Health Finance

Pre & Post-hospitalization Expenses in Health Insurance

Besides hospitalization expenses, health insurance shall also cover expenses incurred after and before admission to the hospital. This is called the pre and post-hospitalization cover which covers the expenses for a specific period as mentioned in your policy schedule. Pre and post-hospitalization can lead to several visits and consultations that could impact your finances. So, to take care of that, the health insurance companies provide the pre and post-hospitalization cover. Using this you can get compensation for the amount incurred before and after the hospitalization. But you can file a claim under this cover only if it is related to the illness/injury for which you’re hospitalized. And the claim amount shall be paid only if the insurer accepts in-patient hospitalization expenses. Let’s read this page below and learn more about the pre and post-hospitalization cover.

What are Pre-hospitalization Expenses?

The insurance company shall cover the medical expenses incurred before admission to the hospital. These are pre-hospitalization expenses and include the following –

  • Doctor consultation fees
  • X-ray, CT scan, MRI, Angiography, Blood-Sugar test, etc.
  • Pharmacy expenses with doctor’s prescription

Mostly, the coverage period is a maximum of 60 days for pre-hospitalization expenses but it may vary from insurer to insurer.

What are Post-hospitalization Expenses?

Any expenses incurred after the discharge from the hospital and are related to the illness/injury for which you were hospitalized will be covered by the insurer. This will include –

  • Medical consultation
  • Medicine as prescribed by the doctor
  • Medical examination expenses if the same is advised by the doctor

Post-hospitalization expenses are covered up to 180 days after discharge from the hospital. However, the coverage period may vary from insurer to insurer.

Why is it Necessary to Have Pre & Post-hospitalization Cover in Health Insurance?

The following are the reasons that make pre and post-hospitalization cover necessary for you to have in your health insurance policy-

Wide Coverage

A health insurance policy is deemed complete when it has a pre and post-hospitalization cover. This will help you tackle the financial difficulties arising after the diagnosis of the disease or coverage during the recovery period. All health insurance plans might not provide this benefit, so read their terms and conditions before buying the plan.

Additional Coverage for Treatment

Pre and post-hospitalization expenses can be financially draining for you if the same is not covered in your insurance policy. So, with this cover, the company shall pay for the surgeries, dialysis, day-care treatment, etc. required after the discharge.

Easy Claim Procedure

You can file a pre and post-hospitalization easily by submitting the required documents to the insurer. And once the claim is approved, the insurer will transfer the claim amount to your linked bank account.
How to File a Claim for Pre and Post-hospitalization Expenses?

To file a claim in respect of pre and post-hospitalization, you need to intimate the insurer within the stipulated time, otherwise, the claim would be rejected on the grounds of non-compliance. For filing a claim, you need to submit the following documents –

  1. Original hospital bills
  2. Medical certificates
  3. Original prescriptions
  4. Discharge summary
  5. Medicine and drugs bills
  6. Other supporting documents as requested by the company

Upon receiving the above documents, the insurer will check the same to see whether they are related to the medical condition for which you are hospitalized. After verification, the company will pay you the claim amount as per the terms and conditions of your health insurance.