Hospitalization Insurance In Health Insurance And More

With inflating medical costs, the expenses you incur on your treatment can quickly go up. Having a health policy is the safest option to go. It helps you against unexpected medical costs and provides financial security. 

The main reason you purchase a health policy is that it would be helpful when you’ve to get admitted to a hospital to undergo the required treatment. 
You expect your policy to cover your hospitalization expenses and save you from the financial burden. 

Health policies cover hospitalization subject to the policy sum insured and coverage (inclusions and exclusions). 

Here in this blog, let’s talk about types of hospitalization covers under health insurance: 

• In-patient hospitalization cover

Have you ever been to the hospital and your doctor told you to get admitted?

If yes, that is what in-patient hospitalization is.

When you need to get admitted to the hospital for treatment, undergoing tests, surgery or a medical procedure, it is inpatient hospitalization.

It requires a stay of 24 hours or longer to be considered as inpatient hospitalization. Patients who come for pre-planned surgeries and in emergency are also considered under inpatient department, popularly known as IPD. If you have a health policy, then policies cover inpatient hospitalization (if your treatment is under the policy coverage).

Expenses like room rent, surgeon fees, anaesthesia, etc. may be covered by your health insurance company under IPD treatment.

• Day care hospitalization cover

When you’re admitted in a hospital for a medical procedure for less than 24 hours, it is known as day care hospitalization. Due to advancement in science and medical field, a lot of treatments and medical procedures today do not require a patient to be hospitalized for a complete 24 hours or more.

That is why the Insurance Regulatory and Development Authority of India (IRDAI) asked health insurance policies to cover day care hospitalization in health policies.

Procedures like cataract surgery, chemotherapy, dialysis, radiotherapy, nasal sinus aspiration, etc. are a few examples of day care procedures covered by health insurance companies.

• Domiciliary hospitalization cover

Domiciliary hospitalization is when a patient receives medical treatment and hospital-like care at home due to unavailability of hospital bed or critical condition of the patient due to which he/she can’t be moved to the hospital.

The patient is considered hospitalized and is provided cover for domiciliary hospitalization by the health insurance company under the below conditions:

1. 1. If it is recommended by the treating doctor or medical practitioner along with a stated reason
   2. If patient is in an urgent need of hospitalization and there is no required hospital bed available or the condition of the patient is such that he/she cannot be shifted to the hospital
   3. If the minimum hospitalization period is 72 hours or 3 days

There are many conditions and treatments that are not eligible to be covered under domiciliary hospitalization. Also, not all health policies include a domiciliary hospitalization cover.

So, you should always check the scope of your coverage for better clarity at the time of claim.

• Pre and Post hospitalization cover

There are a lot of diagnostic tests, scans and OPD consultations that one goes through even before and after hospitalization.

The tests are prescribed to diagnose the problem, identify the correct treatment to be given and to track the progress of the patient’s condition. The expenses incurred before and after hospitalization on these regular tests, check ups and consultations are referred to as pre and post hospitalization expenses that are covered by most health policies.

The period during which these expenses are incurred and would be covered for, may differ across plans and insurers. Some may provide a window of 30 days before and 60 days after hospitalization period or 30 days before and 90 days after, etc.

You can get these expenses reimbursed from your insurer by filing a pre and post hospitalization claim along with all relevant documents.

In any case of a medical emergency, it’s always helpful to have a health policy to cover for your hospitalization expenses.