Cashless Health Insurance
Cashless Health Insurance
Medical emergencies can happen to anybody without any prior notice. They are not only emotionally challenging but also financially stressful. Hence, to shield their finances during unforeseen medical events, people prefer to invest in health insurance plans.
However, even after purchasing a health insurance policy, people still have to pay their medical bills out-of-pocket first before insurance companies can reimburse them. This can be an excruciating process for someone dealing with a medical emergency.
This is why most prefer health insurance plans with cashless benefits. It lets individuals claim treatment in network or non-network hospitals* without worrying about getting last-minute funds.
Read on to learn how you can find the best cashless health insurance policy and Go Cashless Everywhere!
What Is Cashless Health Insurance?
Cashless health insurance is a health insurance plan where the insurer covers medical expenses, such as hospitalisation charges, treatment bills, etc., and pays the hospitals directly.
It is a type of claims procedure that can be chosen instead of a reimbursement claim.
Policyholders do not have to pay out-of-pocket during cashless claims, as the insurer settles the bill directly with the hospital upon approval. With this health insurance policy, one can benefit from cashless treatment in any network hospital or non-network hospitals* of the insurance company.
However, they need to understand the policy terms and conditions to be eligible for cashless claim benefits.
How Does Cashless Health Insurance Policy Work?
The overall cashless claims process will involve the policyholder contacting their insurer upon hospitalisation, submitting their documents, the insurer verifying their documents and then settling their bill directly with the hospital, be it a network or non-network hospital
In all other respects, a cashless health insurance policy will function the same way a regular health insurance plan does.
With TATA AIG health insurance plans, you now get cashless claims in any network and non-network hospitals* near you in just 3 easy steps.
#GoCashless In 3 Easy Steps
Step 1: Send an SMS - "GoCashless” “
Step2: Talk to an expert
Step 3: Get cashless anywhere*
**Cashless facility cannot be extended to hospitals listed in the excluded providers published on the TATA AIG website. Furthermore, cashless services are not available for healthcare facilities that do not meet the minimum eligibility criteria set forth by IRDAI. TATA AIG reserves the right to exercise its own discretion in making the final decision.
Importance of Health Insurance Plans with Cashless Benefits
A cashless health insurance policy can be beneficial during medical emergencies. This is because hospitalisations can rack up a huge bill, leaving people scrambling to gather last-minute funds.
However, if you have a cashless health insurance policy, the insurer will settle the bill directly with the hospital, allowing you to focus on your recovery.
Below are some key benefits of buying cashless medical insurance for your family:
Convenience - The very first benefit of a health insurance plan with cashless coverage is convenience. The policyholder doesn't have to worry about anything while being hospitalised. All the medical expenses will be taken care of by the insurance company in their stead.
Preferred Hospitals - The second benefit of having a health insurance policy with cashless coverage is to get access to any of the preferred hospitals, which can be a network or non-network hospital. The policyholder can take treatment in any of their preferred hospitals, considering their health condition, proximity to their residence, infrastructure facilities, etc., without worrying about out-of-pocket medical expenses.
Quality Health Care -Another benefit of cashless health insurance is access to quality healthcare without dipping into savings. Often, people will overlook health due to expensive medical treatments. A health insurance plan with cashless benefits grants people the ability to receive quality medical care in their time of need.
No Medical Billing Hassles - Lastly, with a cashless hospitalisation process, policyholders don't have to worry about settling their medical bills. Instead, they can spend time with their loved ones and family. The health insurance provider allows direct settlement of medical bills and expenses with the network or non-network hospital*.
Types of Cashless Health Insurance Plans
There are different types of health insurance policies with cashless coverage. Some of them are listed below:
Individual Health Insurance with Cashless Coverage - This type of health insurance plan covers one individual (a single policyholder).
Cashless Medical Insurance For Family - This medical insurance policy covers a family, which includes self, spouse, parents, and kids.
Critical Illness Insurance with Cashless Coverage - This medical insurance policy covers the treatment of critical illnesses such as cancer, heart disease, etc. It generally offers a lump sum payment on diagnosis of the illness.
Senior Citizen Health Insurance with Cashless Coverage - This health insurance policy covers medical expenses for senior citizens aged 60 years and over.
Maternity Health Insurance with Cashless Coverage - The policy type will cover maternity/pregnancy-related expenses for individuals who wish to have children in future.
Things To Consider While Buying Cashless Medical Insurance
Unplanned hospitalisation is where a medical emergency arises suddenly and unexpectedly. These can be cases like an accident, heart attack, etc., where the person suffering was unaware of the hospitalisation. This can be very stressful, and having cashless medical insurance can reduce the stress. However, before opting for cashless medical insurance, some points must be considered.
Sum Insured - When choosing the cashless health insurance policy, remember the maximum sum insured value. Choosing a plan that provides sufficient coverage for the entire year is best.
Waiting Period -Another thing to remember is the waiting period for cashless health insurance claims. It is best to go with the health insurance plan that offers the least waiting period in times of emergency.
Network and Non-Network Hospitals - While buying a health insurance policy with cashless benefits is essential, checking its network hospital connection is equally important. We at Tata AIG have a network of 10,000+ hospitals where one can easily avail the cashless health insurance claim with a simple and hassle-free process.
Now, you can also avail of cashless claims in non-network hospitals*. The process and the documentation can get slightly lengthier and are applicable only when the request is accepted by the hospital and in line with TATA AIG's terms and conditions.
Co-payment - To save from entire expenses, a co-payment feature is best. In this case, the policyholder pays for some expenses out of their pocket while the insurance company covers the remaining. It doesn't put a financial burden on policyholders.
Tata AIG For Cashless Health Insurance
Tata AIG is a reputable name that is dedicated to providing the best care at the time of need.
With our health insurance plan, you will get umpteen benefits such as pre and post-hospitalisation coverage, ambulance cover, etc.
Moreover, a key benefit we offer our policyholders is cashless claims benefits at any applicable network or non-network hospital* across India.
How Cashless Mediclaim Claims Work in TATA AIG's Network Hospitals
Understanding how cashless health insurance claims work in network hospitals is essential when initiating a cashless claim process with Tata AIG.
Step 1: Look for the Tata AIG network hospitals in your area. In case of emergency, inform us within 24 hours. Further, if the treatment is planned, inform us 3 days before hospitalisation.
Step 2: Remember to carry the essential documents, such as the issued Tata AIG health insurance policy, insurance card, etc., while visiting network hospitals. Further, a valid ID proof will be necessary while filling cashless insurance claims at hospitals.
Step 3: Fill out the other necessary pre-procedural forms and submit them to the hospitals.
Step 4: A request should be raised by visiting the Tata AIG official portal to expedite the procedure.
Step 5: After reviewing the application, Tata AIG releases an authorisation letter that will be sent to network hospitals directly. The amount will be settled directly with the hospitals; you don't have to worry about anything.
Note: Here, the cashless settlement would be at ease as our 10,000+ network hospitals are aligned with TATA AIG's requirements.
Now Get Cashless Mediclaim From Non-Network Hospitals
Your well-being matters no matter where you are. That's why we've introduced cashless healthcare convenience, not only in our network but also in non-network hospitals across the nation. Choose the freedom of cashless transactions and alleviate stress during emergency situations.
Terms and Conditions
For Planned Admission, the Company should receive the Intimation about the Planned Admission at least 48 hours prior to the proposed date of admission.
For Emergency Admission, the Company should receive the Request for Cashless Facility in the Prescribed Form at least within 48 hours after the time of admission.
The Hospital where the treatment is to be taken should meet the requirements of the Policy and the Company's internal guidelines.
Cashless Facility would be available only if the treatment is found admissible under the terms of the Policy.
The Request for Cashless Facility should be completed and signed by the Insured Person and the Hospital and submitted with all the requisite documents, including a copy of the Insured Person's Identification.
The Request for a Cashless Facility needs to be shared with TATA AIG via email.
Hospitals which are not in the Company's Network should provide a Letter of Consent to extend the Cashless Facility.
The Company reserves the right to reject the request for a Cashless Facility. If the Cashless Facility is denied, the Customer may submit the papers on completion of treatment, and admissibility of the claim would be subject to the terms of the Policy.
Documents Required for Cashless Hospitalisation
Below are the documents needed for availing the cashless hospitalisation.
Health insurance policy document.
Identity proof such as driving licence, Aadhar card, etc.
Address proof such as ration card, etc.
Medical documents such as prescription forms, admission forms, etc.
Cashless health insurance document if provided.
Any additional document needed by authorities.
Reasons For Rejection Of Cashless Health Insurance
Taking advantage of cashless hospitalisation is beneficial, but knowing the intricacies of the claim so it will be accepted is also essential. Some of the prominent reasons for cashless claim requests get rejected are:
If you have not informed the insurance provider about the hospitalisation within the decided timeframe.
If you have availed of the treatment in a hospital that does not meet the requirements of the policy guidelines.
If the treatment is not permissible under the policy terms.
If you failed to provide the correct information about a pre-existing disease at the time of authorisation.
Further, the personal information provided is incorrect or wrong at the time of pre-authorising for a cashless claim.
Moreover, if the treatment is outside the policy coverage offered to policyholders.
There are specific exclusions listed under cashless health insurance that the insurance company won't cover.
If the sum insured limit of the health insurance policy is exhausted.
Cashless health insurance is a value-added benefit for the policyholder. With this benefit in hand, individuals can avail of medical services in any preferred hospital, network or non-network hospital* without worrying about medical expenses.
Not only this, but it also reduces the worry of loaning money from relatives and friends during medical emergencies. Therefore, Go Cashless Everywhere while ensuring quality and timely treatment for all your medical needs with the cashless claim benefit!
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Disclaimer / TnC
Your policy is subjected to terms and conditions & inclusions and exclusions mentioned in your policy wording. Please go through the documents carefully.
What is a cashless process in insurance?
What is a cashless process in insurance?
It is the process that saves policyholders from out-of-pocket expenses during medical emergencies.
Is OPD treatment part of cashless health insurance?
Yes, OPD expenses are usually covered under a health insurance policy. However, checking the policy terms and conditions for inclusions and exclusions is best.
What is a network hospital?
A network hospital is a healthcare facility with a tie-up with the insurance company. In case of any medical emergency, policyholders can visit the network hospital and take benefit of the cashless hadith insurance claim. Tata AIG has a vast network of 7400+ hospitals all across the nation.