Network Hospitals

A network hospital is in an empanelled hospital. It includes a vast number of public-private network (PPN) hospitals across India. Every health insurance general insurance provider has a dedicated tie-up with a chain of hospitals.
Only within this network hospital, you can avail cashless health insurance facilities. In case you are admitted to any one specific network hospital, all you need to do is furnish your cashless claim card. The rest of the procedure will be managed directly by the Third Party Administrators/Insurer and the hospital.
The cost of medical treatment and hospitalization is rising on an annual basis. It is better to stay protected in the long run with a comprehensive medical insurance policy. With a cashless healthcare plan, you will not have to worry about the financial obligation arising from hospitalization expenses. In case you do not have adequate savings to pay hospitals bills, a cashless mode of reimbursement is the best option to go for.

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What is meant by Cashless Hospitalization?

There are often instances when a network hospital might not be accessible. In case of a medical emergency, you can get yourself admitted to a regular non-network hospital and pay the bill from your own pocket. Once you get discharged from the hospital, you can file for a reimbursement claim with your health insurance policy provider.
In short, a non-network hospital is a medical institution that is not included in the network list of a general insurer. It is advisable to choose an insurer with a maximum number of network hospitals within your city, especially near your place of residence.

What to do in case of a Planned Hospitalization?

There are instances where you might have to get yourself admitted to a network hospital beforehand. This is known as planned hospitalization; you have made a prior decision to undergo the specified treatment and stay in the hospital for a number of days. In order to avail the cashless option, you have to get a pre-authorization letter and submit the same in the network hospital. Once the TPA or insurer approves the application, your medical treatment begins at the hospital.

What if It is a case of emergency hospitalization?

Accidents are unpredictable. In case of emergency hospitalization, the TPA must approve the cashless reimbursement application along with the pre-authorization letter within 48 hours. You need to provide all the relevant documents and details to the TPA in order to approve the pre-authorization letter. The insurer/TPA has the authority to reject a claim in case of discrepancy.

Top Health Insurance Plans available on Coverfox

Health Insurance Plans Sum Insured (Rs.) Network Hospital
HDFC ERGO My:health Suraksha Min-3Lakh Max- 50 Lakh 10,000+
HDFC ERGO Health Optima Restore Plan Min-3 Lakh Max- 50 Lakh 10,000+
Star Health Family Health Optima Insurance Plan Min-1 Lakh Max- 25 Lakh 9800+
Care Health Care Plan Min-4 Lakh Max- 6 Crore 7400+
Bajaj Allianz Health Guard Plan Min - 1.5 Lakh Max - 50 Lakh 6500+
Chola MS Healthline Plan Min-2 Lakh Max- 25 Lakh 6500+
Manipal Cigna ProHealth Plan Min-2.5 Lakh Max- 1 Crore 6500+
Aditya Birla Active Assure Diamond Plan Min - 2 Lakh Max - 2 Crore 6000+
SBI Arogya Premier Policy Min-10 Lakh Max- 30 Lakh 6000+
Bajaj Allianz Healthcare Supreme Plan Min-5 Lakh Max- 50 Lakh 5000+
Bharti Axa Smart Health Insurance Plan Min - 3Lakh Max - 5 Lakh 4300+
Oriental Individual Mediclaim Health Plan Min-1 Lakh Max- 10 Lakh 4300+
Max Bupa Companion Individual Health Plan Min-3 Lakh Max- 1 Crore 4115+
Reliance Critical Illness Insurance Min-5 Lakh Max- 10 Lakh 4000+
National Parivar Mediclaim Plus Up to 50 Lakh 3000+

FAQs

A network hospital is a hospital empanelled by an insurance company to provide cashless health insurance facilities to its policyholders as per the agreed terms and conditions.

A network hospital provides cashless health services to the health insurance policyholders. This way a person can get the best health facilities to overcome their illness without worrying about financial constraints.

A hospital which is empanelled by an insurance company is called a Network Hospital whereas hospitals which are not on the insurance companies panel are called Non-Network Hospitals. A network hospital provides you cashless and reimbursement claim facilities. On the other hand, a non-network hospital offers you only a reimbursement claim facility.