Network Hospitals

Insurance Companies tie-up with leading hospitals with pre-agreed rates for treatments..

Hospitals and other health care providers contracted to provide services to customers of the insurance companies on a pre-agreed fees are called Network Hospitals or Provider Network. If the policyholder undergoes treatment in any of these network hospitals, there is no need for the Policyholder/ Insured to pay hospital bills, which is called ‘Cashless Facility’.

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Pre-Hospitalisation

Pre-hospitalisation expenses include various charges related to medical tests before an individual gets hospitalised, as doctors/physicians conduct tests to accurately diagnose the patient before prescribing treatment. In most cases, charges incurred by an individual 30 days prior to their admission are covered.

Post-Hospitalisation

The policy covers certain expenses after the patient is discharged from the hospital.

Post hospitalisation expenses include all expenses or charges incurred by an individual after they are hospitalised. Doctors/physicians may prescribe certain tests to check the progress or recovery of a patient. In most cases, charges incurred by an individual for 60 days from the discharge date are covered.

Proportionate Deduction

A clause in health insurance policies, where if there is a capping on per day room rent in the policy and you avail a room higher than the eligible room all the other hospital expenses like consultation charges, surgeon charges, operation charges, etc. will get reduced as a proportion based on the difference between the eligible and the availed room charge. Only the cost of medicines and consumables which are sold as MRP are paid as per actual.

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