What Is Pre & Post Hospitalisation For Health Insurance Plans In India?

As the name suggests, pre-hospitalisation and post-hospitalisation expenses are the costs that you may incur before and after getting admitted to a hospital. Read on to know about what it is, and it is importance in a health insurance policy.
There is no doubt that a health insurance policy plays a vital role in giving you financial protection against medical emergencies that may occur at any time in the family. But, often due to lack of sufficient knowledge and awareness about the health insurance policy, policyholders do not get the most out of their plan.
Most people believe that their family health insurance policy covers only the expenses while you are admitted to the hospital. However, the reality is that most medical insurance policies in India have certain standard coverage terms, and it covers pre-hospitalisation and post-hospitalisation expenses.
When you get admitted to a hospital, you may have to undergo several medical tests, apart from taking medicines. The expenses you may incur on the tests before getting admitted and the post-hospitalisation care are covered by most health insurance plans in India.
Let us look at what exactly pre-hospitalisation and post-hospitalisation charges are:
Pre-hospitalisation Cost
The expenses that you incur before getting admitted to the hospital for further treatment are categorised as pre-hospitalisation expenses. Some of the common pre-hospitalisation expenses that most health insurance plans in India cover, include:
- Vaccination
- Doctor consultation fees
- Medical tests such as X-ray, urine test, blood test, ultrasound
- Medicines
However, it is important to note that the terms and conditions for the coverage may vary based on the type of healthcare plan you choose. For example, some insurance companies cover the expenses up to only 30 days before the admission in the hospital, while others may cover up to 60 days.
Post-hospitalisation Cost
The expenses you may incur after you get discharged from the hospital are called post-hospitalisation costs.
Some of the common expenses that most health insurance policies cover, include:
- Medical tests such as MRI, PET scan, angiography, endoscopy, kidney functioning test, etc.
- Post-surgery or post-hospitalisation treatments like physiotherapy, chemotherapy, dialysis, etc.
- Advanced vaccination
- Advanced medicine
- Doctor/medical expert’s consultation fees
Typically, most insurers in India cover expenses incurred within 60-90 days after hospitalisation.
If your health insurance plan does not cover the pre-and post-hospitalisation expense by default, here are five reasons why you must buy this coverage:
- Under this cover, the insurance company reimburses the expenses you may incur before and after getting admitted to the hospital. To claim the amount, you submit the relevant bills and proofs. You can get reimbursement to a maximum limit of the sum insured, and you need not spend a single Rupee from your pocket.
- If your insurer offers cashless hospitalisation facility, you can opt for the same at any of the network hospitals near your residence. You can get the best medical care without worrying about the cash crunch.
- If your doctor prescribes you to get admitted for better recovery, you get admitted to any network hospitals and get the claim settled.
- Some of the illnesses like cancer may require you to undergo various tests and other medical procedures before and after getting admitted to the hospital. With pre and post-hospitalisation cover at your disposal, you can get the full cost covered under the health insurance.
- Having health insurance plans that cover pre-hospitalisation and post-hospitalisation expenses give you peace of mind knowing that you have sufficient financial protection during an emergency. The insurance plan will help you take care of the costs without draining your hard-earned savings.