Health insurance is a must-have for everyone, to protect against increasing medical care costs. The COVID-19 pandemic has also made people realise the importance of health insurance. Most traditional medical health insurance policies work such that the medical expense amount is reimbursed. However, there is also another type of Medical insurance policy – the Cashless Insurance Policy. Read further to understand why cashless insurance is the best type of medical insurance.
How does cashless health insurance work in India?
Cashless insurance is basically a claim settlement method where the policyholder will not be required to pay the hospital bill upfront. The insurance company will check the details of the claim and once approved, will directly settle the bill with the hospital.
- The insured is not required to pay anything at the network hospital
- The policy covers healthcare expenses such as pre-hospitalisation, post-hospitalisation, and in-patient hospitalisation.
- This policy includes a No Claim Bonus as a benefit. This means you earn a bonus if you do not have any claims on the policy in the period.
- Daily allowance is offered to the policyholder, i.e. a fixed amount for every day spent in hospital.
- Some insurance companies provide complimentary one-time medical check-ups and diagnostic tests.
What are the different types of cashless Mediclaim process?
There are two types of cashless insurance policies, each with a different way to settle claims.
Planned Hospitalisation – This is when the policyholder plans a medical treatment or surgery in advance. The first step for the policyholder is to fill out a pre-authorization form. The policyholder will also need to carry the card provided by the insurance company. Once the insurer verifies the authenticity the policyholder will avail of the cashless facility
Emergency Hospitalisation – When hospitalisation occurs suddenly, without the policyholder foreseeing the need for medical treatment. In this case, the policyholder will have to fill out an authorization form and initiate the cashless claim settlement process. In some cases, if the approval is not given or the paperwork may take a day or so, the policyholder can pay for the hospital expenses (in order to respond to the medical emergency) and claim it later for reimbursement from the insurance company.
Benefits of Cashless Insurance
- When the need for medical treatment arises, it is not always that one has cash in hand. A cashless claim facility saves one from having to worry about arranging money for a treatment.
- During this stressful situation, one can focus on the treatment and not worry about finance
- Cashless health insurance offers extensive coverage. For instance, some insurers offer health check-ups and diagnostic tests at regular intervals
- Premium payments made towards cashless plans are eligible for tax benefits under Section 80D of the Income Tax Act 1961
Points to Remember While Opting for Cashless Mediclaim Policy
- In order to use the cashless facility, the policyholder will have to choose a hospital from the network listed by the insurance company. Remember to check the list of network hospitals to avoid any confusion during an emergency.
- It is important to retain copies of the medical bills even if one chooses the cashless facility. In case, a cashless claim is rejected, one can claim for reimbursement using the bills.
- One must provide accurate and complete information on the pre-authorisation form to avoid claim rejection.
- There are several exclusions in this policy that one must check before choosing this policy.
- If the hospital bill exceeds the sum assured, the policyholder will have to pay the excess amount from their pocket.
- One must read the policy documents, terms and conditions to be aware of the policy in detail.
In today’s world, cashless settlement is preferred by many due to its ease and also to save oneself from spending out of pocket. To know more about health insurance policies, click here!