UNDERSTANDING MAJOR DIFFERENCE BETWEEN NETWORK AND NON NETWORK HOSPITALS

The main difference between network and non-network hospitals lies in how medical expenses of patients are handled. Network hospitals have tie-ups with insurance providers, enabling cashless treatment where bills are settled directly by the insurer. This makes the process smooth and hassle-free for patients. In contrast, non-network hospitals don’t have such agreements, requiring people to pay medical expenses upfront and later claim reimbursement, which often involves more paperwork and takes longer to process.

In this current age, having a health insurance policy is the prime necessity for everyone. Changing lifestyles among individuals have increased the health risks and uncertainties that often come unannounced. Medical insurance coverage can help individuals overcome these challenges by providing them much-needed financial assistance during the time of emergencies.

Availing an appropriate health insurance policy needs an understanding of two key aspects including network and non-network hospitals. While choosing between these two types of hospitals can significantly impact your medical expenses, convenience, and quality of care. Moreover, one-stop platforms like Quickinsure, help you compare health insurance companies and their hospital networks that would further help you make informed decisions not only during health emergencies but also during pre-planned treatments.

What are Network Hospitals?

Network hospital refers to the medical facilities that make an agreement with a health insurance provider to offer services. These specific hospitals are considered as the part of the insurance company’s network. This means they have agreed to provide healthcare services to policyholders under certain terms and conditions. When individuals receive treatment under a network hospital, their health insurance companies mostly settle the bill directly with the hospital. The medical expenses are covered partially or entirely, depending on their policy plans.

Key advantages of network hospitals:

●        Cashless treatments: Opting of network hospitals help policyholders get treatment without making immediate out-of-pocket payments. The insurance company directly handles the financial transactions with the hospital.

●        Minimal costs: Choosing private medical insurance providing companies along with network hospitals can make the treatment more affordable, since the rates are pre-negotiated.

●        Quality assurance: Most insurance companies select network hospitals based on their quality of care, services, and infrastructure. This enables individuals to avail of a reliable standard of treatment.

What are Non-Network Hospitals?

On the other hand, non-network hospitals do not make formal agreements with the health insurance provider of individuals. This means, if individuals choose to receive treatment at a non-network hospital then they are likely to pay the medical expenses upfront. They will not receive cashless hospitalization in these medical set-ups.

Individuals can receive reimbursements from their insurance providers by providing required documents and fulfilling formalities. This part is mostly handled by a third-party administrator (TPA), that is assigned to various hospital networks. They monitor a lot of things, including the documentation process for cashless, entire billing of patients across hospitals, and many more.

Key characteristics of non-network hospitals include:

●        Settling Down medical expenses:  In non-network hospitals, patients need to pay for their medical bills at the time of treatment, and then ask for reimbursement.

●        Higher treatment costs: In these hospitals, people can experience increased treatment costs.

●        Varied quality: Here, patients can feel the difference in quality of care and services compared to network hospitals.

Key Differences Between Network Vs Non-Network Hospitals

Aspects	Network Hospitals	Non-Network Hospitals
Payment Method	Supports cashless transactions	Requires immediate payments, with potential later reimbursement
Convenience	Higher, because of direct settlement of bills by the insurer	Lower, because patients handle all billings and claim submissions by themselves.
Quality Assurance	Top-class standard, as thoroughly examined by insurance companies.	There is significant variation in quality.
Cost	Lower due to pre-negotiated rates.	Generally higher with no pre-negotiated rates.
Claim Process	Simple and minimal paperwork	Lengthy reimbursement process which needs more documentation.

Key Comparisons between Leading Insurer’s Network Hospitals in India

In India, Niva Bupa network hospital and Star Health network hospital are widely popular because of providing extensive benefits to their insurers. Their health insurance plans are designed to meet the requirements of insurers, ensuring they meet the requirements of insurers and get the maximum benefits.

Niva Bupa Health Insurance Plans and Benefits

Niva Bupa Health Insurance provides a wide range of plans tailored to suit different individual needs. Each plan comes with unique features and benefits. Major health offerings are as following:

●        Individual health plans: These plans are designed to cover an individual’s medical expenses, starting with an affordable premium of under ₹5,000, while providing comprehensive protection during medical emergencies.

●        Family plans: These plans provide coverage of the entire family under one single plan. Any family members can benefit from it.

●        Senior citizen plans: These plans are specifically crafted for senior citizens, offering extensive coverage that includes ambulance services, organ donor expenses, AYUSH treatments, and other essential healthcare needs for older adults.

●        Critical illness: This plan offers extensive protection against 20 major critical illnesses, providing financial support during serious health emergencies.

Key benefits of this insurance policy:

●        Niva Bupa has a wide network of over 10,000 hospitals across India, providing cashless treatment facilities to ensure a hassle-free healthcare experience.

●        It offers renewal discount on premiums, allowing individuals to enjoy continued coverage at a reduced cost.

●        It offers an impressive 100% claim settlement ratio, ensuring reliable and timely claim approvals.

Star Health Insurance Plans and Benefits

Star Health Insurance also offers a diverse range of plans tailored to meet various healthcare needs. Here are their health offerings:

●        Individual plans: These Star Health Insurance plans offer comprehensive health coverage tailored to meet individual healthcare needs.

●        Family plans: These plans offer family coverage under a single policy, helping reduce the overall financial burden of medical expenses.

●        Plans for diabetes people: These plans are specially designed for diabetic patients, offering coverage for insulin expenses, regular blood tests, and other diabetes-related treatments.

●        Senior citizen plans: These plans are specifically designed for senior citizens, offering comprehensive health benefits with no mandatory pre-policy medical screening required for eligibility.

Key benefits of star health insurance:

●        Star Health Insurance has a vast network of over 14,000 hospitals, providing customers with extensive options for cashless treatment facilities.

●        A co-payment applies for individuals above 60 years of age, while no co-payment is required for those below 60.

●        It offers a strong claim settlement ratio of 99.6%, demonstrating its reliability and commitment to policyholders.

●        Star Health Insurance provides a variety of wellness programs and offers discounts of up to 20% on these initiatives.

List of Network Hospitals in India

Here are some renowned network hospitals in India:

●        Niva Bupa Health Insurance

●        Star Health Insurance Plan

●        Care Health Insurance

●        Bajaj General Health Insurance

●        TATA AIG Health Insurance

●        ICICI Lombard Health Insurance

●        Aditya Birla Health Insurance

●        Bharti AXA Health Insurance

●        Reliance Health Insurance

●        HDFC ERGO Health Insurance

The Bottom Line

Understanding the difference between network and non-network hospitals is crucial for making informed health insurance decisions. In addition, insurers network hospitals, like Niva Bupa and Star Health, offer comprehensive plans and customer-focused benefits. These insurance policies ensure financial security and access to quality healthcare when needed most, making them reliable choices for your medical insurance needs.

Compare top health insurance companies in India and find the best cashless network with Quickinsure.

FAQs:

1. What is the main difference between network and non-network hospitals?

Network hospitals offer cashless treatment, while non-network hospitals require upfront payment with later reimbursement.

2. Why should I choose a network hospital for treatment?

Network hospitals provide cashless services, lower costs, and assured quality care.

3. Can I get reimbursement if treated in a non-network hospital?

Yes, you can claim reimbursement by submitting required documents to your insurer.

4. How many network hospitals does Niva Bupa have in India?

Niva Bupa has over 10,000 network hospitals across India.

5. What is the claim settlement ratio of Star Health Insurance?

Star Health Insurance boasts a high claim settlement ratio of 99.6%, ensuring reliability.