What are Pre & Post Hospitalisation Expenses in Health Insurance?

Some of these pre-hospitalisation expenses will include:

1. Different diagnostic tests like blood tests, MRIs, or X-rays.
2. Doctor consultations, second opinions, or expert opinions.
3. Routine checkups and evaluations are necessary for your treatment ahead.
4. Medications or certain medical tactics are prescribed to manage any symptoms or prepare for surgery/further treatment.

Usually, most health insurance policies cover pre-hospitalisation expenses for up to 30-60 days (before the hospital admission date). However, note that this timeline can vary from insurer to insurer.

What Does Post-Hospitalisation Expense Consist of?

This refers to the later/recovery phase. Post-hospitalisation involves a series of follow-ups, treatments, and additional costs even after you have been discharged from the hospital. The expenses incurred during this phase are referred to as post-hospitalisation costs. Some of these include:

1. Medicines and treatments are prescribed after discharge to manage your condition better.
2. Follow-up doctor consultations to monitor your recovery progress.
3. Diagnostic tests to ensure that the treatment has worked and is a success.
4. Any necessary physiotherapy or rehabilitation sessions.

Speaking of coverage data, most insurance policies usually cover post-hospitalisation expenses for 60-90 days right after hospital discharge. However, make sure you take a look at the policy document to know the exact duration. It can vary from insurer to insurer.

How Do Pre-and-Post Hospitalisation Benefits Work in a Mediclaim Policy?

Pre and post-hospitalisation expenses are reimbursed or covered by the insurer only if they are related to the same condition for which you were hospitalised. In simple terms, by covering the entire treatment cycle, these benefits make sure that you don't face any surprising out-of-pocket expenses during critical phases.

Let's say,

1. You underwent surgery for a ligament tear. The MRI scan done before admission and physiotherapy after discharge would both qualify for reimbursement.
2. However, unrelated expenses, like routine checkups or unrelated tests, will not be covered.

To claim these expenses, you will have to submit all the supporting documents. This will include doctor prescriptions, medical bills, and diagnostic reports within the insurer’s specified time frame.

How to Choose the Right Mediclaim Policy?

If you want solid health coverage, always go for a plan that covers pre and post hospitalisation expenses with enough coverage duration. Although comprehensive health insurance policies often include these features as a part of their standard offering, it is always good to double-check.

Additionally, some points to keep in mind while investing in a mediclaim policy include:

1. Claim Limits
   Some policies may have a cap on the amount reimbursed for pre and post hospitalisation expenses. Make sure you don’t make an impulsive decision and go through the terms and conditions.
2. Documentation
   To ensure a smooth claim process, proper bills, reports, and prescriptions are highly important. Hence, keep all medical reports intact.
3. Policy Terms
   The coverage duration and inclusions can widely vary between insurers. Ensure that you pick a certain policy that meets your needs (both medically and financially) and offers sufficient coverage.

Wrap Up

Health insurances is not just limited to covering the hospital costs but the entire treatment journey. And with the right policy, you can truly focus on what matters, instead of juggling between financial as well as physical burden. Having a health insurance plan means you leave all the financial worries to your insurer. However, make sure your plan offers comprehensive coverage. If in doubt, start comparing different policies.

To make the process easier, platforms like Jio Insurance Broking offer a hassle-free way to evaluate your options. You can compare multiple plans, benefits, premiums, coverage, and costs all in one place. This ensures you get to select the right policy that aligns with your medical as well as financial needs!

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