What is a Non-Network Hospital in Health Insurance?

Non network hospital meaning is that it is a hospital that is not in the network of your health insurance company. In health insurance, a non-network hospital refers to a health care facility that doesn't have a formal contract or agreement with your health insurance provider, meaning that you must pay for services upfront and then get a reimbursement, potentially incurring higher out-of-pocket expenses. Non-network hospitals are hospitals that are excluded from the list of health insurance companies' networks altogether. If you're admitted to a non-network hospital, then you must pay for the treatment upfront and then submit a reimbursement claim to your health insurance company. When you seek a reimbursement claim, you must provide the documentation needed to cover the expenses. Also, you must submit all necessary medical bills to your health insurance company for reimbursement. Non network hospitals need upfront payment and may have a slightly complex reimbursement process compared to network hospitals. However, non-network hospitals might provide more flexibility in choosing providers. A non-network hospital could be chosen as the hospital near your location. In some cases, the Non network hospitals might charge higher rates, resulting in higher out-of-pocket expenses. Also, reimbursement for being admitted to a non-network hospital must be collected and submitted to your health insurance company for reimbursement.

Explaining Non-Network Hospitals in Health Insurance Plans

A non-network hospital is a hospital that is not part of an insurance company’s network of healthcare providers. In other words, the hospital is not contracted with the insurance company to provide cashless medical services to policyholders.

When a policyholder receives medical treatment at a non-network hospital, the policyholder has to make the payment and later claim for reimbursement.

In some health insurance companies, the terms and conditions of a health insurance policy will specify whether the policy covers non-network hospitals and, if so, to what extent. Some policies may have a higher deductible or coinsurance for non-network hospitals, while others may not cover non-network hospitals at all.

Policyholders should also consider consulting with a healthcare professional or insurance agent to help them understand the details of the policy and choose the best option for their needs.

Most of the Health Insurance companies provide coverage on the basis of Cashless mode in network hospitals associated with the Insurance company.

However, the policyholders who are hospitalised in non-network hospitals can later claim reimbursement after submitting the necessary bills and documents in their original form to the health insurance company.

In general, it is recommended that policyholders receive medical treatment at network hospitals wherever possible. Network hospitals are part of the insurance company’s network of healthcare providers, and they have agreed to provide medical services to policyholders at a pre-negotiated rate.

As a result, policyholders may pay a lower out-of-pocket cost for the services when they receive treatment at a Network hospital and save their Sum insured.

Policyholders can find out which hospitals are part of their insurance company’s network by checking the official website of the Health Insurance company or calling their customer service number.

A non-network hospital is a hospital that is not part of an insurance company’s network of healthcare providers.

In some cases, policyholders may need medical treatment at a non-network hospital, such as in an emergency. When a policyholder receives medical treatment at a non-network hospital, he/she can only opt for reimbursement after submitting the necessary Original documents to the insurance company.

One of the renowned Health Insurance providers, Star Health Insurance, is associated with a whopping 13000+ network hospitals. Hence, policyholders can avail of treatment at any network hospital in India with a hassle-free experience.

For more details regarding health insurance policies and network hospitals, visit the official website of Star Health Insurance.

HELP CENTRE

Confused? We’ve got the answers

We’re Star Health. We offer the coverage that’s designed to help keep you healthy. It's the care that comes to you, and stays with you.

FAQ

Can non-network hospitals accept health insurance?

Yes, Non-network hospital accept health insurance. However, it provides coverage only in the form of reimbursement and not in cashless mode.

Can I claim my health insurance in any hospital?

You can claim health insurance in any hospitals except excluded hospitals. The difference is you can raise cashless claims in-network hospitals. In the case of non-network hospitals, a cashless facility is not available, but one can get a reimbursement claim there.