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All you need to know about Cashless Health Insurance Policies


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Health insurance is a broad concept which provides protection to a policyholder against medical uncertainties and the costs involved. Today, there are various health insurance products available in the market, and the extent of cover and benefits varies between products. The rising cost of in health care sector has prompted individuals to focus more on health insurance, and if reports are to believed, more than 62% Indian nationals believe that a health insurance policy has become an absolute necessity. To add this, cashless health insurance is a type of policy that helps you to deal with medical emergencies, especially when you are not able to arrange the funds at a short notice.

What is cashless health insurance policy?

A cashless health insurance policy is a type of policy where the health insurance companies in India settle your hospitalization and treatment bills directly with the hospitals without the immediate involvement of the insured. Under cashless health insurance policy, you can avail the benefit of getting medical treatment at one of the best hospitals without burning a hole in your pocket. Under the policy, the third party administrators act as a bridge between your insurance provider and hospitals. All the hospital bills are sent across to TP, who then coordinate with your insurance company to settle the claim. The whole process minimizes the need to furnish any major amount at the time of hospitalization, and also minimizes the documentation required to avail the medical services.

As per the scheme, if you choose cashless health insurance policy, the insurance company directly pays the amount of your medical treatment to the hospital. However, you have to ensure that the amount should not exceed the sum insured.

Cashless Health Insurance Policy can be further classified into two types:

  • Planned Claim: When the insured is aware about the surgery/hospitalization well in advance
  • Emergency Claim: When immediate hospitalization is required due to medical emergency or accident.

Things to keep in mind while choosing Cashless Health Insurance Policy

  • Well, the cashless service is available only in network hospitals; hence one has to check the hospitals in network of your insurance company at the time of taking cashless health insurance policies.
  • In case of planned claim, you have to inform your TPA (third party administrators) at least 24 hours before getting admitted in to hospital.
  • Make sure that you read and fully aware of what are the limits as per your policy. This awareness will enable you to decide what kind of room and facilities you can avail at the hospital and what amount will be paid by your insurer.


Benefits of Cashless Health Insurance Policy:

Well, there are several benefits associated with cashless health insurance policies, some of them are-

  • Cover against Overcharging: Under cashless claim, an individual gets access to best hospitals that are on insurer’s network, without worrying about the cost. With cashless insurance policy, a policyholder doesn’t need to fret about immediate cash in hand to cover the medical expenses.
  • Hassle Free Process- Not only it provides the ease with financial relief, it also enables smooth functioning in terms of documentation. Since all coordination is carried in between the hospital insurance desk members and insurance company through third party administrators. TP members coordinate with the hospitals to furnish every piece of details such as scan copy of bills, reports and prescription to the insurance company.
  • Secure Your Emergency Funds: From our monthly expenses, we all make some investments in the form of emergency fund to meet any exigencies. It could be in the form of Mutual Funds, Gold bonds, Fixed Deposits, etc. Since with the cashless health insurance policy, you don’t have to break them in middle at all, as the policy takes care of such emergency situation. And, you can rotate your investments further ahead to get better returns.

Hence, these were some of the major things that one needs to know about cashless health insurance policy. Hope this information has been helpful!

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