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Things to Consider About Cashless Network Hospitals in India

Understanding Cashless Network Hospital?

With the increasing cost of healthcare, a large number of people are vouching on health insurance policies to meet their medical bills without any financial stress. Health insurance is beneficial for those who wish to avail the best medical services without having to pay the skyrocketing hospital fees for even a minor treatment. The hospital expenses would be reimbursed, but the insured person would still need to pay the annual premium which is mostly a huge amount, especially for people above 30-35 years.

However, a cashless claim means that the policyholder would not be required to pay at the hospital for the medical treatment up to the sum insured limit. The health insurance company would directly pay off the hospital bill.

Cashless hospitalization makes healthcare even more accessible and affordable, as the insured person doesn’t need to fret about paying off hefty hospital admission fees and also the expenses that were incurred during the course of treatment.

And the point to note is that this facility is only available at the network hospitals/ registered hospitals/ partner hospitals/nursing homes.

Usually, the health insurance companies have a tie-up/agreement with the network hospitals and it permits the insured members to avail the best treatment in network hospitals on a deferred payment basis. For instance, if you have Star Health Insurance, then you can avail cashless treatment at any of the Star Health Network Hospital.

How do Cashless Network Hospitals Work?

A cashless network hospital functions just like other non-partner hospitals work. The insured members can visit the nearest network hospital and avail medical treatment without paying at the hospital. It includes room rent, admission charges, treatment cost, ambulance cost as well as the doctor/specialist fees.

The hospital bills would be settled as per the Sum insured limit opted by you at the time of health insurance policy purchase. All the expenses that were mentioned-above would be paid by the health insurance provider (except particular treatments that are not covered by your insurance company).

The insured person only needs to intimate the network hospital that your health insurance policy covers cashless treatment and you would prefer to go ahead with that.  To start with it, you would need to furnish your identification proofs, including policy documents or health card issued by your health insurance provider.

Advantages of Taking Treatment in Cashless Network Hospitals

When a person is admitted to the hospital for medical treatment (emergency or routine), then it can be stressful for the family and the patient as well. These days all the private hospitals insisting on payment of bills periodically, families have to juggle to pay off exorbitant bills to continue with the quality medical treatment.

With cashless hospitalization facility, all the medical bills will be borne by your health insurance company upon completion of the treatment or before getting discharged.

In case the insured person is to be treated in a hospital away from home, then also you can avail the treatment. As most of the health insurance companies provide the facility to avail cashless treatment in network hospitals across the country without having to pay the bills.

In case of an emergency hospitalization or if the insured person is facing financial problems, then network hospitals work as a saving grace. The insured members are assured of quality treatment without any financial burden.

How to Lodge a Health Claim through a Cashless Network Hospital?

To register a cashless claim you can follow the process as listed below. However, the process may vary from one insurance provider to another:

  • In the event of planned hospitalizations, you need to inform your health insurance company so as to authorize the cashless hospitalization.
  • In case of an emergency procedure or surgery, you need to notify your health insurance company within 24 hours of getting admitted into the hospital.
  • Some health insurance providers give the insured members a health card that can be used to avail cashless medical treatment at any of the network hospitals.
  • The insured person can undergo treatment at a network hospital without making the payment
  • Your health insurance company would then send the insured person all the details regarding the medical expenses, and any co-payments or exclusions that the insured person would require to pay.

You can also check the list of network hospitals on the insurer’s website and see what all network hospitals are there in your vicinity. If you have Star health insurance then you can visit their official website to check the Star Health Insurance Hospital List.

Limitations of Cashless Network Hospital Services

A number of treatments and procedures are covered under cashless treatment; there are certain exclusions for which your health insurance company will not pay the hospitalization expenses. Here is a quick rundown:

  • Health issues resulting in hospitalization after a war, or due to chemical reactions, weapons, and radiations
  • Hospitalization resulting due to suicidal attempts, self-injury, or any deliberate attempt
  • Items of personal convenience
  • Hospitalization required due to the consumption of alcohol or drugs
  • Hospitalization required to treat HIV/AIDS, unless it is mentioned in the policy
  • Mental disorders and congenital diseases as mentioned in the policy wordings
  • Cost of non-medical items or the cost of spectacles, supplements, etc.

Summing up

So, the next time you are buying a health insurance policy make sure that it offers cashless hospitalization cover in-network hospitals. It will offer you ease and will also ward off any financial pressure that may come with the illness or surgery or hospitalization. Make sure that you check the policy wordings that mentions the policy coverage and limitations.

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