How Long Do You Have To Submit A Medical Insurance Claim?

How Long Do You Have To Submit A Medical Insurance Claim?

We all know very well how much health insurance is helpful to us in our day-to-day life. And, after the Pandemic, we are more aware of the benefits of having health insurnace. But, still, a few people complete health claim information.

So, in this article, we will tell you every essential thing about health insurance that one should know and its claiming process.

Now, let’s start the article by knowing the actual meaning of health Insurance claims.

What is Medical Insurance Claim?

A medical Insurance claim, also known as a health insurance claim, is a request that the policyholder makes to their insurance company for all the benefits they require during any medical emergency. 

Medical insurance is helpful to all those people who are really in need of financial support to get better treatment. Now, after knowing the actual meaning of medical insurance claims, let’s come to the next point: the type of medical health Insurance Claim.

Types of Medical Insurance Claims:

There are two primary types of Medical Insurance Claims, which includes;

  • Cashless Medical Claim:

Cashless Medical Claims are those where we do not need to pay any treatment or hospital bills. Because in this case, once your claim is submitted to your particular company, the company directly pays the complete medical expenses to your insurance networking hospital.

  • Reimbursement Claims:

Suppose you have cancer, and the hospitals covered under your insurance policy are not providing cancer treatment. So, in that case, you can use the Reimbursement Claim. A reimbursement Claim is nothing but an amount that is paid by you first, and then you make a claim based on that amount by giving enough evidence to your insurance company.

Reimbursement claims are specifically used when taking any treatment from non-networking hospitals.

Essential things to consider while filing a Medical Insurance Claim:

Now, before moving directly toward the Medical Insurance Claiming process, here one must have to take care of a few things, such as;

  • First, your policy will only cover those expenses mentioned in their insurance policy, and the other holder pays all the costs out of pocket.
  • Suppose you still need to complete the claim process accurately; your claim will not be accepted.
  • The time limit for claiming health insurance is 30 days only.
  • So, the policyholder must send all the expense-related details and others before the 30 days are completed.

Process of Claiming Medical Insurance Claim:

As discussed above, the claim is especially of two types cashless and reimbursement. And, here we have the Medical Insurance Claiming process for both types, so let’s discuss one after another;

Cashless Medical Insurance Process:

The following are the steps that one should follow while claiming by using Cashless Medical Insurance.

  • You need to be hospitalized in your insurance networking hospital only and then make contact with your insurance adjuster for further help.
  • Another step after being admitted to the hospital is to show some valid proof, such as the health card of the particular insurance firm in the hospital.
  • Once the verification completes, the hospital will take a pre-authorization detail filled by you in a form for their records.
  • After filing the form, you need to submit it to the hospital desk, as you have to submit this form to your insurance providers.
  • Once your form is submitted to your insurance providers, they will double-check the paper and see all the documentation you have submitted, along with the pre-authorization letter.
  • Then, the next and vital step you need to consider is paying for all the other expenses that are not part of your coverage. 

Reimbursement Medical Insurance Claiming Process:

Following are the steps of the Reimbursement Medical Insurance policy;

  • The first step is to inform your insurance company that you are hospitalized for whatever reason as soon as possible.
  • They start taking treatment from the hospital.
  • Now, once the treatment is over, pay the hospital bill; and collect all the documents and treatment bills from the hospital.
  • Then, submit all the relevant documents to your insurance company when you are discharged.
  • After submitting the documents, your insurance company will check them thoroughly and then claim as per the terms and conditions of the company.
  • And after the entire process of claim is get completed, then and then only you will get paid for all the expenses.

Now, if we talk about the total time the claim requires, it depends upon your process and how accurately you are filling out the entire claiming process. Sometimes, it might take a few days, or some may take a month to complete the process. Mostly all those using the reimbursement claiming process need more time to make a claim.

Final Words:

We already know the importance of Medical Insurance, so most of us have the policy with us. But many people still are so tense when claiming by using the health insurance policy; they don’t have the appropriate information.

So, here this article is specifically written to help those who need more information related to making a health insurance claim. Here, we have mentioned the types of medical insurnace claims, their process, and the time it takes.

We hope that, by reading our article, you get clarity about how to make a medical claim and what things you must consider before making a claim. Still, if you need any help related to the same, feel free to comment in our given comment section.

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