Insurance Approval: What You Need to Know Before You Apply

When you need surgery, medication, or hospital care, insurance approval, the formal green light from your health insurer before treatment. Also known as pre-authorization, it’s the gatekeeper between your doctor’s plan and your wallet. In India, where out-of-pocket medical spending still dominates, getting this approval right can mean the difference between paying ₹50,000 or ₹5,000 for the same procedure.

It’s not just about hospitals and forms. health insurance India, the system covering medical costs through private or government plans is full of hidden rules. Many people assume their policy covers everything—until they get denied. Why? Because medical insurance claim, the formal request for payment after treatment often fails not because the treatment wasn’t needed, but because the paperwork was incomplete, the doctor didn’t code it right, or the insurer says it’s "not medically necessary"—a phrase that’s used way too often.

Some claims get rejected because the procedure wasn’t pre-approved. Others get stuck because the hospital didn’t send the right documents. Even something as simple as using a non-network hospital can trigger a denial. And if you’re dealing with something like heart surgery, diabetes medication, or mental health treatment—topics covered in our posts—you’re even more likely to hit these roadblocks. Insurers often demand extra proof for high-cost treatments, even when your doctor says it’s urgent.

What helps? Know your policy inside out. Keep copies of every prescription, referral, and doctor’s note. Ask your hospital’s billing team to confirm the approval status before you’re admitted. Don’t assume your doctor handles it all—many don’t. And if you’re denied, don’t accept it as final. Most denials can be appealed, especially if you have supporting medical records.

You’ll find real stories here—like why Day 3 after heart surgery is the worst, how brain fog shows up after cardiac procedures, or how weight-loss drugs like Ozempic are now being covered under some plans. These aren’t just medical facts—they’re insurance battles waiting to happen. The posts below show you what people actually faced, what got approved, what got denied, and how they fought back. No fluff. No jargon. Just what works when your health—and your money—are on the line.