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Blog > Health Insurance > How Network vs. Non-Network Hospitals Affects Health claims?

Network vs. Non-Network Hospitals

Getting health insurance has become an important investment for you and your family in the present pandemic situation. Health insurance companies offer policies for all, even for COVID-19 patients. You must take an adequate health insurance policy as per the need. It does not protect you only during a medical emergency, but also provides tax benefits under section 80D of the Income-tax act. You must consider two crucial things while buying a health insurance policy for you and your family.
 

  • Is your policy offers cashless mediclaim facility, and
  • The list of network hospitals it covers
 

What is Cashless medical treatment?


 
Although, health insurance policies offer a long list of benefits to the policy holders, a cashless medical treatment facility and the list of network hospitals are some important aspects of a policy. If your policy covers cashless medical treatment, then you need not pay a single penny in the network hospitals. But, on the other side, if people want to get it treated in non-network hospitals then they need to pay complete hospital bills from their pocket at the time of discharge. So, you must consider this factor before buying your health insurance policy.
 

Do you know the difference between Network Hospitals & Non-Network Hospitals?

 
If your health insurance company has a tie-up with a long list of hospitals, then it is more convenient for you to find the medical facility in the nearby residing place. Let’s discuss the differences between network and non-network hospitals and know the process of getting admitted in a network hospital or non-network hospital during a medical emergency: 
 
Network Hospitals
All the registered health insurance companies in India have a tie-up with health care service providers. They appoint a network of hospitals, medical specialists for offering cashless treatment to their policy holders. The listed network hospitals in policy usually charge a reasonable fee for medical treatment services and in return, hospitals get more patients through the network of insurance companies across India.
 
The health insured person raises his medical claims against the medical expenses and the health insurance service provider pays the settlement bill to the hospital. That is why, health insurance companies negotiate with the hospitals, reduce the medical costs, and list them as a network hospital. You can check the name of the listed hospital in your policy, either on the website of the health insurance company or in the policy document you got by the health insurance company.
 
When the insured person is admitted to a tie-up hospital, they don’t need to pay a single amount of money to the hospital. All the expenses even pre and post-hospitalization charges are payable by the health insurance company.
 
To better understand the meaning of network hospitals, let’s take an example:
Suppose your known person has availed a cashless medical facility and he needs urgent medical care. He got admitted to a nearby network hospital. Since he has a cashless medical facility and is getting medical treatment in a network hospital, he is not required to pay hospitalization charges such as admission charge, surgery charge, doctor’s visit fees, room rent, medication charge, etc. from his pocket. The third-party administrator (TPA) facilitates him or his family to get a cashless hospitalization facility. Once he gets well and discharged from the hospital, just he needs to collect all the hospitalization documents of the claim from the hospital for future reference.
 
Non-Network Hospitals
These hospitals are not listed in the panel of your health insurance company. When you need a medical emergency and get admitted to a non-network hospital, you’ll need to pay all hospitalization expenses. When you get discharged from the hospital, you need to collect all the hospitalization related documents and submit them to the health insurance company.
 
Your health insurance service provider checks all the hospitalization documents and approves the claim whatever they find reasonable. The approved claim amount is then refunded to the insured person account within 10 to 15 working days. 
 
Know more about Affordable Insurance Cover for Coronavirus
 
Now here you can find the claim difference with non-network hospitals, for example:
A patient needs an urgent medical treatment. He got admitted to a non-network hospital for his treatment. The medical health insurance company will not provide him cashless treatment. In this case, after getting a discharge, he needs to pay all medical expenses to the hospital and collect all the relevant hospitalization documents. Later on, he needs to submit all the hospitalization documents to the insurance service provider. After verifying all the documents, the insurer will reimburse all the medical expenses as per the terms and conditions of the offered policy to the policy holder. 
 
Conclusion
To get mental peace in the present pandemic situation worldwide and for an unseen medical emergency, you should have a good insurance policy with world-class features and facilities. There could be no other considerable gift, vacation plan, or other materialistic things that can bring you such a mental peace in the present situation. You can opt for suitable and trusted individual health policy, family floater health insurance, long term health insurance, personal accidental health insurance, or senior citizen’s health insurance at minimum cost with top-rated health insurance companies.
Avail maximum benefits with HDFC ERGO Health
You can do the little market research, and purchase the best health insurance policy that acts as the extra shield in the critical time. Some world-class health insurance companies like HDFC ERGO Health is offering great health insurance policies that facilitate a cashless facility and has a long list of world-class network hospitals across the country. A small investment with health care policies can bring you extra confidence in your life and provide mental peace during the medical emergency. It will add an extra layer of protection and you and your family will always be ready in advance to fight against any sort of medical emergency with great confidence. So, plan and buy the best healthcare policy for you and your family and get ready to enjoy your life with near and dear ones.

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