What is Cashless Health Insurance

Cashless health insurance is a type of health insurance plan that enables you (the policyholder) to seek cashless hospitalisation or medical treatment at any of the network hospitals listed by the insurer. With this policy, you do not have to worry about paying for medical expenses upfront. The insurance provider pays the hospital directly for the covered medical expenses. Keep reading to know the features and benefits of availing cashless treatment in India.

No Room Rent Capping | No Medical Check-up up to 55yrs | Tax Benefit up to 75k | Buy Health Insurance starting @ ₹244 pm

Top Cashless Health Insurance Plans

Here are the top 3 cashless health insurance plans in India:

  • Bajaj Allianz Health Insurance Plan

  • Aditya Birla Health Insurance Plan

  • Care Health Insurance Plan

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: 

Plans Available 

Sum Insured 

Starting Rate of Premiums (per annum)

Check Plans

Bajaj Allianz Health Insurance 

Rs. 3 Lakhs to Rs. 50 Lakhs

Rs. 5,912

Aditya Birla Health Insurance 

Rs. 3 Lakhs to Rs. 50 Lakhs

Rs. 5,200

Care Health Insurance

Rs. 4 Lakhs to Rs. 50 Lakhs

Rs. 8,065

Features of Cashless Health Insurance 

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.

Types of Cashless Health Insurance Plans in India

Cashless Health Insurance plans in India are available under the following categories: 

  • Individual Cashless Health Insurance 

This type of cashless insurance is for individuals seeking health coverage for themselves. 

  • Family Floater Cashless Health Insurance 

This type of health insurance is for families seeking to get cashless health coverage under a single plan. 

  • Senior Citizens Cashless Health Insurance 

This type of insurance is meant for senior citizens, i.e. people above the age of 60 seeking cashless healthcare services. 

Exclusions Under Cashless Health Insurance

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: 

  • Service charges

  • Registration fees

  • Admission fees

  • Charges on toiletries

  • Attendant’s fees

How Does Cashless Medical Insurance Work

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 insurance 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.

How to Buy Cashless Health Insurance at Bajaj Markets

You can buy Cashless Health Insurance on Bajaj Markets in just a few minutes by following the given steps:

  • Step 1: Click on the ‘Buy Now’ button mentioned on the top of the page.

  • Step 2: Enter your personal details on the form available on the page and click on ‘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. 

Why is it Important to Have a Cashless Health Insurance

It is important to get Cashless Health Insurance for the following reasons: 

  • Financial Help

A cashless treatment will provide you with financial support during any planned or emergency medical treatment, requiring hospitalisation.

  • Extensive Coverage

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.

  • Health Protection During Travel

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. 

  • 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.

Important Points to Remember Before Availing a Cashless Health Insurance Policy

You must always remember to consider the following factors before purchasing a Cashless Health Insurance Policy:

  • 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 to 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 the rejection of claims.

  • Proper Documentation

All original documents, including doctor’s prescriptions, medical tests, 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.

How to Claim Cashless Health Insurance in India

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.

How to Avail Cashless Hospitalisation

Here’s how you can avail cashless hospitalisation:

1. Planned Hospitalisation

This is when you are aware of the fact that you must get hospitalised in the coming few days. In such a case, all you have to do is opt for a specific network hospital to avail the cashless services. Follow these steps in that case:

  • Call on your insurer’s toll-free number to enquire about your nearest network hospital.

  • After finalising the network hospital, collect your policy card and pre-authorisation form. This can be collected from the hospital’s insurance desk or the insurer’s website. 

  • Submit that form to ensure its authenticity at the insurance desk of the hospital.

  • The form will then be faxed to the Third Party Administrator who will have to process it and decide whether it will be accepted or rejected.

  • If the pre-authorisation request gets approved, you will receive an authorisation letter from them.  This letter will contain a detail with the treatment’s sanctioned amount.

2. Emergency Hospitalisation

If there is a case of an emergency hospitalisation, you are required to receive immediate care. In such a case, you must initiate a cashless Mediclaim facility within twenty four hours of getting hospitalised. Follow these steps to avail cashless hospitalisation:

  • Submit your health insurance card containing your policy’s number, insurer’s name, and health policy type at the network hospital.

  • Enter the pre-authorisation form to allow the insurance executive process your claim. Wait for the approval from the TPA or make the payment instantly and get it reimbursed from your insurer later.

According to the protocol passed on for emergency conditions, a Third Party Administrator must process an emergency hospitalisation within six hours.

Top Reasons for Claim Rejection in Cashless Health Insurance 

You should avoid making the following mistakes to ensure that your claim does not get rejected:

  • Providing Incorrect Information

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. 

  • Missing Documents 

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. 

  • Expired Policy 

If you make an insurance claim on your health policy which has already expired, your claim will also be rejected. 

  • Claiming for Exclusions 

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.

Health Insurance Plans Available at Bajaj Markets

FAQs on Cashless Health Insurance

  • ✔️What is the difference between a life insurance policy and a cashless health insurance policy?

    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.

  • ✔️Can I get admitted to any hospital?

    No, cashless health insurance can be availed only at empanelled network hospitals affiliated with your insurance provider.

  • ✔️What if my claim for cashless treatment is denied?

     If your cashless claim is denied, you will be required to pay for the hospital expenses from your own pocket, and then apply for reimbursement.

  • ✔️Do I need to pay extra charges for a cashless health insurance policy? Are there any hidden charges?

    No, there are no extra or hidden charges for the cashless benefit as it comes included with the health policy.

  • ✔️How do I know the list of network hospitals where I can avail cashless treatment?

    When buying health insurance at Bajaj Markets, you will receive a list of network hospitals where you can get the cashless claim settlement facility.

  • ✔️Does OPD treatment cover cashless health insurance plans?

    Most health insurance plans cover OPD treatment charges as well. However, it totally depends on the company and its inclusion terms of a health plan. 

  • ✔️Do I have to notify my cashless health insurance company of my planned hospitalisation?

    Yes. When it comes to planned hospitalisation, the insured has to inform the insurance provider at least 48 hours prior to hospitalisation.

  • ✔️Can I get tax benefits for cashless health insurance?

    Under Section 80D of the Income Tax Act, a policyholder can avail tax benefits against premiums paid for cashless health insurance.

  • ✔️What kinds of cashless health insurance plans are available in India?

    The types of cashless health insurance plans available in India are as follows:

    • Senior Citizen Mediclaim Policy.

    • Critical Illness Plans.

    • Individual Mediclaim Plan.

    • Hospital Daily Cash Benefit Policy.

    • Personal Accident Plans.

  • ✔️How many claims are permitted annually under a cashless health insurance plan?

    There is no limitation to the no. of claims that are allowed to be registered during a specific policy year. The claims can be made until the insured sum of the policy gets exhausted.