Aditya Birla Health Insurance Co. Limited

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Aditya Birla Health Insurance Co. Limited

What Are Pre & Post-Hospitalisation Expenses?

Understand the medical costs covered before and after your hospital stay

Pre-Hospitalisation Expenses

Medical costs incurred before you are admitted to the hospital, such as doctor consultations, diagnostic tests, or prescribed medicines related to the illness.

Typically covered: 30 days before admission
Post-Hospitalisation Expenses

Costs incurred after discharge, including follow-up consultations, medicines, and tests needed for recovery from your treatment.

Typically covered: 60-90 days after discharge

Disclaimer: Coverage duration and limits vary by policy, always refer to your policy document for clarity.

Type of Expense

Below are the few examples

You visit a doctor for consultation due to a health concern
Doctor recommends diagnostic tests (e.g., blood tests, scans)
Medicines are prescribed before hospital admission

How to Claim Pre & Post-Hospitalisation Expenses

You can submit your claim easily through the Activ Health App or Customer Portal.

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Before submitting your claim, ensure that the expenses you're claiming are:

  • Directly related to the same illness or treatment for which you were hospitalised
  • Prescribed by a registered medical practitioner
  • Incurred within the allowed pre- and post-hospitalisation period mentioned in your policy
Disclaimer: Expenses unrelated to the hospitalisation or incurred outside the allowed duration may not be covered.

Having complete and clear documents helps avoid delays. Keep the following ready:

  • Duly filled, signed, and stamped claim form
  • Doctor's prescriptions corresponding to the bills
  • Pre- and post-hospitalization bills and payment receipts
  • Consultation papers and diagnostic reports
  • Discharge summary from the hospital
  • Cancelled cheque / bank details of the proposer (In case of death, a cancelled cheque of the nominee)

Upload your documents and submit your claim within the timeline specified in your policy generally within 30 to 90 days from the date of discharge.

For exact timelines applicable to your plan, please refer to your policy document.

Once your claim is submitted:

  • Our claims team reviews the documents
  • We verify whether the expenses are linked to the hospitalization
  • If additional information or documents are required, we'll notify you promptly via SMS, email, or app notification

If the expenses are found to be:

  • Medically necessary
  • Related to the same condition as the hospitalisation
  • Within policy limits

Your claim will be approved and settled as per policy terms. The reimbursement amount will be credited to your registered bank account.

Disclaimer: You can track the status anytime through the Activ Health App or via the Track Claim page on our website.

Important Things to Keep in Mind

Pre & post-hospitalisation claims follow the same registration and intimation flow as your main hospitalisation claim.

Only expenses backed by valid prescriptions and invoices are considered.

Claims submitted beyond the allowed timeline may require a reason for delay and are subject to approval.

Coverage duration and limits vary by policy always refer to your policy document for clarity.

Documents Required for Health Insurance Claims

The documents required may vary depending on the type of claim you are submitting. Refer to the table below to understand what's needed.

Document Type
Pre & Post Hospitalisation
Claim Form (duly filled & signed – required only for offline submission)
Personalized Cancelled Cheque with proposer’s name / Passbook / Bank-signed NEFT form
CKYC Form with CKYC Number (PAN & Aadhaar mandatory as per IRDAI guidelines)
Discharge Summary / Day Care Summary
Final Hospital Bill with Paid Receipt
Doctor’s Prescriptions corresponding to bills
Diagnostic Reports (X-Ray / CT Scan / MRI Reports & Films)
Pre & Post-Hospitalisation Bills and Payment Receipts
Consultation Papers

Common Reasons for Rejection

Submitted beyond allowed time
  • Claims should be submitted within:
    Pre-hospitalisation:
    within 30 days before admission
    Post-hospitalisation:
    within 60–90 days after discharge
Late submissions may not be accepted
Missing or Incorrect documents
  • Bills, prescriptions, or reports are incomplete or not submitted
  • Details in documents do not match (e.g., name, dates, treatment)
Ensure all documents are accurate and complete
Unverified or Invalid reports
  • Diagnostic reports are inconsistent or not from valid sources
  • Mismatch between diagnosis and treatment bills
All reports must be valid and consistent
Non-Hospital Expenses
  • Expenses are not linked to the same illness or treatment
  • General or unrelated medical costs are included
Only related expenses are covered