Health Insurance turns out to be a necessary investment at current times. With medical inflation skyrocketing, a suitable Health Insurance plan can help mitigate exorbitant medical expenses. Besides providing financial assistance, Health Insurance also offers additional benefits such as Maternity coverage, Wellness programs, Telemedicine services, Second medical opinion, OPD consultations, etc.
There are many factors to consider before purchasing a medical insurance policy. One such important factor is Network Hospitals. Every Health Insurance company has a network of hospitals with whom the insurers agree with. The insurer has tie-ups with numerous hospitals to provide cashless claim settlement thereby ensuring a hassle-free claim process and quality service. Getting treated in Network Hospitals entitles the policyholders to cashless treatment and minimizing out-of-pocket expenses because the insurer settles the claim directly with the hospital.
Health Insurance has its own definition for hospitals which have also been categorized accordingly. As per the guidelines of the Insurance Regulatory and Development Authority of India (IRDAI), a hospital/nursing home is any established institution registered with local authorities under the Clinical Establishments (Registration and Regulation) Act, 2010 or under the enactments specified under the Schedule of Section 56(1) of the said Act. The hospital should fulfill the following criteria as per the guidelines.
Unlike emergency hospitalization, we might take ample time and effort to choose a hospital for a planned hospitalization. There are chances that the chosen hospital may not fall under the Network Hospitals category, in which case, people cannot claim for cashless treatments. However, the policyholders can avail reimbursement claims if they get treatment in non-network hospitals.
Irrespective of the type policy, whether it is Individual Health Insurance, Family Health Insurance, Critical Illness policy or Group Health Insurance, people can avail cashless treatment facilities and quality service at network hospitals. Moreover, most policies that provide outpatient cover offer coverage only if the OPD consultations are taken at network hospitals.
But there is another category of hospitals that do not fall under both categories, which are called Excluded Hospitals/Service Providers. The insurers will not settle claims for getting treatment at such hospitals. However, in case of medical emergencies, we may not have ample time to choose and shortlist the hospital. Understanding that, the hospitalization expenses arising due to life-threatening emergencies up to the stage of stabilization of the insured patients are payable.
Most of us overlook the policy’s terms and conditions when we buy a Health Insurance policy, and doing so might result in last minute hassles. The policy clause and documents contain a list of definitions and terms & conditions. It is time-consuming to go through all the information, however, it is important to read the necessary details such as exclusions, waiting periods, etc. Similarly, it is crucial to check the Network Hospitals list and see what all nearby hospitals fall under the Network Hospitals category.
By choosing Network Hospitals, you do not have to worry about paying your medical bills out-of-pocket. Opt for an insurance provider who offers a wide network of hospitals, so you may not have trouble finding one near your locality. Star Health And Allied Insurance Co Ltd., with a wide network of 14,000+ hospitals across the country, provide cashless treatment facilities and quality treatments without people having to worry about medical bills.