Is Cashless Facility Available in Your Health Insurance Policy?


Health insurance is no luxury but a necessity in today’s fast-paced world. Where lifestyle ailments are growing with each passing decade, a protection in the form of a health insurance cover is an utmost necessity. Selecting health insurance plans requires carefully assessing the policy features, the settlement procedure policy terms and more.

Among that cashless facility is an important factor to consider. Health insurance claims are settled by either of the two ways—reimbursement mode or cashless mode. As the name suggests, a reimbursement policy is where the insurance company compensates for the cost of medical treatment. Here, you need to pay for the medical treatment first, which is then followed by the reimbursement by the insurance company. Contrary to this, cashless claims are settled without any payment requirement. The entire treatment cost that is admissible as per the policy terms is covered by the insurance company offering a hassle-free medical treatment.

The working of cashless health insurance

Before buying a policy that offers cashless health insurance, it is critical to know that such facility is only available at a network hospital. A network hospital is the one that is affiliated with the insurance company and additional benefits in the form of cashless treatment are available. So, selecting an insurer with larger network of affiliated hospitals is advisable.

The benefits of cashless facility can be availed by policyholders at times of a planned medical procedure or even during an emergency hospitalisation. Primary advantage of such cashless insurance claim is any financial stress concerning the medical treatment is relieved by the insurance company. So, you need not pay for any costs other than the excess as mentioned in the policy terms. * Standard T&C Apply

Here’s how a planned or an emergency cashless treatment can either made:

In case of planned hospitalisation

Planned hospitalisation, as the name suggests is the medical procedure that is required after diagnosis. There is enough time to decide the medical facility which can be select and accordingly get admitted to the concerned hospital. For such planned treatments, it is critical to keep your insurer up to date and seek necessary approval in advance. Form like the pre-authorisation form need to be submitted at the insurance desk at the hospital which then seeks approval for the treatment from the insurance company. Based on its approval, rejection, or even partial approval, the balance costs need to be borne by you, the policyholder. * Standard T&C Apply

In case of emergency hospitalisation

Unlike a planned treatment, emergency treatment requires the patients medical needs to be placed higher than the insurance process. Here, the treatment is first provided to the patient and subsequently intimated to the concerned insurance company of such hospitalisation. While the process remains the same, the chronology changes where an approval for the treatment is sought, but after immediate medical assistance is provided. Any difference in the treatment cost from authorised treatment by the insurance company are required to be paid in the end. * Standard T&C Apply

Benefits of health insurance are many and cashless treatment is one among them. So, look out for a policy that offers cashless coverage along with a broad network hospital list. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms and conditions, please read sales brochure/policy wording carefully before concluding a sale.