Types of cashless health insurance in India
Cashless medical insurance offers convenience by allowing direct settlement of medical bills with the hospital, avoiding upfront payment by the insured. In India, there are several types of cashless health insurance:
- Individual cashless plans: Cover medical expenses for a single individual.
- Family floater plans: Provide coverage for an entire family under one policy.
- Critical illness plans: Focus on specific severe health conditions.
- Top-up plans: Offer additional coverage beyond the base policy.
Understanding these types helps in selecting the right cashless medical insurance to meet your healthcare needs.
What is cashless facility in health insurance?
Cashless health insurance is a type of insurance plan where policyholders can avail of medical treatment without having to pay the hospital or medical facility directly. Instead, the insurance company settles the bill directly. This means that the policyholder does not need to worry about the cost of treatment or expenses incurred during hospitalisation.
Cashless health insurance makes the process simpler and easier for customers, ensuring they receive the best possible medical treatment without any stress or financial burden. It is an effective way to secure the financial well-being of individuals and families during a medical emergency.
Also, read: Family Health Insurance
How does cashless health insurance work?
A cashless mediclaim policy simplifies healthcare expenses by directly settling bills with network hospitals. Here’s how it works:
- Hospitalisation: Choose a hospital from the insurer’s network.
- Identity verification: Present your health insurance card and ID.
- Pre-authorisation: Complete a pre-authorisation form for approval.
- Treatment: Receive treatment without paying upfront.
- Billing: The insurer settles the bill directly with the hospital.
This process ensures a hassle-free experience for policyholders.
Benefits of cashless facility in health insurance policy
- With the cashless treatment facility, you can get admission into any network hospital and receive treatment without having to make any payments. The insurance provider must be notified as soon as possible, after which the entire process becomes quite convenient.
- When insurers empanel hospitals into their network, they have a stringent process that requires the hospital to pass several crucial qualifying parameters. As a result, when you are under the care of a network hospital, you can be sure of actually receiving top-notch medical care as well as expert guidance from licenced medical professionals.
- The insurer and the network hospital directly settle the expenses between themselves. Also since there is no stress to arrange a large amount of money for treatment. The insured can keep their focus on recovery.
- Under Section 80D of the Income Tax Act of 1961, you can claim tax exemptions for the premiums paid for a health insurance policy. Therefore, in addition to gaining peace of mind, you also get to lower your tax obligations.
- Get coverage for pre- and post-hospitalisation charges, diagnosis, treatment, medical costs, doctor visits, etc. This is as per the insurance policy that you choose. Cashless mediclaim also covers specialised treatments including dialysis, chemotherapy, surgical costs, lodging costs (per policy), and other day-care costs.
- You can be sure that your savings will not deplete by paying for medical bills if you use a cashless facility. Additionally, you will not need to scramble to find loans in order to pay the medical bills.
Also, read: Mediclaim Insurance Policy
The process to avail cashless health insurance
To raise a cashless claim request, you can follow these simple steps:
Step 1: Search for a partner hospital in your city and inform the insurance provider within 48 hours of hospitalisation (for emergency situations) or at least three days prior to admission (for planned hospitalisation).
Step 2: Make sure to carry the policy details or the patient's insurance cashless card provided with the policy document when you visit the network hospital.
Step 3: Produce a valid ID proof and insurance cashless card at the insurance desk of the hospital.
Step 4: Fill up all the details in the pre-authorisation form and submit it at the hospital.
Step 5: To expedite the procedure, fill up a request form on the official portal and inform your insurer about the same.
Step 6: Your insurance provider might take a few hours to review an application and inform you accordingly via SMS and e-mail.
Step 7: You can even check the status of the claim online.
The insurer will process the claim as per the terms and conditions after the completion of all the formalities.
What are the exclusions of cashless mediclaim policy?
Cashless medical insurance policies come with specific exclusions that are important to understand. These typically include:
- Pre-existing conditions: Often excluded for a certain period after the policy begins.
- Cosmetic procedures: Non-medical procedures like plastic surgery are usually not covered.
- Experimental treatments: Treatments or drugs not yet approved or in clinical trials.
- Self-inflicted injuries: Injuries caused intentionally are excluded.
Understanding these exclusions helps avoid surprises during claims.
Things to keep in mind before buying a cashless health insurance policy
Before purchasing a cashless medical insurance policy, consider these factors:
- Network hospitals: Ensure the insurer has a wide network of hospitals.
- Coverage details: Check what medical conditions and treatments are covered.
- Exclusions: Be aware of what is not covered under the policy.
- Claim process: Understand the process and documentation required for cashless claims.
These steps will help you select the most suitable policy for your needs.
Importance of having a cashless health insurance plan
Due to rising medical expenditures and emergencies, people are frequently in need of money and struggle to pay for medical expenses effectively. This sometimes results in compromising on the health care you receive. Cashless health insurance plans come in handy in such situations because they allow an individual to receive care without having immediate access to money. To receive the treatment, the policyholder needs to go to one of the network hospitals of the insurer and the procedures will be taken care of.
This facility allows the insured to feel less stressed and have peace of mind. Additionally, it will save time, effort, and energy while settling the claim with the insurance provider.
The points we have shared with you today are aimed at making sure that when you put your health insurance to the test during an emergency, it gives you the financial security you need without any hassles. To choose a health insurance plan that’s got you covered well in all these aspects, visit the Bajaj Finance website. Here, you can explore health insurance plans from our trusted partners, view product features, compare prices and purchase a plan that is best suited to your needs. All this in a matter of minutes and from the comfort of your home. It truly is becoming the new way to buy insurance.
