When you buy health insurance, one of the most important things to understand is how your hospital bills will be handled. Will you need to pay upfront? Will the insurance company pay the hospital directly? This is where the concept of network hospitals and hospitals come into play. Understanding the difference between network and hospital can help you to make informed choices not only during emergencies but also during pre-planned treatments.

Working mechanism of network and non-network hospitals

Before getting into the comparison, it is important to know what is network and non-network hospital and the process adopted when you require medical assistance:

Network hospitals:

Network Hospitals are the type of hospitals that have a tie-up with your insurer. This means:

• They provide cashless treatment, in which your insurance pays the hospital
• The only thing you need to pay for are non-covered expenses (such as meals, personal items, and so on).
• These hospitals are pre-approved and adhere to service levels agreed upon in advance with the insurer.

If you have a planned surgery or face an emergency, you can choose a network hospital and avoid the stress of arranging funds.

Non-network hospitals:

Non-network hospitals have no agreement with your insurer. This means:

• You will be responsible for first covering all medical costs
• Later, you can file for reimbursement with your insurance
• Reimbursement requires documentation such as hospital bills, discharge summaries, prescriptions, and other relevant medical records.

The absence of cashless service in non-network hospitals can be inconvenient during emergencies. But in remote locations or under certain circumstances, they might be your only option.

Network vs Non-Network Hospitals: A Comparison

Let’s take a quick look at how network and non-network hospital options compare in different scenarios:

1. Cashless facility

• Network hospitals: Offer cashless You only pay for what insurance doesn’t

cover.

• Non-network hospitals: No cashless You pay everything first and claim later.

2. Ease of access

• Network hospitals: Typically available on your insurer’s website or app. Easy to
• Non-network hospitals: You will have to locate the hospital or decide yourself where to get the treatment.

3.  Paperwork and formalities

• Networked hospitals: Less TPA (Third-Party Administrator) takes care of it.
• Non-network hospitals: Extensive paperwork for

4.  Emergency support

• Network hospitals: Quicker admission and support because the hospital has experience dealing with your insurer.
• Non-network hospitals: The process is less smooth; you’ll have to manage payments and

5.  Financial convenience

• Network Hospitals: Less financial strain at the
• Non-network hospitals can temporarily strain your

6.  Claim settlement time

• Network hospitals: Faster settlement via the insurer directly to the
• Non-network hospitals: Settlement only after you submit documents and they are

Why it matters for insurance policyholders

If you're covered under a group health insurance or group insurance policy from your employer,

it’s essential to understand how hospital networks work:

• Group policies often come with a predefined list of network
• Using these hospitals allows you to avail of quick treatment without upfront
• Non-network hospital visits can lead to delays in reimbursement and added

Whether you’re managing your own health insurance or are covered under your employer’s

group insurance, knowing this distinction saves time and money.

Tips for policyholders

• Check hospital networks regularly: Insurers frequently update their list of network
• Inform insurer in advance (if planned): If you’re opting for a scheduled surgery, notify your insurer at least 48 hours in advance.

• Carry your insurance card: It helps speed up admission at network

• Collect and save all documents: If admitted to a non-network hospital, you’ll need every receipt and report for reimbursement.

• Use customer care support: Most insurers offer helpline support to locate network hospitals nearby.

Conclusion

Knowing the difference between network and non-network hospital is important when purchasing or using health insurance. If you want to avoid financial stress during a medical emergency, always prefer network hospitals if possible. They offer cashless facilities and ensure a smoother claims processing experience.

However, if a non-network hospital is your only option, be prepared to pay upfront and retain the documents to receive reimbursement for the expenses. Whether you’re planning treatment or facing an emergency, knowing what is network and non-network hospital is important.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is advised to verify the currency and relevance of the data and information before taking any major steps. Please read the sales brochure / policy wordings carefully for detailed information about on risk factors, terms, conditions and exclusions. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.