be accepted.
How to Claim Pre- and Post-Hospitalisation Expenses with Reliance Health Insurance?
Step 1 - Inform us regarding the claim after hospitalisation by calling +91-22-4890-3009 or using our
Reliance Self-i App.
You can only file a claim for pre-hospitalisation expenses incurred anywhere within 30 days before the date of hospital admission.
You can only file a claim for pre-hospitalisation expenses incurred within 45 to 90 days from the date of discharge from the hospital.
Step 2 - `Next, you must submit a duly filled claim form along with supporting documents for your claim. The list includes
Pre-Hospitalisation Expenses: Original doctor prescriptions, medicine bills, diagnostic test reports, and ambulance fees.
Post-Hospitalisation Expenses: Original follow-up doctor prescriptions, additional medicine bills, new diagnostic test results, hospital discharge summary, alternative treatment charges, etc.
Step 3 - Once you have done this, wait for the insurer to verify your documents based on your coverage of pre-post hospitalisation expenses.
Step 4 - When approved, your claim will be settled in one of the following ways
Reimbursement Claim: Based on your specific policy terms, you will receive the claim settlement amount reimbursed in your bank account.
Cashless Claim: Your pre-and post-hospitalisation expenses will be settled directly with the hospital on your behalf by the insurer.
Factors Affecting Pre- and Post-Hospitalisation Expenses Coverage
Type of Policy
The choice of health insurance plan is an important factor that impacts the scope of coverage for pre- and post-hospitalisation expenses.
Waiting Period
Health insurance plans often have a pre-decided waiting period, after which you can file a claim for pre- and post-hospitalisation expenses. Thus, you must check individual policy waiting periods to make the right choice.
Policy Inclusion Limits
Depending on the policy type and inclusions, there might be some limitations regarding how much you can claim with your plan. Thus, you must assess your requirements and choose a plan that aligns with your needs.
Add-Ons
Many health insurance providers offer a range of add-ons to help you personalise your policy for specific needs. This ensures you get the necessary coverage for pre- and post-hospitalisation expenses, along with additional financial support.
Claim Process
Check the claim filing convenience offered by different insurers and choose the one that promises a quick and straightforward online process and 24/7 customer support.
Claim Settlement Ratio (CSR)
You must also check the insurer's claim settlement ratio. The higher the CSR, the faster and more efficient your claim settlement will be. Reliance General offers a 100% claim settlement ratio.
Secure Yourself with Reliance General Health Insurance
Understanding the role and importance of pre-and post-hospitalisation expenses allows you to choose the right health insurance policy for you and your family.
However, you must also learn about what you can claim under this coverage to reduce your financial burden during emergencies.
Reliance General offers a wide range of
health insurance plans that offer extensive coverage for pre-post hospitalisation expenses. Moreover, our 100% claim settlement ratio, ample customisation flexibility, a wide range of add-ons and a user-friendly website ensure maximum convenience and satisfaction.
Frequently Asked Questions
How do I increase my chances of successful claim settlement for Pre- and Post-Hospitalisation Expenses?
File a claim with the insurer on time.
Collect and submit all the necessary claim documents.
Provide accurate information and documents.
Keep a record of all the follow-up calls and messages with the insurance provider.
Review your policy document carefully to understand coverage, limits, eligibility, inclusions, and other details.
How to buy a health insurance plan from Reliance General Insurance?
Visit our
website > Explore Products > Health Insurance.
Add your details in the space provided and click on View Prices.
All the health insurance plans will be displayed on the screen. Read the specific coverage offered by each plan and choose the one that aligns with your needs.
On the next page, select a sum insured amount, add your details, and combine add-ons to get a premium quote.
If the quote is satisfactory, make the payment to buy your chosen plan.
How to choose the right health insurance plan?
Assess your needs and budget.
Review policy inclusions and exclusions.
Compare plans based on their scope of coverage.
Check customisation flexibility.
Assess waiting periods.
Do all health insurance plans cover Pre- and Post-Hospitalisation Expenses?
Most comprehensive health insurance plans cover pre- and post-hospitalisation expenses. However, you must check your policy document to ensure the scope of coverage meets your requirements.
Can I claim for pre-hospitalisation expenses as soon as I buy a health insurance plan?
No, you cannot file a pre-hospitalisation claim as soon as you buy a health insurance plan. For most plans, there is a pre-determined waiting period, usually for 30 days, after which you can file a claim. You can check the waiting period before buying any plan to make the right choice.