In an era where health is paramount, Cashless Health Insurance plans redefine the way you access medical care. With a seamless process that eliminates the need for upfront payments during hospitalization, the comprehensive policies offered on Coverfox ensure that your focus remains solely on recovery.
Immediate Access to Treatment: With cashless health insurance, policyholders can access medical treatment at network hospitals without making upfront payments. This ensures timely medical attention in emergencies or planned hospitalizations without worrying about arranging immediate funds.
Financial Security: It offers financial security by covering medical expenses directly through the insurance provider at network hospitals. Policyholders don't have to bear the burden of large medical bills, reducing financial strain during health crises.
Convenience: Cashless health insurance eliminates the hassle of reimbursement procedures. Policyholders can avail treatment without worrying about paying upfront and later claiming reimbursement from the insurer, making the process smoother and more convenient.
Wider Network of Hospitals: Insurers usually have tie-ups with a vast network of hospitals, providing policyholders with options for quality healthcare services at these network facilities, often offering discounted rates.
Emergency Preparedness: In critical situations where time is crucial, cashless health insurance enables immediate admission and treatment without delay, ensuring patients receive timely care.
Transparency: It enhances transparency in healthcare costs as policyholders are aware of covered expenses, facilitating better financial planning for medical needs.
Best Cashless Health Insurance Plans | Sum Insured | Waiting Period | Coverage | Eligibility |
---|---|---|---|---|
ICICI Lombard Health Care Plus |
NA | Pre-existing diseases are covered after 4 years | Pre & Post Hospitalization | 5 years to 65 years |
Care Health Plan (formerly known as Religare) |
Rs. 3 lakhs to Rs. 6 Crores | Pre-existing diseases are covered after 4 years | Pre & Post Hospitalization | 5 years to 18 years above | Niva Bupa Health Insurance |
Rs. 5 lakhs | Pre-existing disease waiting period of 24 months | Pre & Post Hospitalization | 18 to 65 years |
Bajaj Allianz Health Insurance Family Floater |
1.5 Lakh to 50 Lakh | Pre-existing disease waiting period of 24 months | Pre & Post Hospitalization | 18 years to 65 years |
Cashless health insurance plans revolutionize access to healthcare by offering a seamless, cash-free experience during hospitalization. These plans provide policyholders the privilege to receive medical treatment at network hospitals without the need for upfront payments. Instead, the insurer directly settles the covered medical expenses with the hospital, ensuring immediate and hassle-free care during emergencies or planned hospital visits.
Cashless health insurance is a type of health insurance policy that allows policyholders to avail of medical treatment at network hospitals without having to pay the medical bills upfront. Under this policy, policyholders can seek treatment at specified hospitals within the insurer's network and have the medical expenses settled directly by the insurance company. When policyholders are admitted to a network hospital for covered treatments or procedures, they present their health insurance card or policy details, and the hospital coordinates with the insurer for the settlement of bills. This eliminates the need for policyholders to pay for medical expenses at the time of discharge, providing a seamless and cash-free experience during hospitalization.
Cashless hospitalisation refers to a process wherein a policyholder can receive medical treatment or undergo a procedure at a network hospital without making any direct payments at the time of discharge.
Cashless health insurance policies offer a variety of benefits that can improve policyholders' healthcare experience. These include access to a broad network of hospitals, where policyholders can receive cashless treatments, making it easier to access quality healthcare facilities.
Policyholders can enjoy financial security as medical expenses are covered directly, reducing the burden of large medical bills. Furthermore, paperwork is minimized as the insurer settles the bills directly with the hospital, simplifying the reimbursement process.
The coverage is extensive, including a wide range of medical expenses such as hospitalization, surgical procedures, diagnostics, and more, depending on the policy terms and coverage limits. This can result in policyholders receiving discounted rates at network hospitals, maximizing the benefits of the insurance coverage.
Immediate Access to Treatment: Policyholders can seek immediate medical attention at network hospitals without upfront payments, ensuring timely care during emergencies.
Financial Security: It provides financial security by covering medical expenses directly, relieving policyholders from the burden of arranging funds for large medical bills.
Convenience and Ease: Streamlines the hospitalization process by eliminating the need for immediate payments, reducing paperwork, and facilitating a hassle-free healthcare experience.
Wider Access to Quality Healthcare: Offers access to a wide network of hospitals, allowing policyholders to choose from various quality healthcare facilities for treatment.
Emergency Preparedness: Ensures readiness for unexpected medical emergencies without worrying about arranging funds, enabling policyholders to focus solely on recovery.
Discounted Rates: Policyholders often receive discounted rates for medical services at network hospitals, maximizing the benefits of the insurance coverage.
Reduced Stress: Eliminates the stress of managing immediate healthcare expenses, allowing individuals and families to prioritize health without financial worries.
When you need to be hospitalized for treatment of a pre-existing disease, you can use the cashless claim settlement facility provided by your insurance company.
To use this facility, you should first check if the hospital you plan to visit is a part of your insurer's Preferred Provider Network (PPN).
If it is, follow these steps to avail the cashless claim settlement:
By following these steps, you can ensure hassle-free cashless hospitalization for your pre-existing medical condition.
In case of an unexpected event such as an accident or a critical illness, hospitalization may be required. If this happens, the policyholder or their family members should follow a specific procedure:
For the treatment of a pre-existing disease
Every insurance company has a tie-up with certain hospitals that forms a part of their Preferred Provider Network or PPN. When you plan to get treated in such hospitals, you can avail the cashless claim settlement facility. To avail it, you need to do the following:
For an unexpected event like an accident or a critical illness
In an unforeseen situation like an accident or a critical illness, if hospitalization is required, then the policyholder or his/ her family members should follow the following procedure:
You can opt for cashless claim settlement during hospitalization at network hospitals specified by your insurance provider. When requiring medical treatment, choose a network hospital and inform them about your cashless health insurance coverage. Present your health insurance card or policy details for verification.
A cashless health card is a document that serves as proof of your medical insurance identification. It contains personal and policy details, including the sum insured under your active health insurance policy. It enables you to make cashless payments for medical expenditures incurred during hospitalisation and other medical expenses.
When you purchase a medical insurance policy, you will receive your cashless card along with the policy papers from the insurance company. If your entire family is covered by the health insurance plan, each member will have a distinct and unique cashless card.
In cashless health insurance, certain aspects may not be covered under the policy:
Also Read: Do's and Don'ts a Policyholder Must Know While Buying Cashless Health Insurance
Under this system, the insurer settles the covered medical expenses directly with the hospital, sparing the policyholder from paying at the time of discharge. Policyholders present their insurance details, and upon approval from the insurer, the hospital provides treatment without the need for the policyholder to pay out-of-pocket expenses.
At Coverfox, buying Cashless Health Insurance Online is a streamlined and empowering experience. With a vast array of policies from leading insurers, we offer a one-stop platform for comparing and selecting the most suitable plan for your healthcare needs. Our user-friendly interface simplifies the process, allowing you to explore policy features, inclusions, and network hospitals effortlessly.
Planned hospitalization implies that you are aware that you will be hospitalization in a few days and, therefore, you have some time on your hands to make certain arrangements. Here’s what you should do before a planned hospitalization with a cashless health insurance policy:
Choose Network Hospitals: Identify and familiarize yourself with the hospitals in your insurer's network where you can avail of cashless services.
Know Your Policy Details: Understand your policy coverage, including inclusions, exclusions, sub-limits, waiting periods, and any co-payment requirements.
Keep Policy Details Handy: Carry your health insurance card or keep policy details readily available for quick access during hospital visits.
Pre-Authorization: In case of planned hospitalization, inform the insurer in advance about the treatment to obtain pre-authorization. Follow the insurer's process for pre-authorization, including providing necessary documents or forms required by the hospital.
Emergency Hospitalization: During emergencies, inform the hospital immediately about your cashless insurance coverage. Show your insurance card or provide policy details for verification.
Understand Process: Familiarize yourself with the insurer's cashless claim process, including the documentation required, timelines for approvals, and the hospital's coordination with the insurer.
To use cashless health insurance, show your insurance card to the hospital authorities at the time of hospitalization. Fill out and submit the pre-authorization form available at the insurance desk to expedite the claim settlement process. In an emergency, the TPA is required to process claims within 6 hours. Alternatively, you can pay the hospital bills and initiate the claim settlement process later.
Cashless health insurance plans have gained significant popularity in India in recent times. They provide a hassle-free and convenient way for people to access medical treatment without worrying about the financial burden.
Cashless health insurance plans have gained significant popularity in India in recent times. They provide a hassle-free and convenient way for people to access medical treatment without worrying about the financial burden.
The detailed list of all the network hospitals is available with your insurance company. If you have still not received the same, please contact your insurance company for an update. Simultaneously, you can also access this information through the online portal of your insurer.
As per the strict IRDAI guidelines, the insurance company/TPA cannot deny your request for cashless treatment unless there’s a valid reason to do so. Some of these reasons could be that:
Because OPD treatments are not covered in your health insurance policy, you cannot opt for cashless treatment for them. However, if it’s a part of hospitalization that is covered by the insurance company, you can claim the amount.
Congratulations and all the best! The good news is – yes, you can opt for the cashless treatment. You will have to refer to your policy wordings to check the waiting period and the scope of coverage related to maternity.
If you have lost your health card, you should intimate your insurance company/TPA as soon as possible. Further, it's entirely at the discretion of the insurance company/TPA to accept or reject your request for cashless treatment. Some TPAs/insurers allow their policyholders to proceed with treatment on the basis of KYC documents, if the health card is not available. Cashless settlement of hospitalization expenses is one of the biggest advantages of health insurance. In times, when you are already emotionally fragile, what can be more comforting than a financial respite to reduce your worries and stress?
Cashless health insurance policies can usually be renewed throughout the policyholders’ lifetime.
Here are some of the exceptions to the benefits of cashless health insurance:
Cashless health insurance is a form of payment system under which the insurance company pays the treatment expenses directly to the network hospital where treatment has taken place up to the sum insured opted under the plan. This facility of payment is available under both types of plans i.e. family floater and individual health insurance plans.
Similar to most health insurance products, cashless health insurance policies are generally offered for a standard policy tenure of 1 year. They have to be renewed annually. Some insurance companies also offer a term of 2 years or 3 years on some of their health insurance policies.