Insurance formalities should be the least of your worries during a medical emergency. That's why we ensure
your insurance process is as seamless as your care. At Manipal Hospitals, we work closely with leading insurance providers, corporate insurers, and Third-Party Administrators (TPAs) to offer you a smooth,
hassle-free experience. Our dedicated Insurance Helpdesk is here to assist you with everything, from
coverage details and cashless treatments to claims and approvals.
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FAQs
Is Manipal Hospital empanelled with my health insurance provider?
Manipal Hospital is associated with multiple insurance companies and TPAs for
cashless treatment. You can check the Manipal Hospital insurance list or contact the Manipal
Hospital insurance desk to confirm if your insurance is accepted.
What is the pre-authorisation process for cashless treatment at Manipal Hospitals?
Pre-authorisation is the approval required from your insurer before you can
avail of cashless treatment. At Manipal Hospitals, the process is as follows:
Inform the Hospital: Share your insurance details with the Insurance Desk
before admission (for planned procedures) or within 24 hours (in case of emergencies).
Submit Documents: Provide a valid ID proof, insurance policy details, and a
completed pre-authorisation request form signed by your treating doctor.
Insurer Coordination: The hospital shares your documents with the insurer
or Third-Party Administrator (TPA), who reviews your coverage and may request additional
information.
Approval or Rejection: Based on policy terms, the insurer either approves
or denies the request. If approved, your treatment can proceed cashlessly. If denied, you
may opt for reimbursement.
Are there exclusions related to pre-authorisation?
Yes, your pre-authorisation may be denied if:
The treatment is not medically necessary.
The requested procedure is not covered under your policy.
Incorrect or incomplete documentation is submitted.
What queries can my insurance provider or TPA raise during pre-authorisation?
Your insurer may ask for additional medical reports for verification, any
clarifications on pre-existing conditions, detailed treatment plans for cost assessment and the
policy validity confirmation.
What is a co-payment, and how does it affect my bills?
Co-payment is a fixed percentage of the hospital bill that you must pay, while
the insurer covers the rest. Co-payments vary based on the policy type, patient age or treatment.
What should I do if my insurance policy has a waiting period?
A waiting period is the time you must wait before claiming coverage for specific
conditions. Standard waiting periods include:
30 days for general illnesses.
2-4 years for pre-existing diseases.
1-2 years for maternity benefits.
If your Manipal Health Insurance policy has a waiting period, you may need to bear the treatment
cost until the waiting period is over. However, some group policies or employer-provided plans might
have reduced waiting periods—check with your insurer for details.
How can I contact the Manipal Hospital Insurance Desk?
For queries related to cashless treatment, policy coverage, or claims, you can
reach out to the Manipal Hospital insurance desk contact number available at your nearest hospital
branch.
What health insurance plans are accepted at Manipal Hospital?
We accept a wide range of insurance providers, including Manipal Health
Insurance, Star Health Insurance, and Manipal Cigna Health Insurance hospital empanelment. It's
recommended that you verify with your insurer for specific coverage details.
What happens if my insurance claim is denied?
If your insurance claim is rejected, you will need to pay the bill out of pocket
and later file for reimbursement. Manipal Hospital is not liable for any claim rejection by the
insurance company or TPA.
How can I check if my health insurance is accepted at Manipal Hospital?
You can verify your insurance coverage by:
Checking the Manipal Hospital insurance list on our website.
Contacting the Manipal Hospital Insurance Desk for confirmation.
Call your insurance provider for details about network hospitals.
You can check the Manipal Health Insurance hospital list on our official website or contact our
Manipal Insurance customer care number for assistance.
What are the common exclusions in Manipal Hospital's health insurance policies?
Most insurance policies do not cover:
Pre-existing conditions within the waiting period.
Cosmetic or plastic surgery (unless medically necessary).
Alternative therapies like Ayurveda or Homeopathy.
Non-prescribed treatments or experimental procedures.
Are there excursions based on age or medical history?
Yes, certain policies impose age-based restrictions, limiting coverage for
seniors above 65-70 years. Pre-existing conditions like diabetes, hypertension or heart disease may
also be excluded unless specifically covered.
Can my treatment be denied due to provider network exclusions?
Yes, if your Manipal Hospital branch is not on your insurer's hospital list,
cashless treatment may not be available. However, you can still claim reimbursement.
What are the general grounds for denial of a health insurance claim?
Insurance claims can be denied for:
Incorrect information was provided during pre-authorisation.
Policy lapses or non-renewal.
Treatment taken at a non-network hospital (if cashless claim).
Failure to submit the required documents within the stipulated time.
How can I contact Manipal Health Insurance customer care?
For assistance with policy details, claims, or empanelment, you can reach the
Manipal Insurance customer care number provided on our website or at your nearest hospital branch.
What types of insurance policies are accepted for cashless hospitalisation?
Most health insurance policies, including individual health plans, family
floater policies, group insurance, and critical illness policies, offer cashless hospitalisation
benefits. However, the specific terms can vary based on the insurance provider and policy.
Does my policy cover pre- and post-hospitalisation expenses?
Many insurance policies cover pre-hospitalisation (up to 30 days before
admission) and post-hospitalisation expenses (up to 60 or 90 days after discharge). However, this
depends on the specifics of your policy.
Can I avail cashless facility from multiple insurance for single hospitalisation?
Yes, if you have more than one health insurance policy, you can use both
policies for a single hospitalisation. However, one insurance will be cashless and other insurer can
reimburse for balance amount.
Still have questions? Fill out the 'Contact Us' form below, and our team will reach out to assist
you.
