Conditions Associated With Post-Hospitalisation Expenses?
In order for your health insurance policy to cover post-hospitalization expenses, certain conditions must be met. Please note that these may vary from insurer to insurer.
Post-Hospitalization Expenses Should Be Under The Same Treatment For Which The Insurer Has Approved The Claim
Only when the hospitalisation treatment is payable as per the policy conditions, then the expenses incurred for prescribed treatment after discharge will be payable under this policy.
For instance, Lalit was hospitalised for jaundice treatment. Now, his insurance policy will only cover the post-hospitalization expenses for jaundice. In the event he undergoes MRI for another medical condition, say for another health condition like a backache , his policy will not cover the costs.
Limit On Coverage
A few insurers do not specify a post-hospitalization cap in the policy document, which means they cover the costs up to the base sum insured. Each insurer will have a different limit on the amount you can claim under the post-hospitalization benefit.
For instance, United India's Family Medicare policy covers post-hospitalization expenses to a maximum of 10% of the Sum Insured.
Must Be Prescribed By Your Current Doctor
Only those post-hospitalization expenses prescribed by your treating physician will be covered under your policy.
Consider Lalit's example again. He was hospitalised for jaundice treatment. His health insurance covered all post-hospitalization expenses. A month after the discharge, he underwent a whole body checkup that was not prescribed by the doctor. His policy won't cover such costs.
Some Policies Include Specific Benefits
Although all health insurance policies cover post-hospitalization expenses following an inpatient hospital stay, some policies also cover post-hospitalization expenses related to organ donations, psychiatric illnesses, and domiciliary hospitalisation.
Here are a few policies that provide these benefits:
National Insurance Mediclaim Plus Policy
Aditya Birla Active Health
Digit Health Care Plus
Magma One Health Policy
National insurance Parivar Mediclaim Plus Policy
Oriental Mediclaim Insurance Policy