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What are Pre- and Post-Hospitalization Expenses?

Health Insurance Guidelines

Having a coverage of health insurance saves your finances during medical emergencies by clearing most of the bills for costs that you incur. However, your medical treatment expenses are not limited to hospitalization expenses only. Rather, they also include pre- and post-hospitalization expenses.

Pre-and Post-Hospitalization expenses are the ones that an insured patient has to incur before and after getting hospitalized for a specific treatment. The expenses for the treatment that is carried on before you are hospitalized is called pre-hospitalization expenses. And the expenses that you undergo after the treatment or after hospitalization are called post-hospitalization expenses.

The pre-and post-hospitalization expenses for a patient depends on the medical condition that the person is suffering from. Most health insurance companies cover these expenses of pre- and post-hospitalization under their health plans.

A good health insurance plan offers coverage against pre-and post-hospitalization expenses like diagnostic tests, medicines, lab tests etc. If your health policy does not provide such coverage, you will have to spend all your savings to get the treatment.

So, what is pre-and post-hospitalization meaning? Let us understand them and the clause related to them in detail in this post.

What are pre-hospitalization expenses?

When the health of people deteriorates, they visit the doctor to get a check-up done to find out the cause of the condition. Doctors generally prescribe different tests and diagnosis before confirming the condition and referring the patient for hospital admission. The costs incurred for such medical tests conducted before hospitalization are called pre-hospitalization expenses.

Some of these tests include X-rays, MRIs, CT scans, angiograms, medication, and so on. Generally, most health policies allow coverage for up to 30 days prior to the hospitalization date in case of pre-hospitalization expense coverage. However, this duration might change depending on your insurance company. So, getting a confirmation of the same by reading the policy document is important.

What are post-hospitalization expenses?

In case of most health conditions, the treatment of the patient doesn’t end even after getting discharged from the hospital. There are post-hospitalization expenses that they have to go through after the treatment. These expenses include things like follow-up consultation, diagnostic tests, medicines etc. In most health insurance policies the costs that an insured patient incurs for post-hospitalization treatment within 45-90 of getting discharged are covered by the insurance company under post-hospitalization expenses.

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How to claim pre-and post-hospitalization expenses?

The first and the most important thing to remember while raising claims for pre- and post-hospitalization costs is to make the claim within the prescribed time limit mentioned in the policy.

Below steps will guide you better:

  1. The expenses of pre-and post-hospitalization should be for the same treatment or health condition for which the patient is hospitalized
  2. You need to duly fill the claim form and submit your bills received from the hospital along with all the other required documents like diagnosis details, prescriptions, discharge summary etc., and share them with the TPA
  3. Don’t forget to submit the claim within the prescribed time limit, which is in most cases 45-90 days. However, it is important to cross check this duration with the Insurer
  4. Once you submit the documents, the team at insurer’s end verifies the papers before accepting them after making sure that the expenses are valid

The timing of raising the claim for pre-and post-hospitalization expenditures is the most important thing that plays the key role in accepting or rejecting the claims by the insurer. You must note that the insurance companies generally follow a very stringent time frame regarding claim settlement of such types.

Hence, if the insured patient or his/her family members fails to raise claims within the timeframe prescribed, the insurer might reject the request. so, you must know the time duration during which such claims should be settled.

Benefits of having pre- and post-hospitalization coverage

Buying health insurance with pre and post hospitalization coverage allows the insured to avail numerous benefits. Some of them include:

Reduces your financial burden

If your health policy covers these extra expenses, it reduces the financial burden of the policyholder to a great extent.

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Less stress

With this coverage the insured can rather focus on the treatment as compared to taking stress about the medical expenses that the person is going to face.

It prepares you for medical emergencies

This coverage will prepare you for any unforeseen medical emergency that you may face requiring pre- and post- hospitalization treatment.

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Keep your savings intact

Policies covering pre-and post-hospitalization keeps your savings intact as you don’t have to pay much from your pocket and you can get the best care also.

You cannot expect your medical expenses to be limited to hospitalization costs only when undergoing treatment for a health condition. This is because medical expenses are never limited to just staying in the hospital. Other than accidents, for most other conditions you need to go through various medical tests before getting hospitalized for the actual treatment. Also, there are some tests that are required to be carried out after hospitalization when you are recovering. These expenses vary as per the treatment and can exhaust your savings. Hence, having a policy with pre-and post-hospitalization coverage is necessary.

Documents needed to claim pre-and post-hospitalization expenses

You would require the below mentioned documents:

  • Original bills of hospital
  • All the original prescriptions
  • Medical papers
  • Bills of medicines 
  • Copy of discharge summary etc.

Frequently Asked Questions

You can claim both pre and post hospitalization expenses by submitting the required documents like doctor’s certificate, discharge summary etc. to your insurer.

Pre and post hospitalization claims may not be approved if you raise the claim after the mandated period during which you are required to raise it. Or it may not approve if you don’t submit the proper bills or documents that are needed.

Generally, most health insurance plans cover these expenses within the policy. However, it is advisable to check the policy documents to understand the inclusion better.

It actually depends on the policy chosen and the insurance company. Hence, it is important to review the terms and conditions of the policy to determine if ayurvedic therapies are covered or not under post-hospitalization charges.

Yes, you can buy pre and post hospitalization cover online.

Pre-and Post-Hospitalization expenses are the ones that an insured patient has to incur before and after getting hospitalized for the treatment of a specific health condition.

Domiciliary hospitalisation means that the patient is receiving medical treatment at the comfort of their home who is otherwise required to be hospitalised.

* Rs. 245/month is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*! Rs. 334/month is the starting price for a 10 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*@ Rs. 12/day is the starting price for a 5 lac family health insurance for an 25-year-old male and 22-year-old female, with no pre-existing diseases.
*# Rs. 12/day is the starting price for a 5 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*$ Rs. 600/month is the starting price for a 20 lac health insurance for an 25-year-old male, with no pre-existing diseases.
*^ Rs. 12/day is the starting price for a health insurance that covers coronavirus for an 25-year-old male, with no pre-existing diseases.