Hospitalization

What it means, and what it does to a claim.

Being admitted to a hospital as an in-patient for at least 24 consecutive hours — except for procedures on the day-care list, which are covered in less.

Why it matters

The 24-hour rule is the hinge most health claims turn on. An overnight stay for observation may not qualify; a listed day-care procedure lasting two hours does. If a doctor suggests admission, the useful question is not "how long" but "does this qualify", because that is what the insurer will ask.

The legal definition

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