A single medical emergency is enough to make a big hole into one’s lifetime savings, apart from all the mental trauma. This is the reason why a person should go for an investment in an adequate health insurance policy so that (s)he gets sufficient financial assistance in case of an emergency.
Well, it is true that a health insurance policy offers the much needed financial assistance against the cost of the treatment but still, you might have to pay a part of it from your own pocket before raising any claim. And this can become a nightmare for all the people who do not carry any savings. These are a few circumstances where health insurance policy come out as a savior.
Meaning of Cashless Hospitalization
There is no doubt in saying that the hospitalization and its associated treatment are becoming costlier day by day. To tackle with the same and to deal with any medical emergency it becomes quite important to have an investment in a cashless health insurance policy. It is something that you should add in your financial plan.
So, basically, if someone gets admitted into the hospital and do not carry the required funds to deal with the cost of the treatment, in such situation cashless hospitalization acts as a savior. In such a scenario he/she has to inform the insurance company about the situation and they will directly clear all your hospital bills. The benefit is that you don't have to deal with the entire reimbursement process.
States With The Highest Hospitalization Costs in Urban India
According to a recent survey:
Average cost of hospitalization
On average people using the public hospital
On average people using the private hospital
Rs 32, 370
Rs 31, 653
With the motive of providing the much needed relief to the insured during the hour of need, the cashless policies are designed. It is basically an arrangement of the insurance companies with their network hospitals. In cashless hospitalization the claim will be settled without the involvement of the insured. IN the same, sual;ly what happens, a Third Party Administrator (TPS) will be there to connect the hospital and the insurance company during the entire process of settling claims. These TPAs has their own desk at the network hospital to facilitate smooth claim settlement process.
Salient Features of Cashless Mediclaim Insurance
Features of any insurance plan are decided by the insurance company and therefore it might vary from insurer to insurer. Below is a list of some basic features that are included in most of the health insurance plans
- Daily cash benefits
- No Claim Bonus
- Pre and post hospitalization medical expenditures
- Cover for critical illnesses like cancer, stroke, heart attack, etc.
- Cover for ambulance services
- In patient Care
- Free-look period
- Cover for domiciliary treatment
- Complementary medical check-up and diagnostic tests
- Tax benefits under the Income Tax Act, 1961
Benefits of Cashless Health Insurance
Here are the benefits that a cashless health insurance policy offers to its policyholder:
- A helping hand for medical emergencies: No matter, a medical emergency is planned or not, but it can easily create a hole in anyone’s pocket when you don't plan for the same in advance. Cashless claim service helps the insured family in dealing with such crucial time successfully. In fact, you can get the necessary treatment on time by just showing your cashless card.
- A relief for the policyholder and his/her family: It is the most important thing that we need at the time of any crisis. A health insurance policy offers the much needed financial assistance so the cost of the treatment would not be a concern for the family and the patient as well. Once the treatment has started, the insurer will start the cashless services through a hassle-free process. With such great services, the insured and his/her family can easily focus on the treatment rather than arranging funds.
- Exclusive range of coverages: Cashless health insurance plans are designed in a way that can offer comprehensive cover to the insured that includes ambulance expenses, inpatient care, domiciliary treatment, pre, and post-hospitalization expenses, etc. are usually liable to get the cover. However, a few health insurance plans also come out with free health check-ups and diagnostic tests regularly.
- Safeguarding health when traveling: In case of any medical emergency, while you are traveling, you might face any medical emergency and getting the required treatment on time to become a need. And many times because of insufficient funds and lack of savings it might become difficult. To deal with such situations, cashless health insurance is a must thing that assures comprehensive coverage during the hour of need without any hassle.
- Tax benefits: Premium payments made towards cashless health insurance policies are eligible for tax benefits under Section 80(d) of the Income Tax Act 1961, up to Rs 25,000 for individuals below 60 years of age and up to Rs 50,000 for senior citizens.
Kind of Cashless Health Insurance Policies in India
- Cashless Individual Health Insurance: Cashless Individual Health Insurance policies provides cashless claims to deal with hospital expenses. As per the features, terms, and conditions of the plans you might get additional benefits as well.
- Cashless Family Health Insurance: The best thing about this plan is that all the members of the family can get cover under the same family health insurance policy. With a Cashless Family Health Insurance plan, you don't have to pay a different-different premium to keep policies of members active, a single-family health insurance plan is enough.
- Cashless mediclaim Insurance for Senior Citizen: As the name suggests, this plan is designed to offer coverage to senior citizens. It offers coverage against ambulance costs, hospitalization expenditures, pre-existing diseases as specified by the policy document, etc.
Top Cashless Health Insurance Policies in India
Here’s a list of five cashless mediclaim insurance policies in India penned down by PolicyX:
- Apollo Munich Optima Restore Health Insurance
- ICICI Lombard Health Care Plus
- Religare Health Care
- Max Bupa Health Insurance
- Bajaj Allianz Health Insurance Family Floater
- Reliance Cashless Health Insurance Plan
- New India Assurance Cashless Health Insurance Plan
- HDFC Life Easy Health Plan
- Cigna TTK Cashless Insurance Term
1. Apollo Munich Optima Restore Health Insurance
Considered as one of the most effective and efficient cashless mediclaim insurance policies, Apollo Munich Optima Restore Health Insurance is very easy to avail the benefit from.
Salient features of Apollo Munich Optima Restore Health Insurance:
- Offers a wide range of coverage on an individual as well as family floater plans
- Offers restore benefit, multiplier benefit and critical illness benefits
- Provides everyday cashless benefits for shared accommodation
- It also covers organ donor charges
- Alternative treatment like Ayurveda is also covered
- Boasts of a wide range of network hospitals
- Includes lifetime policy renewal feature
- Offers tax benefits under Section 80(d) of the Income Tax Act, 1961
2. ICICI Lombard Health Care Plus
Occupying the second place among health insurance companies in India that offer cashless facilities throughout their network hospitals, ICICI Lombard Health Care Plus is loved by its customers.
Salient features of ICICI Lombard Health Care Plus are:
- For every family member of the policyholder, ICICI health care plus offers Individual health insurance cover
- Non-applicable sub-limits on hospital accommodation, doctor’s charges and medical tests
- Add-on features like Maternity Benefit and discounts on treatment for outpatients
- Includes flexible sum assured and deductibles
- Cashless approval within 4 hours
- The quick claim settlement process
3. Religare Health Care
The salient features of Religare Health Care policy are:
- More than 4600 network hospitals included
- Pre and post hospitalization’s comprehensive coverage
- In case it has exhausted, it provides auto recharge facility to the sum insured
- Renewability of lifetime policy
- Alternative treatments like Ayurveda and Homeopathy are covered
- Speedy claim settlement
4. Max Bupa Health Insurance
The salient features of Max Bupa Health Insurance policy are:
- No sub-limits on hospital accommodation
- Lifelong policy renewable feature
- On each claim free year, an increase of sum insured
- Cashless facility applicable to its wide range of network hospitals
5. Bajaj Allianz Health Insurance Family Floater
Salient features of Bajaj Allianz Health Insurance Family Floater are:
- Boasts of an extensive range of over 6000 network hospitals – the highest among its competitors
- 10 percent co-payment for non-network hospitals
- No sub-limit applicable to hospital accommodation
- Quick and hassle-free cashless claims across network hospitals
Offers up to 10 percent discount for covers for a maximum of 6 members of the policyholder’s family.
6. Reliance Cashless Health Insurance Plan
The salient features of Reliance Cashless Mediclaim Insurance Plan are:
- Comprehensive coverages on family floater plan and individual plan
- More than 4000 network hospitals with cashless hospitalization
- Offers lifelong policy renewal
- Offers seamless and easy claim settlements
- Quick medical claim settlements feature
7. New India Assurance Cashless Health Insurance Plan
The salient features of the New India Assurance Cashless Health Insurance Plan:
- Comprehensive coverage
- Offers a benefit of critical care
- Critical illness cover
- Cashless benefit
- Coverage for the family
- Hassle-free claim process
8. HDFC Life Easy Health Plan
The salient features of HDFC Life Easy Health Plan are:
- Cost-effective premium rates for comprehensive coverage
- Covers expenses towards hospital room rent, ICU, medicines, nursing, etc.
- Maternity benefit
- Wide range of network hospitals
- Paperless, hassle-free claim settlement process
9. Cigna TTK Cashless Insurance Term
Salient features of Cigna TTK Cashless Insurance Term are:
- Includes hospitalization expenses as well as pre and post-hospitalization expenses
- Daycare cover
- Emergency ambulance cover
- Restoration benefit
- Maternity expenditures
- Critical illness additional cover
- Tax benefit according to Section 80D of the Income Tax Act, 1961
- Seamless claim settlement
How to Use Cashless Hospitalization
As we all know, the insurance companies collaborate with hospitals across locations in India to prepare a list of network hospitals for the health insurance they provide. On getting hospitalized at any of these network hospitals for any medical treatment, the policyholders of cashless health insurance would be eligible for availing cashless claims whenever the need arises. The medical expenses incurred up to the applicable sum insured are paid by the relevant health insurance company directly to the hospital.
Planned Claim for Cashless Health Insurance
As the name suggests, planned hospitalization implies that you are aware that the policyholder will be hospitalization in a few days. So this is obvious that (s)he have some time on his/her hands to make certain arrangements. Here are a few important points to consider before a planned hospitalization with a cashless health insurance policy:
- Connect with the insurance company or check your policy’s document to get information about network hospitals of your area.
- You have to fill a pre-authorization form once (s)he decides the choice of network hospital where (s)he would like to be treated. You can download the form through TPA website or get it from the insurance desk present at the hospital.
- You have to fill the form with accurate details. A person has to make sure that he is providing accurate information without hiding anything.
- Then the form should be faxed to the TPA, which will approve or reject it.
- If it got the required approval, then the TPA will share the authorization letter with the hospital, along with details about the sanctioned amount.
By all means, we can conclude that cashless health insurance is the key to convenience when an unforeseen medical emergency falls on us. However, the thing to keep in mind is that a cashless service is available only at the network hospitals. If the request for cashless settlement is denied, one can still pay for the expenses at the hospital from his/her pocket and then request for reimbursement. To avail of the cashless facility, it is important to send a timely intimation to the insurance company/TPA. It is mandatory to display the health insurance card at the time of admission in the hospital to avail cashless settlement. However, a cashless settlement of claims is purely subject to the terms and conditions mentioned in the policy wording.
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