• Pre-hospitilisation and Post-hospitilisation Expenses

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    Except for accidental injuries, hospitalisation for a medical condition does not happen all off a sudden. There is a period where symptoms start to appear and people visit doctors for consultation and diagnosis. The medical condition is established after a series of tests, and physicians recommend hospitalisation following this diagnosis.

    Similarly, medical treatment do not stop soon after a patient gets discharged from the hospital. There is a recovery period during which the patient must rest and get better. Frequent medical consultations are also part of this recovery period. Both cases involve various expenses that cannot be avoided. If not adequately covered, these expenses could drain out your savings.

    This is why coverage for pre-hospitalisation and post-hospitalisation expenses is an important factor that must be considered while buying health insurance.

    Pre-hospitalisation Expenses

    Expenses incurred before the actual date of hospitalisation are covered by most health insurance policies to a certain extent. A person’s medical condition can be established with a series of tests before inpatient treatment is recommended by a physician. These expenses typically include the following:

    • Expenses for medical tests
    • X-rays, scans, etc.
    • Consultation fees for physicians

    Insurers typically offer coverage for pre-hospitalisation medical expenses for up to 30 days prior to the date of hospitalisation. However, the exact duration of this coverage may vary from one insurer to another. There are some insurers in the market that provide coverage for up to 60 days. It comes down to your personal requirement as to how much duration is required for this coverage. It must noted that pre-hospitalisation expenses are covered only for the same condition for which the insured is hospitalised.

    Post-hospitalisation Expenses

    These are medical expenses incurred during the recovery period that follows hospitalisation. In most cases following an injury or illness, the patient must have adequate rest before starting with regular professional life activities. This recuperation time is extremely crucial in order to make a full recovery. Some of the expenses incurred during this period include the following:

    • Medicines and drugs
    • Laboratory reports
    • Therapies related to the condition (e.g. physiotherapy)
    • Consultation fees for physicians

    Post-hospitalisation expenses are typically covered for 60 days after discharge from the hospital. Similar to pre-hospitalisation expenses, this duration may also vary from one insurer to another.

    Claim Process

    It is possible for a policyholder to claim both pre-hospitalisation and post-hospitalisation expenses for the same condition. Before opting for a policy, the duration of these expenses must be noted. A successful claim can be filed only for the specified duration. Any expenses incurred beyond the specified duration will not be covered by this policy. In order to make a successful claim, the policyholder must provide proof of these expenses with the insurer. Some of the documents required in this process include:

    • Original bills, medical certificates, etc.
    • Investigation reports (x-ray, blood test, scan, ultrasound, etc.)
    • Certificate from the physician
    • Discharge summary
    • Original prescriptions
    • Bills of medicines and drugs
    • Any other documents requested by the insurer

    Once these documents are submitted to the insurer, the claim process will begin. The insurer will check whether the pre and post hospitalisation expenses are related to the same condition for which the insured was hospitalised. If the conditions are not related, the claim will be rejected by the insurer. After establishing the validity of the claim, the acceptance will be communicated to the insured and the compensation amount will be provided later.

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