When it comes to hospitalisation, the incurred costs are above and beyond just the hospital bills. The medical prologue and epilogue of pre-hospitalisation and post-hospitalisation fetch substantial charges that pile up on a family’s formidable financial burden.

The best financial counter to this is availing of a plan from the best health insurance companies with an in-built pre and post-hospitalisation coverage feature. However, while each health insurance policy these days comes with this ingrained perk, the period for which this coverage lasts makes all the difference.

And considering the financial benefit that this perk offers, this feature has been added to the list of deciding factors when choosing a health insurance policy. Here’s a list of details on the pre and post-hospitalisation that would help you understand the term better.

What is Pre-Hospitalisation Coverage in Health Insurance?

Before a patient gets hospitalized for a surgical procedure or a treatment, he/she undergoes multiple diagnostic tests that help with the imminent surgery/procedure. Such procedures ensure a considerable expenditure that usually burns a hole in an individual's pocket. With the best health insurance policies, the insurer covers such expenses (also called pre-hospitalization costs).

The best health insurance plans cover these expenditures for 30 to 60 days. However, the number of days for which these expenses are funded varies from one insurance provider to another and one health insurance plan to another.

The Best Health Insurance Plans Pre-Hospitalization Coverage
HDFC ERGO Optima Restore 60
Care - Care Advantage 30
NIVA BUPA ReAssure 60
BAJAJ ALLIANZ Health Guard Platinum 60

What is Post-Hospitalisation Coverage in Health Insurance?

Say an individual gets discharged from the hospital. While the insurance provider takes care of the hospital bill, the expenses for the treatment don’t exactly end there. In fact, after hospitalisation, the medical expenses are massive. This includes the costs incurred for medicines, doctor’s fees over consultations, physiotherapy, follow-up treatments, and much more.

Considering such high expenses, health insurance providers often offer coverage for more days during post-hospitalisation than pre-hospitalisation. However, much like in the case of pre-hospitalisation features, the post-hospitalisation feature is also subjected to variation based on the health insurance provider and the plan availed.

The Best Health Insurance Plans Post-Hospitalization Coverage
HDFC ERGO Optima Restore 180
Care - Care Advantage 60
NIVA BUPA ReAssure 180
BAJAJ ALLIANZ Health Guard Platinum 90

What are the Benefits of Pre & Post Hospitalisation Coverage in Health Insurance?

Comprehensive coverage

The coverage for pre and post-hospitalisation in health insurance makes the plan comprehensive.. When policyholders avail of a health insurance plan, they expect a strong financial security net that secures them through and through during a medical emergency. While basic health insurance covers the hospitalization charges, the pre and post-hospitalization coverage takes care of an individual's before and after treatment and medical follow-up costs

Better prepared for medical emergencies

When you have a health insurance plan in place, the lion’s share of your medical emergency funding is taken care of. However, medical emergency expenses are not extended to just the hospitalization bill

  • The diagnostic tests before the surgery/medical procedure,
  • Medicines, follow-up tests, doctor’s fees, and physiotherapy after the policyholder has been discharged

-take up a considerable share of the imminent expenses too. With the coverage for pre and post-hospitalization in health insurance, policyholders stay financially prepped for any medical emergency. Needless to say, this mitigates the strain on policyholders and their families.

Mitigated financial burden

That pre and post-hospitalization coverage means a significant aid in shielding one’s savings is obvious. However, there is one more aspect that we need to consider. What if the hospitalized individual/policyholder is the family's sole bread-earner? Him/Her being hospitalized means a compromised source of income for a few weeks/months. Under such circumstances, a cashless/reimbursement mode of payment for pre and post-hospitalization expenses is a considerable financial assurance that reduces the financial burden for the family.

How to Claim Pre & Post Hospitalization Coverage in Health Insurance?

Much like the claim settlement process for health insurance plans, in the case of pre and post-hospitalisation expense coverage, too, policyholders need to -

  1. Ensure that the procedures, medicines, and treatments are for the same ailment as the one for which he/she will be/was hospitalized.
  2. Collect all the invoices for the procedures & medications.
  3. File the claim with your insurer or your TPA (Third-Party Administrator) within 45 to 90 days of your hospitalisation (days may vary as per your insurer).
  4. Be ready to produce and submit the documents when asked.

Frequently Asked Questions

What kind of expenses are generally covered under pre-hospitalisation expenses?

In the case of pre-hospitalisation in health insurance, the expenses regarding diagnostic tests, MRI, CT scans, physician’s fees, etc., are covered.

Are pre-hospitalisation and post-hospitalisation expenses covered under all health insurance policies?

Yes, pre-hospitalisation and post-hospitalisation expenses are covered under all health insurance policies. However, based on the health insurance provider and the policy, the number of days covered for pre-hospitalisation and post-hospitalisation expenses vary.

What is the time limit for submitting pre-hospitalisation and post-hospitalisation claims to the health insurance provider?

The time limit for submitting pre-hospitalisation and post-hospitalisation claims to the health insurance provider lies in the ballpark of 45 to 90 days from discharge. However, the span of time varies. Ask your insurer about this period to ensure that you don’t miss out on tapping on this financial aid.