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Hospitalisation Claim - Dollar Knots
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Introduction To Hospitalisation & Surgical Insurance

The name itself is self-explanatory. If you happen to need medical treatment at a hospital and you have to go through surgeries plus be warded for a few days, a Hospitalisation & Surgical (H&S) Plan will cover the cost of it. 

In Singapore, the plans that have the word "shield" in the name, are H&S plans.

It strictly covers inpatient expenses. However certain outpatient expenses are covered as well (depend on the terms of the plan). The overall coverage of the plans does depend on whether you have bought the rider (an additional coverage to minimise your own out of pocket expenses).

For medical expenses, you incurred from the trip to the A&E (Accident & Emergency), that will not be covered. Nonetheless, you are able to claim it from your Personal Accident plan.

3 Stages Of Hospitalisation

To make a claim, you do need to clarify which stage you are at. Each stage has different ways of making a claim. 

Pre-hospitalisation

This will constitute an appointment with a medical practitioner that will lead to an eventual trip to the hospital. In other words, you are being referred and advised to head to the hospital for a surgery or a stay there. You are then able to claim the expenses of this appointment.

However, claims at this stage is on a reimbursement basis. Meaning, you have to pay the bills first and subsequently make a claim.

During hospitalisation

At this stage, you are either a patient having needed a surgery or a patient who is being warded at the hospital. Most times, you do need to fork out a single dime when you are getting discharged (depending on the hospital). But this will only work if the hospital knows or has been informed that you do have an H&S plan. With that, it is important to let the hospital staff be aware of this particular information.

Once the hospital staff is informed, the hospital and your insurer will liaise with each other on the information of the hospitalisation. Subsequently, the insurer will issue a Letter of Guarantee (LOG). This LOG is the very document as that will make you walk out of the hospital "free".

Few days or even weeks after the discharge, you will be sent a letter stating how much is the overall bill and also how much you do need to pay.

Post-hospitalisation

Follow-ups to the hospitalisation are basically what a post-hospitalisation constitutes of. So those physiotherapy or evaluation are claimable. Important note, same as the pre-hospitalisation, it is on a reimbursement basis. Pay first, claim later.

NOTE: Both Pre-hospitalisation & Post-hospitalisation have limits on the coverage period. It may be 90 days before admission for Pre-hospitalisation or perhaps 365 days after being discharged. Therefore, do take note of the timeline. 

Things You Need To Make A Claim

Pre-Hospitalisation & Post-Hospitalisation

  1. Medical Report
  2. Doctor's Memo
  3. Receipt

During Hospitalization (When you are staying there)

All you need to do for a smoother claim experience is to make sure you inform of the hospital staff of your insurance coverage. If you are unable to inform them, your family can inform them on your behalf. Which brings to the importance of you telling your family of your own coverage .

Submission

Pre-Hospitalisation & Post-Hospitalisation

Submit the documents above through mail. Or you passed it your financial adviser to assist you with it. Most times, an original copy is needed. With that, make sure you keep hold of it.

During Hospitalization (When you are staying there)

To sum it up, you do not need to do anything as long as you have informed the hospital about your insurance coverage.

All you need to do is rest and recover.

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