Cashless Health Insurance provides cashless hospitalization services to the insured at the network hospitals of the insurance company. Cashless hospitalization is extremely beneficial for people, especially in emergency situations, as it will save them from the hassles of arranging money before being treated at a hospital.
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply
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Cashless Health Insurance refers to a mediclaim policy in which the medical expenses of the insured is directly settled between the insurance company and the network hospital. It provides cashless hospitalization facilities where the insured does not have to pay cash to avail treatment. However, cashless health insurance can be availed only at network hospitals of the insurance company.
A cashless health insurance policy helps the insured to deal with medical emergencies efficiently. It also allows the insured to focus only on the treatment as the hospitalization expenses are taken care of by the insurance provider.
Broadly, there are three types of cashless health insurance in India, which are as follows:
Under this cashless family health insurance policy, the whole family of the policyholder can avail cashless treatment under one policy.
This is the cashless health insurance plan for senior citizens that cover hospitalization expenses, ambulance charges, and pre-existing diseases subject to the terms of the policy.
A cashless critical illness health insurance policy provides cashless treatment to people suffering critical illnesses, such as cancer, heart attack, etc.
Cashless health insurance is necessary at times of a health emergency when you might be cash strapped or do not have immediate access to cash. It is designed to eliminate any form of cash payment to avail medical treatment on time. It also allows people to avail the best quality medical treatment without worrying about arranging money to pay the hospital bills.
Cashless health insurance basically removes the hassles of having to pay cash at the hospitals at the time of need. For cashless health insurance, insurance providers enter into direct negotiations with hospitals in their network to pay for the treatment availed by the insured person. They tie up with these hospitals, which are then known as the network hospitals of the insurance company.
When the insured gets hospitalized in a network hospital, he/she does not have to settle the bill with the hospital at the time of discharge. Instead, the insurance company or their TPA (third party administrator) will coordinate and settle the bill directly with the hospital.
Moreover, health insurance companies are now also offering cashless OPD facilities to the insured. It means that now patients don’t need to be hospitalized for a minimum of 24 hours to avail cashless hospitalization services.
Basically, there are two ways through which cashless hospitalization can be availed:
Planned hospitalization is when you know beforehand that you need to get hospitalized in the next few days. In this case, you have to choose a network hospital to avail cashless services. Follow the steps to avail cashless hospitalization in case of a planned hospitalization:
In the case of emergency hospitalization, you need immediate medical care and thus, you should initiate the cashless mediclaim facility within 24 hours of hospitalization. This is how cashless hospitalization can be availed:
As per the protocol in emergency conditions, a TPA should process an emergency hospitalization claim within 6 hours.
There are some medical expenses, which are not covered by cashless health insurance. Take a look at them below:
Here are a few things that you should keep in mind while availing cashless hospitalization facility through a cashless health plan:
Given below are some of the top reasons for cashless health insurance claim rejection:
However, according to a ruling by the Bombay High Court, the decision to reject or partially disallow health insurance claims can be taken only by insurance companies and not by TPAs who offer various services to policyholders on their behalf.
Making the complicated insurance comparison an uncomplicated process, Policybazaar offers the best assistance when it comes to finding the right cashless health insurance plan. By entering basic details like name, age, annual income, etc. on Policybazaar.com, you will be able to get mediclaim quotes free of cost. Moreover, you get to compare health policies from various insurance providers at Policybazaar.com and ensure that you get the right cover for yourself and your family.
Ans: No. You can avail treatment under cashless health insurance only at the network hospital of your insurance company.
Ans: You can contact the customer care of your insurance company and enquire about the nearest network hospital where cashless treatment is available. You can also visit Policybazaar.com or the website of the insurance company to locate the network hospital where your cashless health insurance policy can be used.
Ans: Yes. Several health insurance plans offer cashless coverage for OPD treatment, provided has been taken at a network provider of the insurance company.
Ans: Yes. Most health insurance companies require you to inform them about your planned hospitalization at least 48 hours before getting admitted to the network hospital.
Ans: Yes. You can avail tax benefits under your cashless health insurance policy as per Section 80D of the Income Tax Act.
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