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After comparing ten health insurance plans, you finally purchased one that fits your checklist. Here’s the surprise: It doesn’t work the same at every hospital. Sounds strange? Rest assured; it is not about the coverage but how you avail it. Cashless treatment is not a universal benefit. It only applies to a category of hospitals, known as “network hospitals”. But what exactly sets this class apart from the non-network hospitals? Also, how does it affect your wallet? We shall explore this section.
What are network hospitals?
Network hospitals are a group of hospitals that have contractual agreements with insurance companies. They act as the insurer's healthcare partner, ultimately facilitating cashless treatment. When you get treated at a network hospital of your insurer, you don’t have to file a claim for reimbursement for medical expenses. The insurance company settles the bills with the hospital, eliminating the hassle.
The most significant advantage of treatments with network hospitals is faster approvals. Most big network hospitals have an insurance helpdesk or third-party administrator right there. So, whether you need pre-approval for a surgery or a medical test, they handle it, typically within hours. That’s not all, you’re more likely to receive good services, infrastructure, and hygiene, since insurers frequently review their network partners.
It all boils down to peace of mind, as you or your family can fully focus on recovery instead of running from pillar to post completing the formalities.
What are non-network hospitals?
A non-network hospital does not have a tie-up with your insurance provider. However, you can still get treated there. Here, the only catch is that you pay first and claim reimbursement later. The claim might get accepted, but you might be charged some deductions. This happens when and if the hospital overcharges or uses services not covered in the policy. In a nutshell, you foot the difference amount.
Getting treatment at a non-network hospital means navigating slow, paper-heavy claim procedures. You must have every bill, prescription, lab report, and relevant document to submit to the insurer. The process doesn’t end there. It involves a great deal of waiting and following up, too.
Moreover, a hospital may charge whatever it wants without adhering to any pre-fixed rates. Your insurance provider will only reimburse you up to what they consider reasonable and covered.
Why is cashless treatment the winner?
Now that we have understood the differences between network and non-network hospitals, let’s discuss cashless health insurance. For starters, it is a feature that eliminates a great deal of hassle. Cashless treatment ensures that you get instant access to medical care. With this feature, you don’t have to wonder, “Can I afford this?” and simply check for the nearest network hospital.
Cashless treatment is preferred for the financial comfort it offers. You don’t have to pay out of your wallet or rush for emergency funds to settle upfront medical bills. Most network hospital claims are approved in 24 to 48 hours.
Which one would you choose?
Here’s the hard pill to swallow: you might not always get the option to choose between a non-network hospital and cashless health insurance! Emergencies often land you in the nearest hospital, networked or not.
But that should not stop you from planning. Here’s what you can do:
Explore the network before buying the plan: Every insurance provider publishes a list of network hospitals. Check if your nearest or the most preferred multispecialty hospital is on it. If it is not, consider a different provider.
Check for Pan-India coverage: If you are a frequent traveller or live away from your hometown, it is best to make sure that your policy has network hospitals across regions.
Have a back-up plan for reimbursement: Even with cashless, some expenses, like non-medical expenses or exclusions, are not covered in many health insurance plans. Keep a buffer fund to avoid any shocks later.
Know the Pre-Authorization Process: Most network claims require prior approval (except emergencies). Learn how your insurer handles this.
Wrapping up!
Buying health insurance plans is not about checking a box off the list, but about ensuring you are covered for future medical expenses. Understanding the difference between network and non-network hospitals is crucial in choosing the best coverage, as it can affect your access to cashless health insurance. So, don't just compare premiums when exploring health insurance plans. Compare hospital networks, too.
Disclaimer: This is a sponsored article. All possible measures have been taken to ensure accuracy, reliability, timeliness and authenticity of the information; however Outlookbusiness.com does not take any liability for the same. Using of any information provided in the article is solely at the viewers’ discretion.
