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  • Cashless Health Insurance

    Overview

    To understand cashless health insurance an understanding of health insurance in general is necessary. Health insurance is an instrument that can be used to ensure that, in case of a medical emergency, policyholders are able to provide their families with the best medical help possible. There are times when this medical help might be too expensive for some people and that is where a health insurance policy steps in to help pay the bills. The cashless mediclaim policy is a type of insurance where policyholders can be hospitalised, get the relevant treatment and be discharged without having to pay anything from their pockets.

    Key Features

    The features of any cashless policy will depend on the insurer who provides the insurance but some of the most common features are:

    • Pre & Post Hospitalization Medical Expenses
    • In-patient Care
    • No-claim bonus
    • Complementary health check up
    • Daily cash benefits
    • Cover for ambulance charges
    • Cover for domiciliary treatment
    • Cover for critical illnesses like cancer, heart attack, stroke, etc.
    • Tax benefits
    • Free-look periods

    Understanding Cashless Hospitalization

    Q. What is cashless hospitalisation?

    A. What is meant by cashless hospitalisation is that when you get admitted in the hospital for treatment, for an illness covered by your health insurance policy, you don’t have to pay for the treatment from your own pocket.

    Q. How does cashless hospitalisation work?

    A. Health insurance providers enter into agreements with various hospitals which state that patients holding cashless mediclaim policies won’t have to pay the hospital for treatment. The charges will be paid directly to the hospital by the insurer.

    Q. Is there anything that the policy will not pay for?

    A. These policies generally cover only the expense of the treatment. This could include cost of medicines, medical procedures, fee for anaesthesiologist and surgeons, ambulances, rooms, etc. They will not cover expenses that are non-medical in nature. Most insurers provide lists of items that the policy won’t pay for and should be consulted by policyholder. The list could include items like tissue paper, air conditioning, television, etc.

    Q. Why is it important to take cashless health insurance?

    A. If you were to need hospitalisation for something and did not have enough money to pay for the treatment, or even a part of the treatment, your options for proper medical care would be severely limited. With cashless health insurance you can be assured of the best possible treatment even if you don’t have the money to pay for it.

    Q. Is it different from other policies like family floater, individual, etc.?

    A. No, a cashless policy is essentially the same as an individual policy or a family floater policy. It will even provide the same benefits as them and have the same exclusions. The best way to describe it would be to say that the cashless part of a health insurance policy is actually a benefit or a feature rather than a type of policy.

    Q. How is it different from co-pay?

    A. In co-pay policies, policyholders and insurance providers share the hospital expenses. A certain percentage of the medical bills are paid by the policyholder while the remainder, the lion’s share, is paid by the insurance company.

    Q. How is it different from reimbursement?

    A. If you go for treatment to a hospital that is not a part of the network hospitals, you need to make the payments from your pocket and then submit the bills to get a reimbursement from the insurer. In a cashless policy, the payment is made directly by the insurance company if treatment is done in a network hospital.

    Q. What is the tenure of the cashless health insurance policy?

    A. Cashless health insurance policies, like most health insurance products, come with a standard tenure of 1 year. They need to be renewed every year. Some insurers, however, do offer tenures of 2 years at a time.

    Q. How long can I renew the policy for?

    A. Most cashless mediclaim policies can be renewed throughout the lifetime of the policyholders.

    Q. What if I fail to renew the policy in time?

    A. In case you fail to make the payment for the policy by the due date, you will be given a grace period of 15 days. However, it must be noted that in most cases, insurance policies are not active during the grace period.

    Q. Is this type of a policy transferable?

    A. Yes, these health insurance policies can be transferred from one insurer to another.More on health insurance portability

    Q. Do these policies cover pre-existing illnesses?

    A. Yes some insurers may offer cashless policies for pre-existing conditions however, this facility may be subject to conditions set forth by the insurer.

    Advantages of Cashless Health Insurance

    Cashless health insurance policies offer policyholders a wealth of benefits like:

    • With this policy in effect, policyholders don’t have to have ready cash to cover medical expenses.
    • Some cashless health insurance policies will be valid outside India as well. This is more of a feature and will depend on the insurer.
    • It will provide for tax benefits under section 80D of the Income Tax Act 1961. The limits defined are Rs. 20,000 per year for senior citizens and Rs. 15,000 for all others.
    • Some of the insurers will also provide policyholders free medical check-ups at regular intervals.

    Who should buy Cashless Medical Insurance?

    Just the convenience of cashless insurance is enough to convince anyone of buying this policy but those that could benefit the most from these policies are self-employed individuals where there is no regular income coming in. For such people a cashless policy could make a lot of difference in case of an emergency. The same can be said for individuals who cannot afford the cost of expensive medical treatments. A cashless policy could also be of great help if the person plans on traveling abroad as some companies offer health insurance cover outside India too.

    Exclusions

    While health insurance plans do offer to cover most of the medical emergencies and conditions, the cover is subject to exclusions. These exclusion are of two types, temporary and permanent. Temporary exclusions are expenses that the policy won’t cover for a period defined by the insurers while permanent exclusions are expenses that the policy will never cover. These things could be:

    • Pre-existing illnesses
    • Congenital disease
    • HIV/AIDS
    • Non-medical expenses
    • Injuries or ailments acquired in the course of conducting illegal activities
    • Routine medical exams
    • Dental procedures
    • Joint replacements unless it is necessitated by an accident
    • Experimental treatments
    • Injuries or medical conditions caused by terrorist acts or wars

    An Example

    Consider 2 people, Divya and Parul. Each of them is married and covered by a substantial health insurance plan. The cover provided by their health insurance plans too is the same, and covers the same medical treatments. The only difference is that Divya has a co-pay family floater plan and Parul has a cashless family floater plan. It so happens that they need to be hospitalised for the same illness. Each one of them gets admitted and receives the same medical treatment, which costs the same at both hospitals, but when the time comes to be discharged Divya’s bill is considerably higher than Parul’s. How could this be?

    The difference in the bills cropped up because Divya’s co-pay policy only paid part of the medical expenses. The remainder was to be paid by her along with the bill for the sundry expenses which means that Divya now has to dip into her savings to pay the bills. On the other hand Parul’s cashless policy paid for the entire treatment and all she had to pay for was sundries that were not covered by the policy.

    This is but one example where a cashless policy makes the most sense.

    Top Health Insurance Policies with Cashless Hospitalization:

    1. Max Bupa Health Insurance:
    2. Health Companion:

      • It is a comprehensive family floater health insurance plan
      • Offers cover for hospitalisation, hospital accommodation, pre and post hospitalisation medical expenses and day care treatments
      • Offers cashless facility at your nearest network hospital
      • Direct claim settlement
      • Offers tax benefits

      Heartbeat:

      • Designed especially for the Indian joint family
      • Offers cover for up to 14 relationships with individual and floater sum assured
      • Cashless approval within 4 hours
      • Assured policy renewal for life
      • Offers a wide range of hospital cover including maternity facility, newborn care, vaccination cover and much more
    3. Apollo Munich Health Insurance:
    4. Optima Restore:

      • Offers a wide range of cover
      • Offers restore benefit
      • Offers everyday cash for shared accommodation
      • Comes with tax benefits under section 80C of the Income Tax Act
      • Multiplier benefit

      Easy Health:

      • Offers a comprehensive cover
      • Offers cover on individual sum basis with an add on optional cover for critical illness
      • Offers daily cash for shared accommodation
      • Provides recovery benefit
      • Offers cashless service for planned admission

      Optima Cash:

      • Optima Cash by Apollo Munich is a top up health insurance plan
      • Offers a vast cover including day care, convalescence benefit and parent’s hospitalisation and much more
      • Sum insured enhancement
      • Offers cashless service facility to ensure the policyholder doesn’t have to worry for cash at the time of a medical emergency

      Optima Vital:

      • It is a unique critical illness health insurance policy
      • Offers cover for critical illnesses and other conditions
      • Offers sum insured enhancement
      • Offers portability
      • Provides cashless service

      Optima Super:

      • It is a top up health insurance plan
      • Offers waiver of deductible benefit on the plan
      • Cashless service with pre authorization
      • Offers portability
      • Offers tax benefits
      • Offers value added service like health risk assessment
    5. Reliance Health Insurance:
    6. Health Gain:

      • It is a general health insurance policy offered by Reliance
      • Provides different plans including family floater plan and individual plan
      • Cashless hospitalisation in over 4000 plus network hospitals
      • Lifelong renewal of the health insurance policy
      • Quick and hassle free claim settlements

      Health Wise:

      • Health insurance policy with a comprehensive cover
      • Provides cashless hospitalisation
      • Reinstatement of base sum insured
      • Offers a variety of options to choose from
      • Easy medical claim settlements
    7. ICICI Lombard Health Insurance:
    8. Health Care Plus:

      • Individual health insurance cover for each member of the family
      • Flexible sum insured
      • Flexible deductibles
      • Offers cashless facility
      • Long term cover
    9. Religare Health Insurance:
    10. Care:

      • Health insurance policy with comprehensive coverage
      • Speedy claim settlement
      • Cashless treatment at 4600+ hospitals & Daily allowance
      • Auto recharge of policy sum insured if it has exhausted
      • Lifetime renewability

      Joy:

      • Offers a wide cover including new born cover
      • A combination of hospitalization and maternity insurance
      • 100% increase of sum insured with no claim bonanza
      • Cashless treatment at 4600+ hospitals
      • Waiting period of 24 hours for maternity claims

      Enhance:

      • It is a top up health insurance policy
      • Cashless treatment available
      • No paperwork required
      • Lifetime renewability
      • Health check-ups for insured members every year
    11. New India Assurance Health Insurance:
    12. Floater Mediclaim Policy

      • It is a health insurance policy offering a wide cover
      • Offers cashless benefit
      • Offers critical care benefit
      • Hassle free claim process

      Asha Kiran Policy

      • Offers health insurance cover for the family
      • Offers cashless benefit
      • Critical illness benefit
      • Hospitalisation necessary to get a claim

      Senior Citizen Mediclaim Policy

      • Health Insurance policy designed especially for senior citizens
      • Pre acceptance health check up
      • Offers a wide health insurance cover
      • Provides cashless hospitalisation
      • Hassle free claim process
    13. Future Generali Health Insurance:
    14. Health Suraksha- Individual

      • It is an individual health insurance policy
      • Pre acceptance medical tests up to 40 years
      • Offers additional accidental hospitalisation
      • Provides cashless hospitalisation
      • 30 days renewal policy

      Health Suraksha- Family floater

      • It is a family floater health insurance policy
      • Offers portability
      • Free health check up
      • Offers cover for a wide range of medical conditions
      • Quality health insurance at a low premium

      Future Criticare

      • It is a critical illness health insurance cover
      • The policy will pay a lump sum benefit on the diagnosis of specified critical illness
      • Offers cashless service at network hospitals
      • Offers tax benefits under section 80C of Income Tax Act
      • Hassle free and easy claim process

    Why Buy Online

    With the busy schedule that most people maintain, these days, it is very difficult to sit and talk to an insurance agent, just to understand which health insurance policy is the best. With BankBazaar.com not only is this process simplified but it also offers much more flexibility. Instead of sitting with someone and talking about various plans, all you have to do is enter your basic information and we will provide you with a choice of plans, from different insurers, which suit you the most. You can even apply for these plans using the BankBazaar website.

    News About Cashless Health Insurance

    • Rajasthan Government to launch a new Cashless Health Insurance scheme

      The Government of Rajasthan today declared its plan to launch a cashless health insurance plan. The plan is designed to include more than 1 crore people starting from 13th December. To execute this plan of launching a new cashless health insurance scheme, the Rajasthan Government has signed a Memorandum of Understanding with the New India Insurance Company.

      The government has so far covered 67% of its people by creating health cards. Consumers having Bhamashah Yojna Card will also be able to enjoy the benefits of this new health insurance scheme. The e-health cards would be made ready by December 13th, 2015. As per this new scheme, a person would be able to enjoy the benefits provided under this scheme in 1700 select hospitals. The scheme would provide coverage up to Rs. 3 lakhs which is subject to pre and post hospitalization.

      25th November 2015

    • App from Remedinet Technologies for Cashless Settlement of Health Insurance Claims

      Remedinet Technologies launched two mobile apps that provide the status of cashless health insurance claims to patients and hospitals. The apps were launched on Windows 8.1, Android platforms and Microsoft Visual studio. Hospitals can download the Remedinet Hospital mobile app to access information regarding claims while the customers can download the Remedinet Consumer app to check the status of their claims. For the consumers, the application will act as a boon since it is easy to navigate and information can be accessed just by entering details such as name of the patient or reference number of the claim.

      13th May 2015

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