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Do We Need Cashless Health Insurance?

Cashless health insurance is designed to avoid financial distress during a medical emergency. Under cashless health insurance, all the medical bills are directly settled by the insurer with the service provider. Therefore, it is recommended to buy a health insurance plan that comes with the cashless facility.

Apart from all the emotional suffering, a medical emergency can burn a hole in your pocket and drain your savings. This is exactly why you must buy a good health insurance policy so that you get sufficient financial assistance during any kind of medical emergency. While a health insurance plan offers coverage against hospitalisation and other related expenses, you might still be required to pay some of the expenses from your own pocket. This is where a cashless health insurance policy acts as a saviour.

What is Cashless Health Insurance?

If you face a medical emergency, you are likely to be hospitalised for a while. Hospitalisation in private hospitals is expensive. Cashless health insurance is the best option available for protecting your savings and keeping the emergency fund intact. Under cashless health insurance, the insurance company directly settles the bill with the hospital rather than you having to pay the hospital bills and then getting the same reimbursed. Hence, it is a smart decision to buy a cashless health insurance policy to save yourself from financial trouble.

Cashless health insurance plans are designed with the sole intention of providing financial relief to the policyholder at the time of hospitalisation. It is an arrangement of the health insurance providers and their empanelled network hospitals, where the insurance claims are settled without the involvement of the policyholder. Under this facility, Third Party Administrator or executives of the insurer who acts as a bridge between network hospitals and the insurance company in settling the claim. Generally, the Third Party Administrators set up a desk at network hospitals to facilitate the smooth processing of insurance claims.

Features & Benefits of cashless health insurance

Features of cashless health insurance

The insurance companies decide the features and benefits offered under cashless health insurance and, therefore, may vary between insurance companies and plans. However, below listed are some of the standard features that are included in most of the cashless health insurance policies:

  • Policyholders don’t have to pay for medical bills at any of the network hospitals.
  • Covers pre and post hospitalisation expenses
  • Offers no claim bonus
  • Covers expenses related to in-patient hospitalisation for more than 24 hours.

Day Care Treatments Covered

  • Hospital daily cash benefit
  • Covers emergency ambulance expenses, organ transplant, domiciliary treatment, etc.
  • Hospital daily cash benefit is available
  • Provide free medical check-up once in a year

Benefits of Cashless Health Insurance

  • Offers financial aid for medical emergencies: Hospitalisation, whether planned or unplanned, burn a hole in your pocket when you don't financially plan for it in advance or don’t have an emergency fund to take care of it. Cashless health insurance is beneficial as it saves critical time that you and your family require to arrange money for the hospital expenses. Instead, you can get your treatment started simply by showing your cashless health insurance card at the network hospital.

  • A source of relief: Cashless hospitalisation assures you that finances would not be a concern for you at the time of medical emergencies. You can get admitted to the hospital and start the treatment without having to worry about arranging the funds. You can solely focus on medical treatment and recovery without money being a concern.

  • Provides an extensive range of coverage: Cashless mediclaim policies offers comprehensive coverages such as pre and post hospitalisation costs, in-patient care, ambulance charges, domiciliary treatment, etc. Some cashless health insurance policies also provide free health check-ups and diagnostic tests once a year.

  • Safeguards your health during travel: Access to the right medical treatment can become a concern while you are travelling. In such cases, a cashless health insurance policy helps you to avail reliable healthcare services at a network hospital, without having to worry about the funds for hospitalisation and medical bills. All you need to do is carry your medical card with you to access the medical services at a network hospital anywhere in the country.

  • Income tax benefit: Premium paid towards cashless health insurance plans are eligible to avail tax benefits under Section 80D of the Income Tax Act, 1961 wherein people below 60 years of age can avail tax benefit up to Rs. 25,000 and senior citizens can avail this benefit up to Rs. 50,000.

How Cashless Health Insurance Works?

Health insurance providers tie-up with several hospitals to offer cashless medical treatment to their policyholders. These hospitals are known as network hospitals of the insurer, and when the need arises, you do not have to pay the hospital. The insurance company settles the claim with the network hospital with the help of Third Party Administrators.

There are two ways through which you can opt for cashless hospitalisation facility:

Planned hospitalisation:

Every health insurance company has a tie-up with a certain number of hospitals that forms a part of their network hospitals. When you plan to avail treatment in such hospitals, you can opt for cashless treatment. To avail cashless treatment at network hospitals, you need to do the following:

  • Fill up a claim form with accurate information about the hospitalisation and patient.
  • Send the form to the insurance company through the Third Party Administrator available at network hospital for approval.
  • After the approval, the insurance company notifies the hospital regarding the approved claim amount.
  • The insurance company directly settles the medical expenses with the hospital once the treatment is done.

Unplanned/emergency hospitalisation:

In unforeseen circumstances such as an accident or emergency hospitalisation, the policyholder or his/her family members should follow the procedure mentioned below:

  • Along with the claim form, intimate the insurance company within 24 hours of the hospitalisation.
  • After reviewing the claim form, the insurance company decides to approve or reject the cashless claim settlement request.
  • If you can’t wait for the approval, you can pay bills at the hospital and later reimburse the same from your insurance company.

Best cashless health insurance policies in India

One of the most common hassles we face at hospitals is paying the bills, and handling all the paperwork that comes along with a medical emergency. With a cashless insurance policy, you can avoid these hassles and make the entire process smooth and quick. It takes away the stress of arranging cash and allow us to stay with our family and support them.

Recommended Link:Do's and Don'ts a Policyholder Must Know While Buying Cashless Health Insurance