How does health insurance work?
The purpose of health insurance is to raise finance when a medical emergency strikes. When you purchase a health plan you are provided with health care card and list of network hospitals where you can avail treatment without paying anything from your own pocket. If you are going for a planned treatment, just intimate your health care provider and the name of network hospital so that your provider can send approval to the hospital authorities in advance and you can seek treatment. In case of emergency treatment, inform the authorities as soon as possible. Even if the approval takes time, go ahead with the treatment and later on file the claim. If you seek treatment in non-network hospital even then you can file a claim and get reimbursement.
How does insurance claim process work?
There are two types of claims:
Cashless settlement: If you avail treatment in network hospital, the claim is directly settled between the insurance authorities and hospital. This is one of the best facilities provided by health cover providers as at times arranging finance at last moment leads to delay in treatment which can prove stressful.
Reimbursement: It may happen that you face an emergency and rush to the nearest hospital to get the treatment, which is not on the network of your health insurance company.. In this case, you can file a claim for reimbursement after discharge.
To file reimbursement you need to submit the following documents in original:
€ Discharge summary
€ Lab investigation reports
€ Doctor's prescription
€ Medical bills
While applying for reimbursements pay heed to the following:
€ Fill in the reimbursement claim form and submit it timely
€ Check the stipulated time frame in which you need to submit the documents. Generally, it is 30 days post discharge
€ Read carefully list of all the documents that need to be submitted
€ Pre and post hospitalization expenses are also covered, so do read the related policy carefully
The insurance claim process is not a tedious task as assumed by many provided you follow the process carefully and timely. Health cover is a facility for people to make their life easier. Hence, get a comprehensive health insurance and live peacefully.