Health insurance can indeed be a boon in today’s day and age when medical emergencies and procedures have become so expensive. While choosing a health insurance policy for yourself and your family members, two of the most important criteria tend to be the affordability of the plan and the list of network hospitals. A longer and more exhaustive list of network hospitals helps you find one closer to you easily. But what exactly is the difference between network and non–network hospitals?
Let’s find out.
What are network hospitals?
Generally, insurance companies create a network of hospitals, clinics, and medical personnel, who charge a lower fee for policyholders. In return for charging a lower fee, hospitals within this network get to treat an increased number of patients who are diverted to them through the insurance company.
Essentially, health insurance companies are aware that when their policyholders deal with illnesses, they will file huge claims, and the company will have to offer substantial payouts. To reduce their burden, they collaborate with hospitals and include them within the network for reduced charges. However, that’s not where the benefits end. Another major feature of network hospitals is that they allow policyholders to enjoy cashless treatment.
Network vs non–network hospital: What is the difference?
When you opt for a network hospital, the patient in question gets admitted for treatment with cashless facility. The patient can simply submit a form to the TPA to avail of cashless benefits. Once such cashless hospitalisation is approved, the patient can avail of the treatment required, and the expenses are handled directly by the insurance company. This process is highly seamless, and the patient does not have to submit any bills or documents. The only expenses borne by the patient are those that are not included within the coverage offered by the policy.
On the other hand, if a person is admitted to a non–network hospital, they have to pay for the entire treatment. Once they are discharged, they must submit all the documentation with the required report to the insurer. The insurer will then check all the documents and approve whatever is found reasonable. The amount is then reimbursed to the patient as per the timeframe of the insurer’s process.
Do keep in mind that things are different if you have not opted for health insurance with the cashless facility, even if you are in a network hospital. In this case, you must submit documents and go through the entire process to receive your health insurance claim.
All in all, opting for a network hospital is much more convenient and reduces your burden during already distressing times. You can seek medical treatment without worrying about arranging for funds, collecting documents, or going through a lengthy procedure. This is especially helpful if you are opting for family health insurance that includes senior citizens. Make sure to go through the terms and conditions offered by the insurance company and opt for a policy with network hospitals situated close to your home.
Disclaimer: The above information is indicative in nature. For more details on the risk factor, terms and conditions, please refer to the Sales Brochure and Policy Wordings carefully before concluding a sale.