What are Pre-Post Hospitalization Expenses in Health Insurance?
Health insurance is an essential safeguard in case of unexpected medical emergencies. But, many people assume that health insurance plans only cover hospitalization or treatment costs. Actually, these days a health insurance also covers things like accidents, psychiatric support, maternity expenses, as well as pre and post hospitalization related expenses.
While hospitalization charges include things like room rent, nursing charges, medicines, oxygen, and other consumables during your hospital stay, but what is pre and post hospitalization expenses? Let’s take a look:
What are Pre Hospitalization Expenses?
These are any medical expenses that are incurred before being admitted to a hospital. These include the medical tests that are conducted to reach a diagnosis before admitting a patient to the hospital for treatment.
Examples include diagnostic tests, X-rays, CT scans, MRIs, angiograms, investigative procedures, medication, and more. Generally, any such expenses up to 30 days prior to the date of hospitalization are covered, but this may vary from insurer to insurer.
What are Post Hospitalization Expenses?
In most cases, treatment and recovery do not usually end immediately after leaving the hospital. Post hospitalization expenses are those costs that are incurred after the patient is discharged from the hospital.
This includes any follow-up treatments, medical consultation sessions, diagnostic tests, medication, etc. Usually, health insurance policies will cover these medical costs incurred between 45-90 days after being discharged from the hospital.
How to Claim Pre and Post Hospitalization Expenses?
Remember to make a claim for pre and post hospitalization expenses within the mentioned time period for each of these covers. The following stems should be considered:
- Step 1: Ensure that the claim for before and after hospitalization is for treatment for the same condition for which the patient was admitted.
- Step 2: Fill in the required claims from and attach your hospital bills and all relevant documents (such as confirmation of diagnosis. prescriptions, discharge summary, etc.) and share the same with your insurer and the TPA.
- Step 3: Remember to submit the claim within 45-90 days of hospitalization. (check with your Insurer about the timelines to file a claim).
- Step 4: Once the documents are submitted, the insurer will verify them and then, if they decide that the expenses were related to the same medical condition for which the patient was hospitalized, the claim will be accepted.
Benefits of Pre and Post Hospitalization Coverage
When you have a health insurance that covers pre and post hospitalization expenses, there are a number of benefits, such as:
- Less Financial Burden: Having these extra expenses covered with help to reduce your financial burden.
- Reduced Stress: When you have this coverage, you can focus on your treatment and recovery without worrying too much about your medical expenses.
- More Prepared for Medical Emergencies: In case of any unexpected medical emergency, even after hospitalization, you will be more prepared.
- Preserves Your Savings: It will ensure that your savings are not drained, while you still get the best care for your health.
Medical bills often go beyond what you need to pay for your hospitalization stay. When you need to be hospitalized (except in cases of accidents), hospitalized, you would have undergone several tests before this, and afterwards, you may require further tests, medication, or treatment. But, with the rising costs of medical care, these expenses can be very high and even end up exhausting your savings.
Thus, it is important that you look for a health insurance policy that provides coverage for pre hospitalization and post hospitalization expenses
FAQs about Pre & Post Hospitalization Expenses in Health Insurance
What expenses are covered by pre and post hospitalization?
These are medical expenses that go beyond your stay in the hospital. Pre-hospitalization expenses are incurred before you are admitted, and include diagnostic tests, investigative procedures, medication, and more. Post-hospitalization expenses are incurred after discharge and include follow-up tests, continuing treatments, etc.
Do you have to get a pre and post hospitalization cover separately?
For most comprehensive health insurance policies, these expenses are usually covered. Just check the policy documents. However, for some policies, they may need to be purchased separately as an add-on cover.
How do I claim post hospitalization expenses?
You can claim both pre and post hospitalization expenses for diagnostic charges, consulting fees and medicine costs by submitting the relevant medical bills and documents, such as doctor's certificate and discharge summary, to your insurer at the time of making a regular health insurance claim.
When are pre and post hospitalization claims not accepted?
There are some instances when pre-and post-hospitalization expenses will not be accepted such as:
- The claim was made after the mandated period (usually 45-90 days of hospitalization)
- The expenses were for a different treatment that the reason you were in the hospital
- The submitted bills or documents might be wrong, or some might be missing