Out Patient Insurance Coverage

[tonray]

If someone has local health insurance, Bupa Thailand for example, without Out Patient coverage. 

 

If one visits a private hospital and the hospital wants to perform an MRI or other expensive test without admitting you, how is that claim handled ?

 

Thanks for all advice.

[simon43]

If one visits a private hospital and the hospital wants to perform an MRI or other expensive test without admitting you, how is that claim handled ?

 

AFAIK, it would be rejected, on the grounds that you were not admitted.

 

As an example, I have in-patient coverage and no out-patient coverage.  I have an injured shoulder (fell off a ladder), and probably need a scan and then surgery.  To ensure that I'm fully-covered, I need to plan my time so that I can be admitted for the scan and then surgery.

[Sheryl]

Most inpatient only policies will cover day surgeries and most that I have seen also cover procedures like CT, MRI, endoscopy though often requiring pre-approval.

 

The policy should specify.

[tonray]

25 minutes ago, simon43 said:

 

 

 

AFAIK, it would be rejected, on the grounds that you were not admitted.

 

As an example, I have in-patient coverage and no out-patient coverage.  I have an injured shoulder (fell off a ladder), and probably need a scan and then surgery.  To ensure that I'm fully-covered, I need to plan my time so that I can be admitted for the scan and then surgery.

I will attempt to do the same then.