In the health insurance industry the main feature or the requirement of a person who has purchased a health insurance policy is that when he visits a hospital, the company should give the claim. He should not spend a penny on hospital bills. As he is paying the premium on time for many years, so the expectations from the insurance company are higher.
If at the time of hospitalization the insurance company fails to pay and offers a reimbursement, the person who is paying the premium would really be angry. But, it is not the company’s fault. The company is not denying to pay the expenses, it is ready to pay but later not at the time of hospitalization. This situation arises when you are not admitted to the paneled hospital. A health insurance company cannot tie up with each and every hospital whether it is in a village or city. But, for the comfort of its client companies shows the list of network hospitals on its website. A person can easily check the list of network hospitals in his area.
While purchasing a health insurance policy it is one of the most important aspects to know about the network hospital in your nearby area but we focus on Premium Only. Nor we see the financial benefits that you get when you in hospital. Just to save a few thousand we skip the features that worth in Lakhs. So, before buying a health policy, you should compare each and every feature and the network hospital in your area.
For example, as per the online Data available on the websites, Star has 8800+ Cashless Hospitals, Max Bhupa has 3000+ Cashless hospitals and Apollo Munich has 4500+ Cashless hospitals. If the Health insurance Company refuses for a cashless option for the particular hospital, in that situation you have to pay lakhs from your own pocket. If the hospitalization case is of the main person who has the money is admitted then, the family members have to face this problem. No doubt Health Insurance Company will refund you 100% amount in your bank account but later.
Apart from network and non-network hospital, there are other categories also that you should check before buying a health protection plan. You should ask your financial consultant to tell about the network hospitals in your areas.
Let’s compare more about Network Hospitals, Non-Network Hospitals, Agreed Hospitals and Preferred Hospitals.
What is Network Hospital in Health Insurance?
A network hospital is a hospital has a tie-up with the health insurance company. Tie up with a health insurance company simply means that, the cashless facility is available in the hospital. You just have to show your health policy card. The hospital will not demand any amount from you. When you purchase a health protection plan, the company provides you policy document, I Card and some other documents. The I Card is used in the hospital to avail the cashless feature.
Example: Ram had severe stomach pain and his family called the ambulance. He was admitted to the nearest hospital. The hospital in which he was admitted was a network hospital. Then his family member just showed the health policy I Card to the hospital. The TPA department of the hospital request for the approval of the health insurance company. In the meantime, the treatment of Ram was started. Within few minutes, the health insurance company sends to approval to the hospital and his family has a peace of mind from financial side as they just have to focus on the health of Ram, not on the financial expenses of the treatment.
What is Non-Network Hospital in Health Insurance?
Non-Network hospitals are the where you I Card of the health insurance policy will not work. You will get the expense amount but thru the reimbursement process. While hospitalization you have to pay to the hospital expenses from your pocket. Later you have to submit all the documents related to hospitalization to the insurance company and they will transfer the expenses amount in your bank. It is advisable to visit a network hospital while hospitalization.
Example: Suresh had severe stomach pain and his family called the ambulance. There were not aware that which network hospital in their area is. So, they just went to the nearest hospital and Suresh was admitted there. The hospital in which he was admitted as a non-network hospital. In this situation, his family was already in tension due to the health of Suresh and quickly they have to arrange funds to pay hospital expenses. Within a few minutes, the doctor told them then they need to do an operation which will cost nearly 3-4L. Now Suresh’s family is in financial tension also. Suddenly they have to arrange the funds. The health insurance company will pay all the amount but later. But, in the current situation, still having health policy was under pressure to arrange the funds. So, to avoid such issues check the cashless hospitals near you in advance and choose the health insurance company which has more cashless hospitals. You can consultant your financial advisor to know more about it. A health Insurance Agent is always your partner which you are in most difficult time.
What is a Preferred Hospital in Health Insurance?
Preferred hospitals are basically a level up to network hospitals. The insurance companies have special tie up with them. Under special ties-ups Company provides special discount and features to you if you are hospitalized in preferred hospitals. Your I Card is applicable in preferred hospitals and you full treatment would be done cashless. This is the best category to choose from but they are limited so you should always go from preferred or network hospitals. The only reason is that they provide a cashless facility.
Example: Manoj visited the doctor on OPD basis due to stomach pain. He was using a health policy and was aware of the cashless hospitals near him. He calls his health insurance company and told them as planned by the doctor he will undergo minor surgery. He asked the company to tell the preferred hospitals in his area. The company executive told him. As a result, Manoj enjoyed financially tension free operation and got Rs. 5000 from the company as a reward of choosing a preferred hospital.
What is Agreed Hospital in Health Insurance?
Agreed hospitals are the same as preferred hospitals. You will enjoy the same benefits as you get in the network hospital. The rewards, discounts and cashless treatment.
Health issues can come any time, so to be aware of the cashless hospitals available in your area is for your benefit only. You should tell everyone in your family about the health policy and the I Card and the cashless hospitals available in your area. So that if there is an emergency and you have to go to a hospital in an emergency case, your family should know which hospital to choose for best and cashless treatment. Don’t let your illness create financial pressure on their mind.