Cashless Health Insurance In India

Cashless Medical Insurance

What Is Cashless Health Insurance?

Cashless health insurance is nothing but one of the essential features in your health policy. It is also known as a cashless claim settlement facility in India. The feature ensures that the insured can seek cashless hospitalisation treatment at any of the network hospitals listed by the insurer.

With cashless insurance, the policyholder does not have to worry about the medical expenses and avail high-quality healthcare services for free, as long as the health insurance covers the cost of it.  However, note that the insured needs to be admitted or seeking treatment at a network hospital enlisted by the insurer. Only then, the cashless insurance will come in handy.

Keep reading to know the features and benefits of availing cashless treatment in India.

Features of Cashless Treatment

The features of cashless health insurance are pretty much the same as that of your primary health plan. Here, take a look!

• With a cashless health plan, you will be able to avail high-quality healthcare facilities at an affordable premium rate.
• Most insurers provide reinstatement benefits when you exhaust your sum insured amount during the treatment and hospitalisation.
• You can avail cashless insurance at any of the network hospitals listed by your insurer across India.

Benefits of Cashless Treatment

A cashless health insurance policy will provide you with manifold benefits as enumerated below -

• Financial help: A cashless treatment will provide you financial succour during any planned or emergency medical treatment, requiring hospitalisation.

• Extensive coverage: The policy covers a wide range of medical procedures, like surgeries of eye, bones, skin, ear, etc. It also covers critical illnesses, including cardiac ailments, kidney failure, stroke, organ transplant, and limb paralysis. The critical illness policy, however, can vary as per the type of policy selected. You can also avail cashless treatment for ailments, like piles, cataract, sinusitis etc. after having completed a minimum number of policy years as stipulated in the policy.

• Health protection during travel: Along with pre and post hospitalisation expenses, a cashless mediclaim policy also covers your health while traveling. In the case of an emergency during travel, you can avail cashless hospitalisation at an empanelled hospital.

• Tax benefits: 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.

How Does Cashless Treatment Work?

Typically, the insurance company has a large network of empanelled hospitals across the country for providing medical treatment to policyholders. If you have a cashless mediclaim policy, you will not have to pay for availing medical treatment. Instead, the expenses will be borne by the insurer.

Types of Cashless Treatment

In India, we have two types of cashless mediclaim plans that you can avail -

• Planned Claim:

In the case of planned claims, you have to inform the insurer in advance about the details of the impending medical treatment. The insurer will then ask you to take pre-authorisation from an empanelled hospital. Once you complete the procedure, you will be admitted to the hospital, without requiring paying for your medical bills. You must always remember to inform the insurance company, a few days in advance, before starting the scheduled treatment.

• Emergency Claim:

What if you need immediate hospitalisation due to a life-threatening illness. In that case, a cashless mediclaim policy allows you to avail emergency claims. If you require immediate hospitalisation because of sudden onset of a critical disease, the cashless insurance policy will settle your medical bills with the empanelled hospital directly.

How to Avail Cashless Health Insurance?

If you want to make a cashless health insurance claim, here’s what you need to do –

1. Make sure that you seek treatment or hospitalised at a network hospital enlisted by your insurer.
2. Visit the hospital insurance desk and get a pre-authorisation form.
3. Submit the duly filled pre-authorisation form as soon as possible.
4. Get in touch with your insurer as per the mentioned time and submit the necessary documents.
5. The insurer will verify the documents. Based on the verification and further assessment, the claim management team will approve/reject your claim.
6. Note that if the claim management team requires additional information, they will raise a request. Upon submitting the required details, the insurer will proceed with your claim request.
7. If the claim is approved, the insurer will settle the expenses with the hospital directly.

In case the claim is rejected, you can file for reimbursement claim settlement after your discharge.

Important Points to Remember Before Availing a Cashless Treatment

You must always remember to consider the following points -

• Treatment only at network hospitals: The cashless insurance policy is only valid at the empanelled network hospitals. You must verify the details of the hospital before getting admitted.

• Display health insurance card: You must display your health insurance card to the concerned authorities at the time of getting admitted in the network hospital.

• Timely intimation: All details pertaining to the medical treatment should be provided to the insurance company in a time-bound manner. Remember, delays could result in rejection of claims.

• Proper documentation: All original documents, including doctor’s prescription, medical test 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. 

• Careful perusal of the policy document: 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.

Exclusion under Cashless Treatment

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. The following charges are required to be paid by the policyholder:

• Service charges

• Registration fees

• Admission fees

• Charges on toiletries

• Attendant’s fees

Cashless Health Insurance Plans At Finserv MARKETS

The health insurance plans available on Finserv MARKETS provide cashless claim settlements. So, if you are seeking treatment at any of our listed network hospitals across the country, you can avail the cashless claim settlement facility with ease.

Besides, you can benefit from features such as reinstatement benefit, extensive coverage, hassle-free renewals, tax benefits, and more. You can also buy/renew your health insurance plan using the Finserv MARKETS App.

So, don’t wait! Get a health insurance plan with us at Finserv MARKETS today.