What is Cashless Health Insurance?

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Cashless Health Insurance

Living a healthy life is a luxury; not everyone can afford it. The current times have seen such high inflation levels that it has become absolutely impossible to live comfortably and save our income simultaneously. We spend our life earning our bread and butter every day, with so much determination and willpower. But life is unpredictable; even the smallest incident can drain us of our finances.

Health emergencies often come as a surprise and are unplanned. People don’t realize that they are suffering from an ailment unless the condition aggravates to the extent where one needs to be hospitalized. In such a situation, paying outstanding medical bills can affect our financial stability. However, cashless health insurance ensures that you won’t have to go through such hassles.

Cashless Health Insurance Overview

The panic that ensues us when our loved ones suffer from a health emergency is a tough situation to deal with. These tough times call for a cashless mediclaim policy wherein you don’t need to worry about arranging huge amounts of money at that instant. Your insurance provider will protect you in such circumstances. Read on to understand what exactly cashless health insurance is.

What is Cashless Health Insurance?

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Most health insurance have a feature that says, ‘cashless hospitalization’. But what exactly does this feature entail? This feature is basically an easier, more convenient way of paying your hospital bills. It allows you to be stress-free during medical exigencies as your finances would be taken care of by your insurance provider or the TPA (third-party administrator). The cashless mediclaim can be availed at any of the specified lists of network hospitals that your insurance provider has tie-ups with. You can opt for the best medical treatment needed at that point in time, and the bill will be settled directly between the hospital and the insurance company. Of course, you won’t have to bear the expenses in this case. So, having cashless medical insurance in place is essential.

Relevance of Cashless Health Insurance

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Having a cashless health insurance, also known as cashless mediclaim policy for family health and well-being protects you from chaotic situations like arranging money to pay hefty hospital bills. Cashless health insurance is extremely important for the following reasons:

  1. Ensures focus on the treatment
  2. Option of choosing the best form of therapy and doctor without stressing about the cost
  3. Saves time, money and effort that goes into the entire process of hospitalization
  4. Direct settlement of bills between the network hospital and insurance company

Important Features of Cashless Health Insurance

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The cashless facility on health insurance has certain rules and regulations, subject to your policy terms and agreements. One must read through these important features to enable a successful claim on medical bills:

  • The insured individual should get admission only in the specified list of network hospitals to enable the cashless claim, for TATA AIG’s list of cashless hospital click here.
  • Before buying cashless medical insurance, one should check for the number of partnering hospitals that the insurance company has tie-ups with. A higher number would make certain that there are a multitude of hospital options for availing cashless hospitalization and treatment.
  • The process of claiming cashless health insurance has a set timeframe. Adhering to this timeframe is crucial
  • A cashless health mediclaim policy can be claimed in two ways – Planned & Unplanned.

Claiming Cashless Health Insurance for Planned Hospitalization

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Planned hospitalization refers to a scheduled surgery/treatment/operation or health checkup that is covered under your active health insurance policy. In this scenario, you are aware of your hospitalization. Planned cashless health insurance works in a certain manner. Follow these simple steps:

  1. Admission to network hospital is necessary
  2. Informing the insurance company of the planned hospitalization at least five days beforehand with relevant claim forms and pre-authorization forms that are available on the website or can be collected from the network hospital
  3. The insurance company will issue a confirmation letter for your claim request, and they will notify the network hospital of the same. The letter will be valid for seven days from the issued date.
  4. On the day of the planned hospitalization, you should have the health insurance card and confirmation letter that must be submitted. Your work here is done. You do not have to worry about anything else, and you can address the primary concern, that is, the well-being of the ailing person.

Claiming Cashless Health Insurance for Emergencies

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Unplanned hospitalization is where a medical emergency arises suddenly and unexpectedly. These can be cases like an accident, heart attack etc., where the person suffering was not aware of the hospitalization. This can be a very stressful time, and cashless insurance can reduce the stress substantially. Follow these steps:

  1. The insurer should be informed about the hospitalization within 24 hours to generate relevant documents and forms like an insurance card, policy copy, customer ID proof, customer address proof, etc.
  2. The network hospital will then fill out cashless claim forms and send them further to your insurance provider
  3. The insurance provider will then revert with an authorization letter to the network hospital. The bill amount will then be settled between the concerned parties, and you won’t need to do anything more than caring for your loved one. If admission to the specified list of network hospitals is not viable, there is an option of reimbursement. Here, the bill would be paid by you in full amount, and you can file a claim with relevant documents and medical bills later on with your insurance provider.

Points To Remember

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  1. It is important to note that a cashless mediclaim policy and cashless health insurance cover different aspects of a health insurance plan. Therefore, make sure you are clear on which type of cashless facility you are availing
  2. Cashless Mediclaim policy is limited to hospitalization expenses, so any other expenses incurred will be paid by you
  3. Cashless health insurance provides comprehensive coverage, subject to the terms and conditions of your policy
  4. There are certain exclusions mentioned under cashless health insurances, so one should read the policy wordings carefully

*Cashless Health Insurance *is a salient feature of TATA AIG Health Insurance policies like MediCare. We have a network of 7200+ hospitals where one can avail cashless insurance with ease. In addition, our 94.21% claim settlement ratio makes us a trusted and credible insurance provider. However, to get an all-rounded understanding of cashless claims and other benefits offered under different health insurance policies, you can read through the policy wordings available on our website.

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