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Cashless Health Insurance

Cashless Health Insurance Policy

  • Hassle-Free Experience with 95.2% Claim Settlement Ratio*
  • 21100+ Cashless Healthcare Providers^^
  • Avail Annual Health Checkup & Tax Rebate u/s 80D
  • Coverage for Modern Treatment like Robotic Surgery, etc
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95.2%
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Claim Support

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People often come across medical emergencies that need money readily available in their bank accounts or pockets for the treatment that may cost a fortune. If you are equipped with cashless health insurance in such unpredictable situations, you have got a saviour in disguise. With cashless health insurance comes an assurance that you will not have to spend even a dime while in the hospital because your insurance company has your back.

Table of Content:

What is Cashless Health Insurance?

Due to medical inflation, cashless health insurance is amongst the essential features that a health insurance policy must cover. This facility ensures that one can bypass the reimbursement formalities at any network hospitals by handling the treatment cost. With cashless health insurance, you need not worry about cash arrangements. You can go for the best treatment without worrying about finances.

Care health insurance is acclaimed for its services as it provides the best Cashless medical policy for family and safeguards you.

Why Cashless Health Insurance?

Ritika, 28 years old fashion journalist, realized this fact and started looking for a sound mediclaim policy for herself and her family. But the moment she began browsing the websites, she was lost in the Tsunami of information. Then, her best friend, who already has a mediclaim, suggested going for cashless health insurance. She got overwhelmed with her friend’s suggestion and opted for the same. This page will give you all the reasons to buy Cashless health insurance and why it is wise to be safe beforehand.

Importance of Cashless Health Insurance

In an unforeseen event such as a medical emergency, a family goes through anxiety while arranging finances to pay for the exorbitant medical treatments.

Below are a few reasons that state the Importance of Cashless Health Insurance-

  • Owing to the cashless health insurance facility, one can skip the hassles of arranging money to pay medical bills during Hospitalization.
  • We believe in directly settling the expenses/claims with the hospital, subject to policy terms and conditions right then and there.
  • The cashless feature has changed the way people pay for their medical treatment and offers a lot of convenience in saving time, money, and effort as no one has to rush to banks and fall prey to never-ending loans.

*According to a survey, almost 16 lakh people die every year in India due to poor health care and the unavailability of health insurance.

Cashless vs. Reimbursement Claims in Health Insurance Policies

While filing a claim, the choices available to a policyholder include a cashless claim and a reimbursement for the expenses incurred during medical treatment.

Policyholders must be aware of the claim process under health policy to ensure hassle-free claims. It is also essential to understand the claim settlement process of health insurance policy, either cashless or reimbursement mode.

Let's know the difference between these two features of Health Insurance:

 

Cashless Claim Reimbursement Claim
In the event of hospitalization or related medical expenses, the claim will directly settle with the hospital subject to policy terms and conditions. For reimbursement, the policyholders have to bear the medical expenses beforehand from their pockets.
To avail of this facility, the policyholder must only get treatment at any network hospital. For reimbursement, the policyholders have to bear the medical expenses beforehand from their pockets.
It reduces the hassle of hospitalization and makes policyholders free from the stress of arranging cash for the treatment. The policyholder has to submit the required medical bills and necessary supporting documents to get reimbursement.

 

*In case of rejection, the claim management team will communicate the reason.

Intimation to the claim management team within 24 hours of hospitalization is required and before 48 hours in case of planned hospitalization.

How Does Cashless Health Insurance Work?

To avail of this facility, the patient has to admit to one of the Network hospitals. These are the hospitals that have a tie-up with the health insurance companies to provide cashless treatment. After proper verification, policyholders get the approval for their cashless claims subject to policy terms and conditions. With this benefit, policyholders do not need to worry about their treatment during a medical emergency or planned treatment. Their medicals bills will be directly settled under the policy coverage so that they can focus more on their recovery. 

*We have 8350+ network hospitals across India. Our customers can pick any of the network hospitals in the vicinity as per their feasibility for the treatment.

How to avail of the Best Cashless Health Insurance?

To get the best cashless health insurance, the policyholder must follow the steps given below:

  • Complete the pre-authorization form available at the hospital's insurance/TPA Desk and send us through fax
  • Approval letter sent by the claim management team
  • Hospital/Insured to respond to the query raised by the claim management team
  • In case of rejection, you may initiate the treatment and file for reimbursement claim

How to Choose the Best Cashless Health Insurance?

Here are some points that you must consider before picking cashless health insurance for yourself and your family:

Insured sum: This is the total amount that is liable under the policy every year. It is recommended to select a plan that has the highest coverage while still being within your budget.

Limits on particular treatments: There are specific treatments like cardiac treatments or cataracts that have limits. You must ensure that you read the limits carefully.

Maximum renewable age: It is recommended to pick a cashless mediclaim policy with higher renewable age, especially if you intend to pick an excellent cashless mediclaim for parents.

Co-payment: It refers to the payment the policyholder has to pay for a portion of the medical expenses on their own, and the insurance provider pays the remaining amount. It is carried out with co-pay clauses.

Waiting Period: This variable interval is defined based on the disease for which you are making a claim. You must read the conditions of the policy to know what the different waiting times are. Then, make sure that you pick a plan that has the least waiting period.

Day-care treatments: Since there will be a range of day-care procedures covered, you should compare different policies before selecting the ideal option. Ensure that you pick a cashless mediclaim policy that covers the maximum number of treatments.

Hospital room rent: There will be an upper bound here, so you must always check if the policy coverage is sufficient to absorb the rent charges at your preferred hospital.

Impanelled hospitals: If the insurer empanels your hospital, it becomes effortless when trying to claim the cashless feature. Always make sure that your preferred hospital is a network hospital.

We offer unparalleled and best cashless mediclaim policy for family in India.

Benefits of buying Cashless Mediclaim Policy Online

For selecting the best Cashless Health Insurance plans, it is essential to keep some important points in mind-

  • You can access all the health plans and their details with just one click.
  • You can compare the policies and find the best one out for yourself.
  • Online search enables you to find the best plan.
  • You can choose the minimum premium according to your convenience.
  • You can avail of maximum coverage.
  • You can check the Incurred Ratio Rates quickly.

Care Health Insurance will cater to all your needs if you are looking forward to buying the best cashless mediclaim policy in India.

Salient features of a Cashless Health Insurance policy

  • Immediate Treatment: You are not required to wait and complete fill cash deposit formalities. You have to inform to help desk in the hospital and customer support team about your hospitalization within 24 hours in case of emergency and before 48 hours for planned hospitalization.
  • Tax Benefits: Under Mediclaim 80D, the premium paid for health insurance for self, dependent parents, children, and spouses are exempted from tax. Thus, you can have saved a fair amount of money and enjoy the tax benefit. It also reduces your taxable income, which reflects less tax liability.
  • Peace of Mind: Cashless health insurance Policy gives you peace of mind. You can stand firm in any medical emergency. You do not need to borrow extra money for you or your family member's treatment. From Hospitalization to daily cash allowance, ambulance cover, second opinion, all you get under this cover.

    Of late, things have been devastating for the masses across the nation due to the ceaseless Pandemic. In the current scenario, we all must ensure that our Insurance policy covers Covid-19 so that it doesn't get hard for us to get treatment during an emergency.

For selecting the best Cashless Health Insurance plans, it is essential to keep some points in mind, as we discuss them below:

Exclusions under Cashless Health Insurance

While buying the right cashless health insurance for your needs, consider checking the exclusions mentioned in the policy documents. Doing this will keep you prepared for any contingency you may experience in future. Exclusions are expenses or the various cases when you may not be eligible to get a claim under your mediclaim policy. Some of the exclusions may include:

  • Expenses attributable to use/misuse/abuse of alcohol or drug.
  • Any treatment or medical expenses incurred within 30 days of policy period start date, except accidents.
  • Medical treatment related to congenital diseases.
  • Expenses incurred due to self-inflicted injury, suicide, or attempted suicide.
  • Treatment arising from or traceable to miscarriage and abortion.

Exclusions may vary for Cashless Family Health Insurance.

Conclusion

Health insurance is undoubtedly an armour that protects us and helps us during a crisis. When there is no one to extend the hand of help, a cashless health insurance policy comes to our rescue. We ensure the safety of its patrons, thus, believes in serving them relentlessly.

If you are still struggling to acquire the best cashless health insurance policy for yourself and your family, we are just a call away to ease you out and help you with our services.

Disclaimer: The above information is for reference purposes only. For more details about the health insurance plans, please refer to the sales prospectus, policy terms, and conditions.

FAQs on Cashless Health Insurance

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Q.What if Cashless Claim is Rejected?

Policyholders must be aware of the claim settlement process and must adhere to the same when making a claim. It will enable them to get cashless health insurance benefits and save them from additional cost burden during any medical emergency. However, there could be situations when their claim may get rejected. It is imperative to understand the scenarios when the claim can get rejected.

As health plans are supposed to cover medical expenses, it could be disappointing when a claim gets rejected and, you end up paying for the medical bills. Some reasons for claim rejection are:

  • When the policyholder avails treatment at the non-network hospital where cashless treatment is not possible, and the claim could be rejected
  • If the pre-authorization request is not shared on time
  • In case the hospital or treating doctor does not provide sufficient details to the insurer
  • If the health policy is not valid and has lapsed
  • If treatment cover for the particular medical condition is not covered under the health policy
  • If there is a waiting period for covering treatment for a particular medical condition
  • If a cashless claim gets rejected, the policyholder can refile it for reimbursement. 

When the cashless treatment is denied at a hospital, then the policyholder must approach the insurer to know if the expenses could be reimbursed.

Q.What Could be the Possible Reasons for Denying my Request for a Cashless Settlement?

A policyholder's claim for cashless settlement may get rejected due to various reasons that include:

  • If admitted to the non-network hospital
  • If the pre-authorization request is not shared on time
  • If sufficient details are not given to the insurer by the hospital
  • If the health policy is not valid
  • If the medical condition is not covered under the health policy or if there is a waiting period

Q.Can I Opt for Cashless Treatment for OPD Procedure?

A policyholder can avail cashless treatment facility for OPD procedure, including doctor visits if the healthcare facility or hospital is listed as the network hospitals.

Q.How Long Can I Renew a Cashless Health Insurance Policy?

Before the expiry date of the cashless health policies, the policyholders are required to renew their policy. The policyholders can renew a cashless health insurance policy throughout their entire lifetime.

Q.What is the Policy term of Cashless Health Insurance Plans?

Usually, cashless health insurance plans come with a policy term of one year, at the end of which the policyholder must renew their plans. Some plans also come with a term of two years.

Q.What Key Points Should be Kept in Mind while Selecting the Cashless Health Insurance Plan?

Few key points that must be considered while selecting the best cashless health insurance plan are:

  • Co-payment
  • Insured sum
  • Limits on Treatments
  • Maximum Renewable Age
  • Allowance for Hospital Room Rent
  • Waiting Period
  • Day-care treatments
  • Impanelled Hospitals

Q.How can I Know the list of Hospitals to Avail Cashless Health Insurance?

Cashless Health Insurance facility is available at any of the network hospitals. You will get the list while buying health insurance. You can also know about the network hospitals nearest to their location by visiting the official website.

Q.How does a cashless mediclaim policy help me?

A cashless mediclaim policy helps the insured by preventing even a temporary impact on savings during any planned medical treatment or emergency hospitalization. One does not need to pay for the medical expenses from the pocket and then apply for a health policy reimbursement claim. It helps one get immediate access to medical care at a network hospital in any exigency without worrying about arranging money to pay medical bills.

Q.Can I avail of cashless treatment in any hospital?

You can avail of cashless treatment at any network hospital empaneled with us. The cashless facility is not available at non-network hospitals.

Q.In how many ways can cashless treatment be availed?

You can avail of treatment under your cashless medical insurance plan in two scenarios:

  • In case of emergency hospitalization, where you have to notify us within 24 hours
  • In any planned hospitalization, where you must notify us 48 hours before admission to the hospital

Q.What happens if my cashless health insurance policy lapses during hospitalization?

Cashless health insurance will provide coverage only during the policy term for which the premium has been paid. The insured person will have to bear the costs incurred after the policy lapse. Thus, it is crucial to renew your policy on time.

Q.What are the factors that affect the premium paid towards cashless mediclaim policy in India?

When you buy a health insurance plan, you should be aware of the factors that can affect premium paid towards cashless mediclaim policy. The factors include family medical history, pre-existing medical conditions, gender, age, Body Mass Index (BMI), marital status, etc.

Q.Can I avail Tax benefit under cashless mediclaim plan?

Yes, you can avail tax benefit under cashless mediclaim plan.

 

*Claim Settlement Ratio is for FY 19-20 and number of claims settled till February 2022.

^^Number of Cashless Healthcare Providers till 31st Dec 2022.

^Annual premium for product 'Care' and 'Care Shield (add on)' is Rs. 6160/-(excl. GST) for 1 adult falling under the age bracket 05-24 years, 1 Adult 18-24 age group 3 Yr with NCB Super (Add-on).

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