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Cashless Health Insurance – Advantages, Features and more

An out-of-the-blue health emergency will not only give you emotional stress but also can drain out all your savings. That’s why you should invest wisely in a good health insurance policy to get adequate financial assistance during the time of an emergency. Though a comprehensive health insurance policy offers coverage for your treatment, still, sometimes you may need to pay from your pocket before raising a claim. This situation is not beneficial for those who don’t have adequate savings for their treatment. Here, a cashless health insurance policy acts as a boon and offers cashless facilities to policyholders at selected hospitals.

What is a cashless insurance policy?

In the case of medical emergency like an accident or critical illness, you need to get hospitalized for your treatment. These days, in-patient hospitalization is quite expensive. If you can’t arrange adequate funds for your treatment with short notice, a cashless mediclaim policy is the best option. Under a cashless mediclaim policy, your insurance company directly settles all expenses and bills with the network hospital. Here, you don’t need to pay a single penny from your pocket. Thus, always purchase a cashless medical insurance policy to safeguard your savings.

Cashless health insurance policies are specially designed to give financial relief to policyholders during an emergency hospitalization. An agreement is signed between the insurance companies and their network hospitals, and according to this agreement, the insurance companies will directly settle the claims. Every insurance company is associated with Third-Party Administrators (TPS) that coordinate with companies and hospitals and settle the claims of the customers. These TPAs usually set up a desk at network hospitals to make the claim process smoother and faster.

Features of Cashless Medical Insurance

Let’s take a look at some prominent features of the cashless health insurance policy. Though insurance companies decide these features, they still may vary from company to company.

  • At network hospitals, you don’t need to pay anything from your pocket
  • Coverage for pre-and post-hospitalization costs
  • NCB (No Claim Bonus) for policyholders
  • Covers in-patient hospitalization expenses for more than 24 hours
  • Daily cash allowance
  • Offers coverage for ambulance expenses, domiciliary treatment, organ transplant, etc.
  • Provides one-time free medical check-up and diagnostic test


Types of Cashless Medical Policy


Cashless Individual Health Insurance

These policies offer cashless facilities to policyholders for their hospitalization and treatment expenses, according to the terms and conditions of the policy.

Cashless Mediclaim Policy for Family

Under this type of insurance plan, a proposer can include his/her family under the coverage of the same policy. The individuals (who are covered by the same cashless health insurance policy) in the policyholder’s family are known as members.

Cashless Health Insurance for Senior Citizens

As per the name, this cashless medical policy covers health expenses for senior citizens. In addition, this policy plan compensates for the costs of ambulance, hospitalization expenses, and pre-existing diseases, as mentioned in the policy documents.

How does cashless medical policy work?

Cashless hospitalization process for planned treatment (the treatment of a pre-existing disease)- 

Every Indian insurer is partnered with some leading hospitals that are known as network hospitals. You are eligible for cashless health insurance benefits if you choose these network hospitals for your treatment. Cashless health insurance process for planned hospitalization follows,

  • Intimate your insurance company at least 3-4 days before your admission
  • Fill up a detailed claim form at the time of hospitalization.
  • Now, Fax or email this pre-authorization form to the insurance company/TPA for their approval.
  • Once it is approved, the TPA or insurer will intimate the hospital regarding the approved amount.
  • Finally, the TPA or insurance company directly settles the bills with the hospital.


Emergency Hospitalization

Suppose you need to be hospitalized under any emergency condition like an accident or a critical illness. In that case, you or your family members should follow the below-mentioned processes for cashless claim benefits.

  • You must inform the insurance company or TPA within 24 hours of hospitalization.  
  • Now, send the pre-authorization claim form.
  • After scrutinizing your claim form thoroughly, the TPA/insurance company will either approve or decline your claim request.
  • The ultimate decision will be communicated to the insured person and the treating hospital.


Benefits of Cashless Health Insurance


Assists during the time of medical emergencies

Medical emergencies can happen without any notice. These unplanned incidents will make a hole in your pocket apart from draining you emotionally. Cashless claims rescue those family members who can’t arrange a sufficient amount within short notice for the treatment of the insured person. Under the best cashless health insurance policies, an insured policyholder can get the best treatments by showing his/her cashless health insurance policy card to the hospital.

It gives relief and mental peace

A cashless health insurance policy will lessen the financial burden from you at the time of crisis. Because of this hassle-free cashless claim procedure, you can get admitted to any network hospital and start the necessary treatment without any worry. Now, instead of focusing on your finances, just focus on the treatment and recovery process.

A wide range of coverage

Cashless health insurance policies offer various coverage, including pre and post-hospitalization, ambulance costs, in-patient charges, domiciliary treatment, etc. In addition, some cashless health insurance policies also offer health check-ups and diagnostic tests annually to their policyholders.

It covers your health at the time of travel

If you experience any medical emergency during your travel, then a cashless policy assures you of trustworthy medical treatments at a network hospital. Here also, you don’t need to arrange money for hospitalization and other healthcare expenses.

Tax Benefits

All premium payments for cashless health insurance policies are eligible for tax benefits under Section 80D of the Income Tax Act of 1961.

If you don’t have a stable financial background, then you should opt for the best cashless mediclaim policy that will give you the utmost coverage and financial assistance at the time of crisis.

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