Lack of responsible living in millennial times has been a major cause behind the growing epidemic of dreadful diseases. Although the advancement of technology and science has brought in a ray of hope for survivors, not everyone is blessed with a platter of choices when it comes to tackling pre-hospitalization and post-hospitalization procedures. Expenses are often difficult to pay for, in terms of high-quality health care, which is where medical health insurance steps in and makes the process of hospitalization comparatively simpler.
Hospitalization is required for a person when there is no improvement in the condition of his or her health even after the consumption of prescribed medicines. On the other side, there are also expenses to be paid for even after a patient is discharged from the hospital.
There are several medical health insurance providers who have comprehensive policies which cover both pre and post hospitalization expenses. Let us understand the relevance of these two important sides of hospitalization.
These types of expenses refer to all the expenses that occur before a patient is moved to the hospital for an in-patient treatment. There are various expenditures which are covered under the health insurance policy:
- Medical tests
- Vaccinations and Injections
- Doctor’s/Medical practitioner fees
Under what cases are they covered?
As obviously known, to be included in this policy, it is mandatory that the patient is an inpatient at the hospital to undergo the treatment.
The insurance company is liable to pay only for those costs that directly relate to the patient’s illness or disease for which he or she is hospitalized for.
All health insurance policies include all the expenditure with the inclusion of diagnostic charges (All medical-related tests and X-RAYS). This also includes the consultation fees of the medical practitioner and various other costs exactly one month before being admitted into the hospital.
As clearly stated, these costs are incurred after the patient is released from the hospital. This is also sometimes termed as ‘Recuperation expenses’.
Under what cases are they covered?
This is very similar to the pre-hospitalization policy but with the exception of the expenditure being covered 30 to 60 days from the date of discharge from the hospital.
Under what cases are they not covered?
In the case of any routine medication, the person has to take, for example in the case of high blood pressure, will not be covered under the policy. This includes every other medication and illness for which the patient is not hospitalized for.
If the patient chooses any other method of treatment other than allopathy, for example, alternative therapies such as acupressure, acupuncture or naturopathy, they will not be covered under the medical health insurance.
Things to Remember!
It is to be noted that both pre and post hospitalization costs will be covered by the medical health insurance provider only if the following conditions are met:
- The insurer has accepted the claim for hospitalization costs and charges
- The expenditure has been incurred for the same sickness/wound/ailment for which the hospitalization was needed.
- The expenses have been incurred within the time limit asserted by the insurer:
- Pre-hospitalization time limit ranges between 30 to 60 days before hospitalization
- Post-hospitalization time limit ranges between 60 to 90 days after hospitalization
- The Hospitalization was for an inpatient treatment and not for a domiciliary hospitalization
The Bottom Line
There is a stipulation to declare these expenditures through your medical health insurance policy. These costs are payable for a particular policy-defined period. Both pre-hospitalization and post-hospitalization charges can be declared only after the settlement of the foremost hospitalization claim. The claim submission procedure for pre-hospitalization expenditures and post-hospitalization costs can be considered the same as reimbursement.
So, now that you are backed with the much-needed know-how of hospitalization expenses, you must take the right step when needed. Until then, stay covered!