What is cashless treatment in health insurance policy?

What is cashless treatment in health insurance policy?

Know how you can manage expenses due to medical emergencies without making any out-of-pocket payments.

3 mins

Cashless health insurance policies, as the name suggests, are those insurance plans wherein the policyholder has the option to avail of cashless treatment at an insurer’s network hospital. In case of cashless treatment, the insurer and the hospital settle all the medical bills among themselves. To avail of the cashless claim settlement facility, one only needs to inform the insurer at least two days before (in case of planned hospitalisation) and within 24 hours of hospitalisation in case of emergency. You can avail of this facility at any of the insurer’s network hospitals. The hospital admin will directly contact the insurer and send a pre-authorisation form to start the claim settlement process.

Cashless claims: How they work

Most insurance companies have tie-ups with leading hospitals pan India. They form a robust network of hospitals where their policyholders can avail of cashless treatment.

When choosing a plan, it makes sense to check the network hospitals of the insurer. Also, make it a point to go through your policy document and check the network hospital list. This will give you some idea about the more well-known or popular hospitals around you. This is important because in case of planned hospitalisation, you may have the chance to check network hospitals and choose one that suits. In case of an emergency, a network hospital may be difficult to zero in on if you haven’t checked the list previously.

Either way, cashless treatment is possible only at network hospitals. Once the admission is complete, you need to inform the insurer about the admission. From here on, the insurer only requires your intervention in terms of any documents. The hospital will collect your insurance information and confirm the validity of your policy. Your cashless medical treatment will start after the verification of insurance information. In this scenario, your insurance company will take care of the expenses directly with the hospital after completion of treatment.

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.

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.

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.


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