Pre and Post Hospitalization Expenses in Health Insurance

A health insurance policy is your best friend especially in the case of healthcare contingencies. A comprehensive health insurance policy can safeguard your savings by paying your healthcare bills and also ensures that you will get the best treatment for your ailments. But, healthcare bills are not only constrained to hospitalization. Sometimes, you need to spend a hefty amount on pre-hospitalization and post-hospitalization purposes. Though most health insurance policies compensate for hospitalization expenses, some may also offer coverage for pre-and-post-hospitalization expenses.

Because of advanced treatment and medical inflation, these pre-and post-hospitalization expenses will deplete your hard-end savings if you are not properly covered with health insurance policies. Thus, before handpicking a health insurance policy, closely check whether your policy offers coverage for all pre-and post-hospitalization expenses or not.

What are Pre-hospitalization Expenses?

Pre-hospitalization expenses are expenses you need to spend for the treatment of your ailments before getting admitted to a hospital. An experienced and deft doctor will recommend a plethora of tests to understand your condition so that he can suggest the best line of treatment for your ailment/injury. Most health insurance policies cover charges incurred by an individual 30 days before his/her admission to any hospital, but it is not the same for all insurance companies. Pre-hospitalization expenses include some common to high-level tests like blood tests, urine tests, X-Rays, and so on.

Some insurance companies may also cover pre-hospitalization expenses for up to 60 days. But you should remember that your pre-hospitalization expenses should be relevant to the ailment/injury you need to be hospitalized for.

For the COVID-19 treatment procedure, pre-hospitalization expenses are RT-PCR, blood tests, and CT scan reports.  

What is a Post-hospitalization Expense?

Post-hospitalization is those medical expenses by a policyholder that he/she needs to spend after getting discharged from the hospital. Sometimes, the doctor may recommend more tests to analyze your progress or the speed of recovery. Most insurance companies offer post-hospitalization coverage for up to 60 days from the discharge date. Medical expenses related to acupuncture, naturopathy, etc. are not covered under post-hospitalization expenses. Post-hospitalization treatments cover the below-mentioned expenses.

• Medications and drugs
• Laboratory tests reports
• Therapies related to the condition (e.g. physiotherapy)
• Doctor’s consultation fees

Let’s understand more about pre-hospitalization and post-hospitalization expenses in the case of Mrs. Madhu Sengupta.

Mrs. Madhu Sengupta (58-years-old) lives in Kolkata with her family. Mrs. Sengupta was hospitalized for the treatment of dengue on 8th October 2021. But she had experienced some symptoms for 4-5 days before the hospitalization. In her case, the pre-hospitalization expenses could be the doctor’s fees, conducting all the tests, taking prescribed medications, etc. But after 5 days she was admitted to the hospital as her condition worsened. Hence, Mrs. Sengupta was admitted to an established hospital for the next seven days and was discharged on 15th October 2021. Once she got discharged from the hospital, she took medicines, checked with doctors, and even conducted some tests. These expenses are called post-hospitalization expenses.

Some exclusive health insurance policies offer this post-hospitalization coverage for up to 90 days. But, Corona Kavach policies offer post-hospitalization coverage for up to 30 days after discharge.

Reasons to buy Health Insurance with pre and post hospitalization coverage

• Extraordinary coverage
• Includes Treatment Cost
• The Convenience of Network Hospitals

Let’s find out some reasons why you should purchase a health policy with pre-and post-hospitalization coverage.

Extraordinary coverage

A health insurance policy that offers you pre-and post-hospitalization coverage will help you deal with all financial turbulence you may experience, from diagnosing the disease to recovery. Unfortunately, many health insurance policies may not offer this type of coverage. Thus, before committing anything, go through the policy inclusions and exclusions so that you can understand what is covered under your policy.

Includes Treatment Cost

Sometimes, the post-hospitalization treatment and care expenses may drain out your savings more quickly than initial hospitalization. Because a person may need to get admitted for one week for his disease/injury, but his/her post-treatment care may continue for several months. Post-hospitalization insurance compensates for the treatment cost for surgeries, dialysis, daycare treatment, etc. Thus, this type of coverage lessens your financial burden and encourages you to focus more on your treatment.

The Convenience of Network Hospitals

Once you choose a health insurance policy from an eminent insurer, the insurance company will embrace you with a list of hospitals for your treatment. You are free to choose a hospital at your convenience. You can choose a nearby hospital and settle your claim in a hassle-free way.

How to Claim Pre-and Post-hospitalization Expenses?

Pre-hospitalization claim

To raise the claim for your pre-hospitalization expenses, you must keep all your test receipts properly. You can ask your lab or test center to email all imperative documents and receipts so that you can store them safely. Now, by submitting all these receipts to your insurer or TPA, you can ask for a reimbursement.

Post-hospitalization claim

To raise your post-hospitalization expenses, you need the discharge summary as it mentioned every detail of your treatment, including the treatment procedure, follow-ups, and medications. For a reimbursement claim, initially, you need to bear all expenses; later, your insurance company will reimburse the expenses. Since this is separate from your regular hospitalization claim hence, you should file it distinctly. A post-hospitalization cover offers coverage for treatment and follow-ups for up to 60 days (in some cases, it may go up to 90 days). An insurer needs to submit everything within 7-15 days to the insurance company to initiate the reimbursement claim. After approving your claim, all your medical expenses will be paid off by the insurer.

In today’s unwholesome and stressful lifestyles, medical emergencies can hit any time. Thus, always choose a policy that offers coverage for pre-and post-hospitalization expenses. With this type of plan, you don’t need to spend a hefty amount on before and after hospitalization expenses. So, go through the policy properly, find out what is covered, and make your decision wisely.