What is Cashless Hospitalization and Its Benefits?

Health Insurance is conceived by people as the facility that reimburses the expenses spent on health care. But with growing innovations the insurers have incorporated new features in the insurance policies known as “Cashless Hospitalization.” Well, it is a part of your health insurance policy under which you can get admitted to a network hospital associated with your insurance provider and get complete medical treatment without paying anything from your pocket. The complete expenses will be borne by the insurer, and you can just focus on getting the treatment. Cashless mediclaim is a benefit that provides an easier way in case of medical requirements than getting the expenses reimbursed. It makes the treatment free of cost, resolving the need for waiting till the reimbursement formalities.

It is imperative to understand that the cashless hospitalization is available in the network hospitals of your insurers.

Let us take the example of Ashish Kemar, who belongs to an average middle-class family. He has a job but leads an extremely tight budget-based lifestyle due to a modest income and faces perpetual liquidity limitations. Apart from these, no matter how many other problems he might or might not have in life, at least, he sleeps peacefully when it comes to matters of health in his family. Especially after buying cashless health insurance. He knows he won’t face any financial crunch in case he needs to get his aging parents hospitalized or during his wife’s upcoming delivery. All thanks to smart investment in a health plan with a cashless component attached to it.

There are two Ways Cashless Health Policies in India can be Utilized

1. Planned Hospitalization

Taking Ashish’s example, this will be applicable in the case of his wife’s delivery. After getting a recommendation from her doctor, he can check out the network hospitals and select the best one. After that, he needs to get in touch with the third party administrator (TPA) of his insurance company with required pre-hospitalization paperwork. TPA will study his case, and if everything is in order, it will begin the process of providing cashless hospitalization to Ashish’s wife. Doesn’t this sound like the best health insurance plan?

2. Emergency Hospitalization

This is where most people feel the financial crunch. Arranging cash for admission process in a short span of time while at the same time getting treatment started for the family members or self-becomes a huge challenge. However, even in this case you need to contact the TPA desk and provide them with your id and other details. Based on that they will evaluate your case and get permission from the insurance company. In emergencies, the turnaround time for them to give you a yes or no is 6 hours and in other cases; they have to get back to you within 24 hours. With cashless insurance, health insurance policies in India have come to the rescue of millions for whom getting expensive medical treatment is nearly impossible.

In both the above-mentioned cases, you need to keep photocopies of all documents, hospital bills, doctor reports, etc. as the originals will be submitted with the TPA for claim processing. Only if your claim amount surpasses the sum assured as per the policy that you will have to pay the extra amount on your own and that too later, at the time of filing the claims, not immediately. To ensure claims are not rejected, give correct information while submitting the request.

Advantages of Cashless Hospitalization

  • You can start the best possible medical treatment without spending a single rupee from your pocket
  • Except for non-medical administrative expenses and cost of medicines, every other expense is covered under this plan
  • Certain insurance companies provide this feature on your policy even if you’re travelling abroad
  • You can claim tax benefits on cashless health insurance under section 80D
  • Some insurers also offer free medical check up at regular intervals

The best health insurance plan is one that not only covers your medical expenses, but also comes to your rescue in case you need instant hospitalization with not enough cash in your hand. Just like Ashish has found his peace, you can enjoy it too by planning to get a cashless insurance cover.

Harjot Singh Narula

Harjot Narula is founder and CEO of ComparePolicy.com, an IRDAI approved insurance web aggregator focussed on selling online insurance for companies. Harjot has more than a decade of experience in software development and has also spent 5 years in US working for the mortgage and risk management industry.

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