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What Is Network And Non-Network Hospital In Health Insurance?

Almost all health insurance companies have a collaboration with hospitals, chains of hospitals and healthcare centres. These hospitals are said to be in the network of the insurance company and thus, are called network hospitals. At a network hospital, you have the advantage of getting cashless treatment. The difference between network and non-network hospitals is that at a network hospital, the insurer will settle your medical bills with the hospital directly. If in case you receive some treatment in a non-network hospital, you would not be able to get cashless treatment and would have to pay the bills upfront. After your discharge, you can file for reimbursement for the covered expenses

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 If you’ve ever shopped for a health insurance policy, you would have seen many insurers claiming that they support a large number of network hospitals. Have you ever wondered what that meant?

If you have, then this article can help you understand what is a network and a non-network hospital. Let’s first begin with network hospitals and try to get some clarity on what they are.

Differences between Network and Non-Network Hospitals

There are quite a bit of differences between both network and non-network hospitals. Knowing what they are can help you make a better and a more informed purchase decision when it comes to health insurance policies. Here’s a table that clearly outlines some of the key differences between both kinds of hospitals.

Network Hospitals

Non-Network Hospitals

Network hospitals provide health insurance policyholders with the benefit of cashless claim facilities.

Non-network hospitals don’t provide health insurance policyholders with the benefit of cashless claim facilities. Instead, policyholders are required to make reimbursement claims with their insurer.

The paperwork and documentation that the policyholder is required to fill up and submit are far lower at network hospitals.

Since policyholders are required to make reimbursement claims for the costs incurred at non-network hospitals, the quantum of paperwork is much higher and the entire burden falls on them.

With network hospitals, policyholders don’t have to worry about having to arrange the necessary funds required to undergo treatment. The health insurance provider takes care of it.

Policyholders undergoing treatment at non-network hospitals will have to arrange for funds themselves since they would have to bear the entire cost of treatment out of their own pocket.

Since policyholders get the benefit of cashless claim facilities, there’s no time lag between the treatment and the payment of the treatment costs.

Since only reimbursement claims are supported at non-network hospitals, there’s a significant lag between the time you pay for the treatment cost and the time you get the funds reimbursed to you.

Should you go to a Non-Network Hospital

Ideally, going to a network hospital is the better option since you get to enjoy plenty of benefits such as lower paperwork and cashless claim facility. Also, by visiting a network hospital, you get to focus on getting better instead of having to carry the financial burden of arranging funds for the treatment.

 

That said, not all health insurance plans may have a network hospital near you. In such cases, you may be forced to visit a non-network hospital, especially if it is for emergency medical help, assistance, or treatment. In such cases, you cannot completely rule out the possibility of having to visit a non-network hospital.

 

However, if your condition is stable and non-life threatening or if the procedure and treatment is a planned one, visiting a network hospital will be the better bet for you.

Conclusion

Hope you have now understood what a network and a non-network hospital are. Here’s a piece of advice. When shopping for a health insurance plan, take into account the number of network hospitals supported by the health insurer. Also, make sure to check if any of the network hospitals supported by the insurer is near your usual place of residence.

 

This way, you can ensure that you visit a network hospital even during times of emergencies and make your treatment process as smooth and hassle-free as possible. If you’re looking for health insurance policies, Finserv MARKETS is where you should head to. You can browse through the various options, compare their features, and take a look at the number of network hospitals supported before making your decision.  

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FAQs on Network Hospitals vs Non-Network Hospitals

✔️What is the major advantage that I get to enjoy by going to a network hospital?

By visiting a network hospital, you get to enjoy cashless claim facilities, where the insurer directly settles your bills with the hospital.   

✔️Do non-network hospitals offer cashless claim facilities?

No. Cashless claims are restricted only to network hospitals.  

✔️How long do I have to wait till I get my medical costs reimbursed to me in the case of a reimbursement claim?

Depending on the insurer, it might take days or even weeks for you to get your medical and treatment costs reimbursed.  

✔️Where can I check the list of network hospitals supported by my health insurance policy?

The health insurance policy document will contain the list of network hospitals supported by it. Alternatively, you can also get in touch with your health insurer for more information regarding this as well. 

✔️Do network hospitals offer reimbursement claim facilities?

 Yes. Network hospitals do offer reimbursement claims. However, since they also offer cashless claims, it is more advantageous for a policyholder to opt for cashless claims instead of reimbursement claims.