You hop into an Uber on your way to the office. Forgotten to carry cash? Your online wallet will cover the cost of the commute. No need for any cash to change hands.
How people make day-to-day payments is changing as the world goes digital. But cashless payments are nothing new in the world of health insurance. A cashless health insurance policy fetches you the hospital care you need without your having to pay anything from your pocket. It works like this: You buy the cashless policy and pay the monthly or yearly premiums. Then, at the time of hospitalisation, the insurer directly pays all the medical expenses. You can receive treatment without having any financial worries.
In a cashless policy, the insurer ties up with various hospitals and forms a network. To benefit from cashless hospitalisation, you have to visit one of those network hospitals. If you cannot get into a network hospital for some reason, you can get the hospital bills reimbursed.
Types of Cashless Health Policy
Cashless Individual Health Insurance
Any person above the age of 18 years can get an individual health insurance in his/her name. The insured person is the sole recipient of all the cashless hospitalisation benefits.
Cashless Family Health Insurance
A family health plan typically covers the spouses and their children. The person who buys the insurance is the owner of the policy. The family members are the policy members. Some insurance companies allow the owner to include his/her parents or even in-laws in the family plan. Of course, in such cases, the premium is higher.
Cashless Health Insurance for Senior Citizens
Health insurance is of great importance in old age. Senior citizens largely depend on pension or interest on savings. Any medical emergency can make a dent in their lifestyle. A good cashless medical policy is of extreme help for this category of people. The government has formulated rules, which allow people between 60 and 80 years to get suitable insurance.
How to claim cashless insurance
For planned hospitalisation, you get the time to select a suitable hospital from your insurer’s network. You need to inform the insurance company about the need for hospitalisation three to four days in advance. Fill in the required forms at the hospital insurance desk and you will be ready for admission.
If you need sudden hospitalisation, you have to inform the insurance company within 24 hours. You can do this, too, at the hospital insurance desk. The usual waiting period for approval is about six hours.
What these policies do not cover: Even a cashless policy does not cover certain expenses. These items include extra-medical or luxury items like:
- Ambulance charges
- Oxygen masks
- Service charge
- Documentation charges
The hospitals may take a security deposit at the time of admission to cover these exempted expenses.
How cashless health insurance is different from reimbursement insurance:
|Limited choice of hospitals: The cashless facility is available only in the insurer’s network hospitals. This curtails your choice.||Wider choice of hospitals: You are free to go to any hospital you wish to.|
|No extra financial burden on family: At the time of hospitalisation, the insurance company foots all the medical bills. The family does not have to worry about arranging money for treatment.||Financial burden till reimbursed: You have to clear all hospital bills from your pocket. Your money is locked until you make the claim and the insurer reimburses you.|
|No need to maintain medical bills: The hospitals send the bills directly to the insurance company. The company verifies the bills and makes the payments. You do not need to keep track of all the bills.||Record expenses in detail: You have to keep all the bills, reports, prescriptions and the discharge summary. You need to then fill in the forms and submit the papers to the company. The insurer will then verify the bills and process the claim.|
|Chance of higher premiums in future: The insurance company may increase the premium in future to cover its losses after a hospitalisation.||There may be no change in premium: If you get treated at inexpensive hospitals, the insurer may not increase the premium.|
Cashless health insurance policies have both positives and negatives. But, the positives are way stronger than the negatives. At the time of hospitalisation, a person is already stressed. The finances for treatment should not add to the stress levels. This clinches the deal for the cashless facility. Also, money does not get locked like it does in a reimbursement claim. This gives you the freedom to carry on with life after hospitalisation. Cashless health insurance is surely the better option to go for.