Health Insurance: In the changing lifestyle and uncertain times, the role of health insurance is increasing rapidly. Due to expensive health services, now health insurance is making its way among the people even in small towns. When buying health insurance, apart from the coverage and premium of diseases, whether cashless mediclaim facility is available or not, it is also checked. Before buying a policy, it should also be seen how many hospitals are in the network of insurance companies. The more hospitals in the insurance company’s network, the more convenient it will be to find a hospital in case of an emergency. However, sometimes a situation arises when services have to be taken in a hospital which is not included in the network list of the insurance company. In such a situation, before buying insurance, one should know the difference between network and non-network hospitals.
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Difference between network hospitalization and non-network hospitalization
- For cashless mediclaim, a form has to be submitted to the TPA for treatment or admission in a hospital included in the network of the insurance company. Once the cashless claim is approved, the patient’s treatment continues and all the expenses as per the sum assured are paid directly by the insurance company. The patient does not have to submit any bills or documents. There is no waiting period. For treatment in networked hospitals, only those expenses are to be paid, which is not covered under the policy.
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- On the contrary, if there is a hospitalization which is not included in the network list of the insurance company. In such a situation, the insured has to pay the entire treatment money himself. After being discharged from the hospital, all the documents and necessary reports have to be submitted to the insurance company. The insurance company will examine all the documents and reports and after getting approval will return the money to the insured after 10-12 days. It should be noted here that if the cashless facility is not selected, then all the bills and documents will have to be submitted even after getting treatment in the hospital included in the network.
(Disclaimer: This story is for information only. For more details read the terms and conditions of all the documents carefully before buying the policy.)
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