Pre and post-hospitalisation expenses: All you need to know

A health insurance policy covers hospitalisation expenses provided the policyholder remains hospitalised for at least 24 hours. From room rent to doctor’s fees, the insurer pays for various expenses incurred during hospitalisation. But, there are certain expenses that occur before and after hospitalisation as well. For example, costly medicines and diagnostic tests even after getting discharged could leave a hole in your pocket leading to monetary stress. The good news is your comprehensive or basic health insurance policy is not limited to just hospital-related expenses but gives you more benefits in the form of pre and post hospitalisation expenses.

Pre-hospitalisation Expenses

Before an individual gets hospitalised one has to undergo several medical tests such as blood test, urine test and X-ray among others for an accurate diagnosis so that the treatment can be started. Generally, insurers reimburse you for 30-60 days prior to pre-hospitalisation expenses. The limit for the number of days may vary from insurer to insurer. It is advisable to check your health insurance policy to know the time limit for pre-hospitalisation coverage.

Post-hospitalisation

After the patient gets discharged he is kept under constant monitoring for at least some time. There are expenses such as medicine and diagnostic tests that are covered after the patient gets discharged from the hospital. These expenses are covered under the post-hospitalisation expenses. Generally, an insurance company covers expenses up to 60-90 days post-discharge. To understand what exactly your policy covers under post-hospitalisation read the policy document carefully. For example, acupuncture is generally not covered under post-hospitalisation expenses.

How to claim these expenses

One has to submit original bill receipts, doctor’s certificate, discharge summary and other relevant documents to the insurance company for the reimbursement of the claim. The process largely remains the same as for reimbursement claim for hospitalisation expenses.

Points to note

One can claim for pre and post hospitalisation only when the insurer accepts the cover for hospitalisation expenses. The expenses should arise from the illness which necessitated hospitalisation. Most importantly the pre and post hospitalisation expenses should incur within the time frame specified in the policy.