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Difference between Network and Non-Network Hospitals in India
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What is the Difference between Network and Non-Network Hospitals?

Ajitesh (29-years-old) is married for the last 2 years and he works in a marketing company. Ajitesh is planning to purchase a health insurance policy for both of them so that they can stay protected against various diseases. But Ajitesh doesn’t have much knowledge regarding health insurance policies and how they offer coverage. Ajitesh is accumulating information from the internet to boost his knowledge. He came to know there are two popular terms in the field of health insurance and they are network and non-network hospitals. He got confused about what is the difference between network and non-network hospitals and which one he should opt for.

Here, we are going to discuss network vs non-network hospitals in detail so that people like Ajitesh get adequate knowledge regarding this. We all know, why do we need hospitals, but we will now help you understand which type of hospital to choose between network and non-network hospitals.

What are Network Hospitals?

Health insurance companies realized that if an insured policyholder becomes ill, the insured policyholder will certainly return to insurers with hefty claims for his/her treatment costs. This means the company needs to pay a humongous amount to the policyholder. To turn the situation in their favor, insurance companies have selected some hospitals and incorporated them into their network. These partnered hospitals are known as network hospitals. If you want to avail of health insurance with a cashless facility, you need to only choose network hospitals. Once you are admitted to any network hospital (according to your policy agreement), you don’t need to pay a single penny from your pocket. Your insurance provider will settle the bills directly with the hospital on your behalf.

What are Non-Network Hospitals?

Non-network hospital means those hospitals that are not associated with the insurance company while purchasing a health insurance policy from a service provider. If you are admitted to these non-network hospitals for your injuries/ailments, you need to pay all healthcare bills from your pocket, and then you can raise claims by submitting the required documents for reimbursement of the claim amount.

What is the Difference Between Network and Non-Network Hospitals?

Let’s take a look at some of the prime differences between network and non-network hospitals.

4 Major Difference Between Network and Non-Network Hospitals

S. No. Network Hospital Non-Network Hospital
1 When you buy a health insurance policy from an insurer, network hospitals are exclusively included in the insurance agreement. Non-network hospitals are the hospitals that are not mentioned in the agreement.
2 Network hospitals are the only hospitals that will offer you cashless benefits. So, if you want to enjoy the best treatment without paying anything from your pocket, you must choose a network hospital. Non-network hospitals don’t offer any kind of such services. If you are admitted to a non-network hospital, you need to pay off all the expenses from your side. Once discharged, you can claim reimbursement by submitting all the essential documents.
3 At network hospitals, the paperwork is limited. For network hospitals, the health insurance card from the insurer or pre-authorization form is adequate. If you select a non-network hospital for your treatment, then you have to go through a lengthy process of compiling and filing paperwork for claim reimbursement.
4 The most imperative thing is that if you are admitted to a network hospital, you don’t need to worry about the money. Your treatment will be done without arranging cash. But if you want to get treated at a non-network hospital, you first need to arrange the funds for the treatment.

What is GIPSA for Health Insurance?

GIPSA full form is General Insurance Public Sector Association. GIPSA is made by four eminent public sector insurance companies, including Oriental Insurance Company, New India Assurance Company, National Insurance Company, and United India Insurance Company. These insurance companies have limited cashless services solely for hospitals. Thus, these companies joined their own preferred provider network or PPN and formed GIPSA. This decision has made the life of more than 5.49 crore health insurance policyholders easy. So, now you know the PPN hospital meaning.

According to the report, till now, there are 560 GIPSA hospitals all over India. GIPSA is hopeful that the health insurance industry will get a plethora of advantages from this new system. GIPSA hospitals are situated in cities like Ahmedabad, Chandigarh, Chennai, Delhi, Hyderabad, Mumbai, Indore, Coimbatore, Kolkata, Bangalore, Jaipur, and Pune. The prime purpose of GIPSA is to offer standardized packages & rates to the policyholders so that they don’t get exploited by hospitals. GIPSA also ensures that the sum insured amount has been utilized properly in the case of hospital admission. Treatment procedures, including Kidney Transplant, Total Knee Replacement, Liver Transplant, CABG, Dialysis, etc. are generally covered under GIPSA Rates.

Now, people have an adequate idea regarding GIPSA meaning and how it works in the health insurance industry.

Network vs Non-Network Hospitals- Who Wins?

Choose a network hospital if you are looking for medical treatments for yourself or your loved ones. Every health insurer offers a list of network hospitals to policyholders at the time of purchase. A policyholder should go through the list for quick reference in the case of healthcare emergencies. In the case of any medical contingency, a policyholder should choose a network hospital to get the cashless hospitalization benefit. In case of planned hospitalization, a policyholder should contact the TPA a few days before the admission and must submit all necessary documents.

You can choose a non-network hospital only in case of emergencies or when the required treatment is not covered by any network hospital.

The Conclusion:

It would be a prudent decision if you thoroughly check the list of network hospitals before investing a single penny in your health insurance. Always buy a policy from an insurance company that has a wide range of network hospitals so that you can enjoy the best treatment without bearing any expenses.

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