Do you Know How Cashless Health Insurance Work

• Written by Mudit Handa

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Facts To Know About Cashless Health Insurance

Darshan almost spent his life savings on the treatment of a heart ailment his father was suffering from. Thankfully, he had purchased a health insurance policy and the expenses incurred by him were reimbursed by the insurance company. 

For many people like Darshan who belong to middle-income families, payment of medical bills is a burden. The main reason is the surging costs of healthcare, particularly in private hospitals. Dealing with expensive medical treatment is one of the compelling reasons why people should opt for a health cover. 

Getting a claim under an insurance policy is possible in two ways – cashless claim and reimbursement claim – the former being a highly convenient option. Darshan chose to get his expenses reimbursed as he was not aware of the benefits of the cashless payment feature. Nowadays, the hassle of making payment from one’s pocket is minimized as many mediclaim policies include the feature of cashless hospitalization. 

Here are some facts about cashless health insurance.

1. Available only at network hospitals: Policyholders should remember that the feature of cashless health insurance is available only at network hospitals. These are the hospitals that have tie-ups with health insurance companies offering cashless treatment. At the time of buying a policy, the insured person should get the complete list of network hospitals. 
2. Easy Access to Treatment: Getting admission to a hospital and paying the bills during a medical emergency can be stressful for a family. Thus, a cashless treatment facility minimizes the hassle as one can easily get admitted to any network hospital using a health card. 
3. Affordable: Getting medical expenses reimbursed after paying from one’s pocket can be expensive. The policyholder may have to spend a higher amount in such cases. Also, it could be possible that the claim is partially settled, as per the policy terms and conditions. On the other hand, under the cashless treatment facility, the actual expenses that a policyholder has incurred get covered.
4. The policyholder can Renew their Policy: Like other health policies, cashless health insurance policies must be renewed on time so that the policyholder can enjoy continued benefits. Health policies come with the feature of lifetime renewability which is a huge advantage as one can get uninterrupted coverage.
5. Claims are processed as per the Policy Terms: A policyholder has to carefully read the terms of the health insurance policy so that he or she gets the maximum benefits of the cashless claim feature. Following are some things to keep in mind: 

• The insured persons should notify the insurance company about their hospitalization as per the specified time. That is, within 24 hours in case of emergency hospitalization and 48 hours prior to admission in case of planned hospitalization. 
• The pre-authorization letter should be shared along with the required documents and details, as per the given time. In case the insured person fails to do so, the claim may get rejected. 
• The claim request may also get rejected if the ailment or medical condition is not covered in the policy or if the waiting period is not yet over.  

Secure your finances by opting for a health cover from Care Health Insurance and get cashless treatment facility in any of the 21600+ cashless healthcare providers in India.

>> Also Read: Cashless Claim in Health Insurance

Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.