• Short Term Health Insurance Blog

  • Monday, November 20, 2017

  • Pre-certify Your Hospitalization for Short Term Insurance

    Filed Under: Blogging

Most health insurance plans, including short term health insurance plans, require you to pre-certify your condition prior to hospitalization. This is simply for the insurance company to determine that the hospitalization was, in fact, medically necessary and to approve the hospitalization.

For instance, let’s say you were found to have a fracture and the doctor prescribes a minor surgical procedure followed by hospitalization. If the date of hospitalization is known, you must inform the insurance company of the impending hospitalization a week to 10 days before the hospitalization. This period depends on the plan requirements.

If you are in an emergency situation, you usually have some time before you must notify the insurance company. Depending on the plan, you must let the insurance company know about emergency hospitalizations 24 to 48 hours within the time of the admission.

If you do not pre-certify your hospitalization you stand to lose anywhere from 25% to 50% of eligible benefits. Remember, however, that pre-certification does not mean that your claim will be settled, nor is it guarantee of coverage. While hospital staff usually check whether you have pre-certified the hospitalization prior to admission, it is best to let the nearest relative/friend know about the pre-certification procedure, so that they can either remind you or let the insurance company know in case of an emergency.

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