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Without health insurance, getting sick or injured could mean going bankrupt, going without needed care, or even dying needlessly’- Jan Schakowsky
With the surging healthcare costs, most of us buy health insurance plans as a means to reduce our medical expenses. Health insurance is a boon for people looking for quality medical treatment, as it frees them from worrying about hefty medical bills. Though the sum of money you spent from your own pocket would be reimbursed, you might have to bear the initial amount.
We found a way for you to put this concern to rest, and that is Cashless Claims. But, what are cashless claims?
A cashless claim is an option that states you are not required to pay for the medical procedure or treatment that is covered by your health insurance policy. Your insurance provider will compensate your medical bills directly with the concerned hospital.
This facility makes medical treatments more accessible and affordable, as you do not have to worry about paying a hefty amount of money during hospitalization as well as during the treatment. However, you can avail this facility only at partner hospitals or network hospitals.
A network hospital is a hospital that ties up with your insurance provider and allows you to avail of cashless medical treatment based on deferred payment. Insurance companies, generally, have wide network of hospitals across the country. These network hospitals are also known as Cashless Network Hospitals.
Cashless network hospitals work similar to non-network hospitals or regular hospitals for the most part. You can visit a network hospital and get health care without having to pay to the hospital. This includes room rent (subject to a limit), admission charges, doctor or specialist fees, ambulance cost, and not to forget the treatment cost.
Your insurance provider would settle your medical bills against the Sum Assured, which you chose while purchasing your health insurance policy.
The insurer would bear all the aforementioned expenses, provided that the treatment was assured by your health plan.
You simply have to inform the hospital that your treatment cost would be covered under the cashless facility, and submit a valid identity proof, such as an identity card issued by the insurance provider or your policy documents.
When you get hospitalized for any treatment - be it emergency or routine check-up, it’s a stressful time for your family and you. Many hospitals insist on periodic clearance of the medical bills. In such a case, your family has to run around to pay exorbitant bills and make sure you receive quality healthcare at the same time.
With the cashless medical service, your insurance provider pays your bills after the completion of your treatment.
In case you are away from your residence and you need to get hospitalized, you can use any of your insurance provider’s network hospitals across the country to avail the treatment without making any payments or having to settle the incurred medical cost.
In order to file a claim, you need to follow the procedure mentioned below:
Cashless hospital claims cover the treatment that requires a hospital stay over 24 hours.
The list of the day-care facilities (requiring less than 24 hours stay) is as follows:
Cashless claims also cover surgical treatments and procedures in the digestive tract along with female and male reproductive organs.
While cashless hospitalization covers a number of treatments and medical procedures, there is a list of exclusions as well, under which your insurance provider does not pay for the treatment. Some of the exclusions are listed below: