A health insurance policy is a necessary financial instrument for everyone. The significance of health insurance has been amply driven home during the Covid-19 pandemic. One of the most important items in a health insurance policy is whether the hospital the policyholder is getting treated belongs to the network or not.
Every insurance provider draws up its own network of hospitals and nursing homes. These hospitals render treatment without the patients requiring to pay any cash in lieu of the service provided to them. This is a very significant element of the service that policyholders expect since it relieves them of the responsibility to arrange for money at a critical juncture.
What is network hospital in health insurance?
Therefore, in order to reduce the financial burden on the patient party, the insurance company pays the hospital directly. However, the insurer is not going to pay any hospital where the patient might have been treated. Only those hospitals with which the insurance company has drawn up an agreement – in other words, if it is a network hospital – the insurance company will foot the bill on behalf of the patient.
What to do in case of non-network hospital
Hospitals that do not have any agreement with the insurance company are called non-network hospitals. Any health policyholder is free to be treated at such a hospital but he/she will have to pay for the treatment from his/her own pocket. However, after paying for from his/her own pocket, the patient can apply to the insurer for reimbursement of the expenses. In this case, he/she has to submit all records of medical expenses, and diagnostic/radiological test reports and bills, to the insurance company in prescribed format. Even if the reimbursement is smoothly done, the patient might have to arrange for a significant amount of funds. If the treatment is done at a hospital that belongs to the network of the insurer, the patient almost always can leave just by signing a few documents.
Be careful while buying a health policy
Therefore, while buying a health insurance policy, one has to find out the hospitals that are included in the network. The network must not only be wide, but also should preferably include hospitals in and around the place of residence of the policyholder.
