Know all about Cashless Health Insurance Policy in India

Know all about Cashless Health Insurance Policy in India



 Whether we blame our sedentary lifestyle or the pollution level or adulteration in food, we cannot deny the fact that almost all of us have some kind of health issue these days. What becomes a matter of concern is the health issues getting worse and us taking admission in the hospitals. Apart from the painful treatments, we also start getting holes in our pockets. This is why buying a health insurance policy has become so important now.

Now as you purchase a health insurance policy, you also need to know the concept of cashless health insurance. As you opt for a cashless health insurance policy, you will be able to save yourself from the hassle of paying cash at the hospital. Now, let us discuss cashless health insurance in length.

How does cashless health insurance work?

If you are hospitalized and you have a cashless health insurance policy, you will not be required to pay the bill in cash. You just need to inform the insurance company about it or the hospital reaches out to the insurer. The bill is settled between the insurance company and the hospital. All that you have to do is to avail treatment and check out from the hospital.

Why is it significant to buy a cashless health insurance policy?

These days you can find many people buying a cashless health insurance policy. One of the main reasons for this is dealing during an emergency. We do not know when such a situation will come up and we are not always ready with cash. Therefore, as we have a cashless health insurance policy, we will not have to worry about paying the bills in cash and simply go ahead with taking the required treatment.

All that you need to make sure is the hospital that you are getting admitted to is a network hospital of the insurance company. You can find the list of network hospitals in your health insurance policy.

Types of cashless health insurance in India

Cashless health insurance is basically of two types; cashless family health insurance and cashless health insurance for senior citizens. With cashless family health insurance, you can insure the members of your family. With cashless health insurance for senior citizens, you get a bit more benefits such as pre-existing illnesses, hospitalization charges, and ambulance charges are covered.

Process of cashless health insurance

  • If it is a planned hospitalization, you have to choose a hospital from the list of network hospitals provided by your insurer. You will receive a policy card while buying the policy; you have to submit it to the hospital to avail of the treatment.

  • If it is an emergency case, the cashless treatment is approved by the TPA in around 6 hours. You can also choose to pay the bill in cash and get your treatment. The amount will later be reimbursed to you.

  • As you present the policy card, you will be given a preauthorization form which you will be required to fill up. It might be checked by a physician as well to make sure the form has been duly filled. The form has to be submitted to the TPA and will again be checked for eligibility. After the TPA sanctions it, the hospital will be sent a letter that will approve the treatment.

Things you should know

A cashless health insurance policy definitely has many advantages but some limitations as well. Here are some of the points that you need to know.

  • To avail of the cashless facility, you need to stick only to the network hospitals.

  • There are chances that your cashless insurance claim gets rejected. Make sure the pre-authorization form has been correctly and properly filled.

  • In the cashless family health insurance, ambulance charges, and a few equipment charges are not covered.

  • If the sum insured is exhausted in the treatment, the rest of the money has to be paid by the policyholder.

To find the insurance companies that provide cashless health insurance policies, you can visit the website of IIFL. After a thorough comparison, you can choose your preferred policy.


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