A health insurance plan provides financial coverage to you and your loved ones in case of medical emergencies. Most leading insurers offer the option of cashless medical insurance or a ‘cashless claim settlement facility’. The feature enables you (the policyholder) to seek cashless hospitalisation or medical treatment at any of the network hospitals listed by the insurer. With this feature, you do not have to worry about medical expenses and they can get high-quality healthcare services without paying anything upfront. The insurance provider pays for the covered expenses directly to the hospital. Keep reading to know the features and benefits of availing cashless treatment in India.
The features of cashless health insurance are pretty much the same as that of your primary health plan. They are:
With a cashless health insurance plan, you will be able to avail high-quality healthcare facilities at an affordable premium rate without paying anything out of pocket.
Most insurers provide reinstatement benefits when you exhaust your sum insured amount during the treatment and hospitalisation.
You can get cashless insurance at any of the network hospitals listed by your insurer across India.
Your insurance provider will have a large network of empanelled hospitals across the country for providing medical treatment to policyholders. If you or one of the insured members under your health plan falls sick, you can take them to a nearby network hospital affiliated with your insurer. The network hospital will take your insurance details and verify the authenticity of your insurance plan. Once the insurance details are verified, your cashless hospitalisation treatment will begin. In this case, you will not have to pay for any medical bills as your insurance provider will settle the expenses directly once the treatment is complete.
Cashless health insurance plans in India are available under the following categories:
This type of cashless insurance is for individuals seeking health coverage for themselves.
This type of health insurance is for families seeking to get cashless health coverage under a single plan.
This type of insurance is meant for senior citizens, i.e. people above the age of 60 seeking cashless healthcare services.
You can take a look at the cashless health insurance plans available at Bajaj MARKETS and choose a policy that is appropriate for your needs:
Starting Rate of Premiums
Bajaj Allianz Health Insurance
₹3 Lakhs to ₹50 Lakhs
Aditya Birla Health Insurance
₹3 Lakhs to ₹50 Lakhs
Care Health Insurance
₹4 Lakhs to ₹50 Lakhs
You can buy cashless health insurance on Bajaj MARKETS in just a few minutes by following the given steps:
Step 1: Go to the ‘Health Insurance Premium Calculator’ on Bajaj MARKETS.
Step 2: Enter your personal details on the form available on the page and click ‘Get Quote’.
Step 3: Choose a cashless health insurance plan from the set of health insurance options available on the page.
Step 4: Select any add-on riders you wish to buy on top of your cashless health plans.
Step 5: Pay the online premiums for your chosen cashless health policy.
Your cashless health insurance will be activated shortly and the policy details will be sent to you through email.
It is important to get cashless health insurance for the following reasons:
A cashless treatment will provide you with financial support during any planned or emergency medical treatment, requiring hospitalisation.
The policy covers a wide range of medical procedures, like surgeries on the eye, bones, skin, ear, etc. It also covers critical illnesses, including cardiac ailments, kidney failure, stroke, organ transplant, and limb paralysis. You can also get cashless treatment for ailments, like piles, cataracts, sinusitis etc. after having completed a minimum number of policy years as stipulated in the policy.
Along with pre and post-hospitalisation expenses, a cashless mediclaim policy also covers your health while travelling. In the case of an emergency during travel, you can avail cashless hospitalisation at an empanelled hospital across all of India.
You can avail health insurance tax benefits under Section 80D of the Income Tax Act on premium payments made for availing a cashless health insurance policy.
If you want to make a cashless health insurance claim, here’s what you need to do:
Step 1: Make sure that you seek treatment or hospitalisation at a network hospital enlisted by your insurer.
Step 2: Visit the hospital insurance desk and get a pre-authorisation form.
Step 3: Submit the duly filled pre-authorisation form as soon as possible.
Step 4: Get in touch with your insurer as per the mentioned time and submit the necessary documents.
Step 5: The insurer will verify the documents. Based on the verification and further assessment, the claim management team will approve/reject your claim.
Step 6: Note that if the claim management team requires additional information, they will raise a request. After you submit the required details, the insurer will proceed with your claim request.
Step 7: If the claim is approved, the insurer will settle the expenses with the hospital directly.
Step 8: In case the claim is rejected, you can file for reimbursement claim settlement after your discharge.
Any cashless mediclaim policy will invariably have exclusions. This simply means that these charges are not covered under the policy, and you need to make separate payments for them. You may have to cover the following charges since they will not be covered under a cashless policy:
Charges on toiletries
You must always remember to consider the following points:
The cashless insurance policy is only valid at the empanelled network hospitals. You must verify the details of the hospital before getting admitted.
You must display your health insurance card to the concerned authorities at the time of getting admitted to the network hospital.
All details pertaining to the medical treatment should be provided to the insurance company in a time-bound manner. Remember, delays could result in the rejection of claims.
All original documents, including doctor’s prescription, medical tests, and laboratory reports etc. should be provided to the insurance company. In case you fail to submit the requisite documents, your claim can be rejected.
You must always read the fine print, or the terms and conditions of any cashless health insurance policy carefully. This will help you know the scope and coverage of the policy.
You should avoid making the following mistakes to ensure that your claim does not get rejected:
If you have intentionally or unintentionally added any wrong information while registering for your policy or in the claim application process, the insurance provider will most likely reject your claim.
Similarly, if there are any documents that you have not submitted such as the relevant medical bills or the documents that you have submitted are not satisfactory to the insurance provider, your claim can get rejected.
If you make an insurance claim on your health policy which has already expired, your claim will also be rejected.
If you make any insurance claim for diseases or medical conditions that are not covered under your policy, the claim will most likely get rejected.
Life insurance provides a specific sum assured in case of the death of the policyholder. When it comes to cashless health insurance policy, you will receive the cost of medical treatment incurred at empanelled hospitals. Both require regular premium payments.
No, cashless health insurance can be availed only at empanelled network hospitals affiliated with your insurance provider.
If your cashless claim is denied, you are required to pay for the hospital expenses from your own pocket, and then apply for reimbursement.
No, there are no extra or hidden charges for the cashless benefit as it comes included with the health policy.
When buying health insurance at Bajaj MARKETS, you will receive a list of network hospitals where you can get the cashless claim settlement facility.