What are Post-hospitalisation Expenses in Health Insurance?

Recovering from a medical emergency does not end after you get discharged from the hospital. After discharge, there's often a long list of follow-up visits, tests, and medications that can add up quickly. This is where post-hospitalisation expenses coverage in health insurance comes in to save the day. This feature in your health insurance plan makes sure that your recovery period does not feel like a financial burden for you.

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Post-hospitalisation Expenses in Health Insurance

Post-hospitalisation expenses in health insurance are the medical expenses that arise after you’ve been discharged from the hospital. All these expenses have to be directly connected to the illness or medical condition for which you were admitted to the hospital, and they need to be prescribed by the doctor who is treating you. Here’s what these expenses might include:

Follow-up visits with your doctor or specialist.
Diagnostic tests like blood tests, urine tests, MRIs, CT scans etc.
Medicines that are needed for your recovery.
Rehabilitation services like physiotherapy or acupuncture.
Wound care or injections that are given to you at clinics.

What is not included?

Just as it’s important to understand what's included, it’s also important to know what is not included in these expenses.

Any treatment that is unrelated to the original hospitalisation.
Cosmetic or elective surgeries like rhinoplasty or facelifts post-discharge from the hospital.
Non-medical expenses such as transportation or diet consultations etc.
Over-the-counter (OTC) medicines without a prescription.
Expenses that arise after the post-hospitalisation period - more than 90 days.

Conditions for Post-hospitalisation Claims

There are a few conditions that are required to claim post-hospitalisation expenses. They are mentioned here below:

The hospitalisation needs to be covered by your health insurance policy.
The expenses have to be for the same condition that you were hospitalised for
The treatment should happen in the time frame allowed by your policy, which is 60 or 120 days after you’ve been discharged.
You must make sure all the required documents like bills, doctor’s prescriptions, and test reports, are submitted as per the insurance company’s claim process.

How many days are covered?

Most health insurance plans offer post-hospitalisation expenses coverage for about 60 to 90 days from the day you’re discharged from the hospital. It is important to note that this duration will depend on the details mentioned in your health insurance policy.

Let’s say, for example, you were hospitalised for surgery on May 1st and discharged on May 10th. If your insurance plan covers 60 days of post-hospitalisation expenses, then your follow-up tests or treatments until July 9th will be reimbursed. Just make sure that these expenses are relevant or connected to the surgery or medical condition that you were admitted to the hospital for.

Advantages of Post-hospitalisation Expense Coverage

It provides financial relief during your recovery period by reducing the amount you spend from your pocket.
It covers necessary follow-ups like consultations, lab tests, and medicines.
It helps encourage you to continue treatment for chronic or complicated medical conditions.
Most of the time it is included in your health insurance plan.
It helps you manage long-term costs related to surgeries or major illnesses.
In some cases even offers cashless claims at network hospitals or clinics.

Disadvantages of Post-hospitalisation Expense Coverage

It only covers 60 to 120 days which is a limited period of time.
It must be directly related to the hospitalisation because no unrelated treatments are covered.
It usually has reimbursement claims only which means you need to pay for the treatment upfront first.
Non-medical expenses like transportation or wellness supplements are not covered.
The documentation process can be long and tiring as you have to submit a lot of documents.

Real-Life Example Scenario

Imagine you’ve just undergone surgery and have been finally discharged from the hospital. You might think you don’t need to come back to the hospital for anything else. But, you do. You’ll still need to do things like

Visit the doctor for follow-up consultations
Get blood tests, X-rays, or MRIs done to track your recovery
Buy prescription medicines for your recovery
Attend physiotherapy sessions or wound care appointments

These expenses can easily add up to ₹10,000 - ₹30,000 depending on your medical condition. If your health insurance only covers hospitalisation you’ll end up paying for these out of your pocket.

That’s why post-hospitalisation coverage in health insurance is important. It helps in making your treatment journey financially protected from start to finish, and not stressed about these expenses after leaving the hospital.

Conclusion

When it comes to health insurance it is not just always about hospital bills, it’s also about what comes next. It is important to know what is included in post-hospitalisation coverage so that it can provide financial relief for you during your recovery journey. Whether it’s a scan, follow-up visits, or months of medication, post-hospitalisation expenses coverage in health insurance can make your path to healing a smooth and stress-free one.

Frequently Asked Questions

Can I get post-hospitalisation expenses without hospitalisation?

No, you cannot. As the term suggests, you need to be admitted to the hospital to be considered as a post-hospitalisation claim. You can only make this claim after you have been hospitalised and after it has been approved by your health insurance provider.

Can post-hospitalisation expenses be cashless?

No. They are usually done on a reimbursement basis. You have to pay upfront and then make a claim with the insurance company. Some insurers provide cashless claims if the treatment is done at a network hospital or clinic and as per the details mentioned in your policy.

How do I claim post-hospitalisation expenses?

You need to submit a claim form along with all the required documents such as discharge summary, medical bills, doctor’s prescriptions, and receipts, and follow the claim process as instructed to you by your health insurance company.

Is physiotherapy included in post-hospitalisation expenses?

If your physiotherapy is directly related to your hospitalisation and prescribed by the doctor in charge of your treatment, then yes. You need to also check and confirm with your insurance provider if this is included in your health insurance policy.

Do all health insurance plans have post-hospitalisation coverage?

While most plans do have this benefit included in the policy, it can vary depending on the insurance company and terms & conditions included in your policy.

Written by Roocha Kanade

2.5K Linkedin Followers

Reviewed by Dr. Harshita Dahiya

Health Insurance content enthusiast who turns complex topics into easy, binge-worthy reads—fueled by SEO, creativity, and way too much chai! Loves juggling multiple projects, cracking impossible deadlines, and sprinkling humor into the mix. When not geeking out over digital trends, you'll find her lurking on Quora and Reddit, planning the next getaway, or passionately decoding all things health and insurance!