What's Included In Pre- and Post-Hospitalisation In Health Insurance?

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A health insurance policy serves as a financial safeguard during medical emergencies. In challenging times, it prevents you from burning through your savings by covering the majority of your medical expenses. Beyond hospitalisation and treatment, a comprehensive health insurance policy also includes coverage for pre- and post-hospitalisation expenses. Read on to understand the significance of pre- and post-hospitalisation coverage in health insurance.

What is Pre- and Post-hospitalisation in Health Insurance?

Pre- and post-hospitalisation cover in health insurance refers to provisions within the policy that cater to expenses occurring before and after a patient's hospital admission. Such coverage in a health policy is extensive, as it not only handles costs during hospitalisation but also addresses certain expenses before admission and after discharge. Without this coverage, these expenses could deplete your savings. Therefore, pre- and post-hospitalisation coverage serves to protect your savings by providing financial assistance for settling medical bills during these challenging periods.

What are Pre-hospitalisation Expenses?

Medical expenses incurred before hospital admission are classified as pre-hospitalisation expenses. Typically, individuals consult their family doctors when feeling unwell. The doctor may then recommend necessary scans and tests for accurate diagnosis. If the condition is severe, then hospital admission might be advised.

Common medical tests conducted before hospital admission include X-rays, CT scans, blood sugar tests, MRIs, and angiography, aimed at determining the patient's medical condition. These expenses are covered under pre-hospitalisation coverage, subject to the plan's terms and conditions. Examples of pre-hospitalisation expenses covered in health insurance policies include:

  • Medical tests for diagnosing the condition.
  • Prescription medication prescribed by the doctor or medical practitioner leading up to hospitalisation for which an inpatient claim has been accepted.
  • Fees paid to a doctor or medical practitioner.

Most insurance companies cover pre-hospitalisation expenses for up to 30 days before the hospitalisation date, although this duration can vary. Some plans may extend coverage up to 60 days. It's important to note that insurance coverage is provided for the same illness for which the policyholder is admitted to the hospital.

What are Post-hospitalisation Expenses?

Medical expenses incurred after discharge from hospital are referred to as post-hospitalisation expenses. Treatment doesn't conclude upon leaving the hospital; patients often require post-discharge care, including medication and attentive care.

Upon discharge, it's common to need ongoing care at home for full recovery. Doctors may prescribe specific therapy, treatments, and continued medication. Follow-up tests, scans, and doctor visits may also be necessary. Consequently, expenses for these activities post-discharge are classified as post-hospitalisation expenses.

Post-hospitalisation coverage is designed to support during this phase. It covers expenses for follow-up treatments, diagnostic tests, consultations, medications, and physiotherapy needed for recovery after discharge. Typically, health insurance companies cover these costs for a period ranging from 45 to 90 days after the discharge date from the hospital.

Benefits of Pre- and Post-hospitalisation Coverage

Here are the top benefits of buying health insurance with pre- and post-hospitalisation coverage:

1. Better Coverage

A health insurance policy featuring pre- and post-hospitalisation coverage can assist in managing financial hurdles from diagnosis to recovery. Not all health insurance plans provide this coverage, so it's crucial to thoroughly review policy details, including inclusions and exclusions, before making a purchase.

2. Less Financial Burden 

Pre- and post-hospitalisation expenses can often be significant, sometimes even matching the cost of hospitalisation itself. This can quickly deplete your savings. However, with coverage for these expenses in your health policy, your financial strain will be alleviated.

3. Cashless Cover

Another advantage of purchasing a health policy with pre- and post-hospitalisation coverage is access to cashless coverage. You can undergo pre-hospitalisation tests and receive post-hospitalisation treatments at a network hospital affiliated with your insurance company. This means you won't have to pay for pre- and post-hospitalisation expenses out of your pocket, ensuring convenience and peace of mind.

4. Coverage of Treatment Cost

In certain cases, the cost of post-hospitalisation treatment for a disease can pose a greater financial strain than the initial hospitalisation. For instance, while a person may be hospitalised for a week, the ongoing post-discharge treatment could extend for months. Post-hospitalisation insurance typically covers treatment costs for dialysis, surgeries, daycare treatment, and more, effectively easing the financial burden.

When are Pre- and Post-hospitalisation Claims Rejected?

To fully benefit from your health insurance, it's essential to understand when your insurance provider is likely to approve your claims. Remember, there are specific conditions under which your claims for pre- and post-hospitalisation expenses may not be accepted. Here's what you should keep in mind:

  • Your insurance provider will cover pre- and post-hospitalisation expenses only for the disease or medical condition for which you were hospitalised.
  • Pre- and post-hospitalisation expenses are typically covered for a fixed number of days, usually around 30-60 days and 45-90 days, respectively. Expenses incurred beyond this period won't be covered under your policy. Hence, ensure to check the coverage period before submitting a claim.
  • Coverage for pre- and post-hospitalisation expenses is activated only if you're admitted to the hospital. You can't claim these expenses if you were treated at home without hospitalisation.
  • When filing a claim for pre- and post-hospitalisation expenses, be sure to provide all bills and payment receipts to your insurance company.


Many medical expenses arise before a disease diagnosis, and similarly, significant costs follow hospital discharge for follow-up treatments and medications to ensure complete recovery. With pre- and post-hospitalisation coverage, you can ensure your insurance company covers these expenses. Before making a claim, remember to verify the coverage period for pre- and post-hospitalisation expenses.

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Frequently Asked Questions

What is pre-hospitalisation coverage?

Pre-hospitalisation coverage in health insurance refers to medical expenses incurred before hospital admission, such as diagnostic tests, consultations, and medications prescribed by the doctor before hospitalisation.

Post-hospitalisation coverage includes medical expenses incurred after discharge from the hospital, such as follow-up consultations, medications, diagnostic tests, and rehabilitation services, within a specified time frame.

The duration of pre- and post-hospitalisation coverage varies depending on the health insurance policy. Typically, it ranges from 30-60 days before hospitalisation to 45-90 days after discharge.

Yes, some health insurance policies may have limitations on the types of expenses covered and the maximum amount reimbursed for pre- and post-hospitalisation expenses. It's essential to review the policy terms and conditions for details.

Yes, you can claim pre- and post-hospitalisation expenses separately within the coverage limits specified in your health insurance policy. Keep all relevant medical bills and documents for submission during the claim process.

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