Comparing network hospitals across health insurance plans: Why it matters?
Premiums, sum insured, waiting periods, and essentially, the money you have saved, these are the few things that come to mind as you hear about health insurance. More or less, terms and conditions also take up a good share of attention. All of these are crucial, but one aspect that sometimes (if not always) gets sidelined. We are talking about the network hospital list, a part of health insurance policies that is too critical to overlook, especially if you are about to buy a family floater plan. What are network hospitals and what do they mean for you? Keep reading to find out.
What are network hospitals?
The network hospital is one that has a tie-up with your insurance provider. So, if you are hospitalised there, you can opt for cashless treatment. This means that the insurer will settle the bills (which qualify for approval as per policy terms) directly within the hospital. This is more convenient than non-network hospitals, where you must pay up front and then submit bills to your insurer to get reimbursed.
5 benefits of network hospitals
What seemed like a premium benefit at one point has now become common practice in the health insurance space. According to IRDAI’s annual health report, health insurance companies have settled 58.39% of the total number of claims through cashless mode 2023-24.
Before we discuss the tips to compare network hospitals, let’s briefly discuss this roundup of the reasons why they even matter in the first place.
- Quick access to treatment during emergencies: Network hospitals reduce the need to arrange large sums at short notice.
- Faster, simpler process: Treatments at network hospitals mean less paperwork and processing friction. 
- Lower out-of-pocket surprises: With pre-authorisation controls and negotiated rates, you can access treatments at lower costs compared to non-network hospitals.
- Higher chance of on-the-spot support: Hospitals in-network usually have a dedicated claims desk and direct lines to a TPA or insurer for claim approvals.
The catch is: Cashless claims can still be delayed or rejected for different reasons, like policy exclusions, late intimation, non-medical issues, or documentation.
How to compare network hospitals when you evaluate health insurance policies?
Looking for a health insurance plan with a solid cashless hospitalisation scope? Use these tips to make sure you pick the right option:
- Search hospitals by location: This is one of the most important things to do, especially if you are opting for a family floater plan. Make sure hospitals near your home, parents’ homes, and frequently visited cities are empanelled.
- Download the product-specific network list: Walking through the insurer’s generic panel won’t help, since networks can differ between policy variants.
- Check hospital categories: Check if there are tertiary-care centres and specialists that you may need, including cardiac, oncology, neonatal ICU etc.
- Look for large-chain coverage: If you prefer a specific hospital chain, check if it accepts cashless for that insurer (and for that specific plan). Recent disputes have shown this can change suddenly. 
- Confirm cashless process: Health insurance companies with quick online pre-authorisation and a responsive TPA network reduce stress during emergencies.
- Catch up on real customer reviews: Search for claimant stories about cashless approvals and turnaround time for that insurer’s network in your city. News and consumer forums often reveal patterns that can make a huge difference.
- Ask about exclusions and co-pay at-network: Some health insurance plans may require co-pay even at network hospitals or have sub-limits for specific procedures. Read the policy word-for-word.
- Re-confirm at admission: Even if a hospital is listed as empanelled, confirm with both hospital and insurance provider or TPA before admission. Get pre-authorisation in writing.
Making claims easier with network hospitals
Network hospitals help determine how perfectly a health insurance plan works out in the real world, especially in case of an emergency. In family floater plans, where a single coverage is shared among multiple people, finding a policy with the right network ensures a stress-free cashless admission and a long, expensive reimbursement fight at bay. This is important for people with elderly parents and children in the house. That said, the wise move is to always compare product-specific network lists, read terms, and check empanelment at the time of need.
Disclaimer: Plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.
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