Cashless Health Insurance: Top 10 Cashless Health Insurance Policy in India

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19 min read

Updated on Jan 22, 2024

We all know how important health insurance is to protect us against the odds of life in the form of health emergencies and unforeseen situations. With an all-inclusive and cashless health insurance plan, you can stay protected from such unpredictable expenses.

In this post, we are guiding you with the best cashless health insurance policy in India for your best health coverage.

10 Best Cashless Health Insurance Plans 2024

Plan Name Entry age  Sum assured  Waiting period  Min. Premium
Bajaj Allianz Health Guard Family Cover 18 – 65 years INR 5 – 50 lakh 30 days (initial waiting period)

3 years (for Pre-existing diseases or PEDs)

INR 6,962 per year
Care Health Insurance Care Plan 91 days – 18 years Up to INR 75 lakh 30 days (initial waiting period)

2 -4 years (for PEDs)

Varies
HDFC ERGO Optima Restore Health Insurance Plan 18 – 65 years INR 3 – 50 lakhs 30 days (initial waiting period)

2 – 3 years (for PEDs)

Varies
Max Bupa Health Insurance Plan 18 – 65 years Up to INR 12.5 lakh 30 days (initial waiting period)

2 – 4 years (for PEDs)

Varies
ICICI Lombard Health Care Plus 5 – 18 years Up to INR 50 lakhs 30 days (initial waiting period)

 

2 years (for PEDs)

Varies as per the plan
Apollo Munich Optima Restore Health Insurance 5 – 65 years INR 5 to 50 lakh 30 days (for accidental hospitalization)

 

2 to 3 years (for PEDs)

INR 24 per day
Navi Health Insurance 91 days – 70 years Up to INR 1 crore Up to 1 year (with terms and conditions) INR 235 per month
Aditya Birla Cashless Health Insurance Policies Varies according to plan Starts at INR 5 lakh 30 days (initial waiting period) INR 2,486 per year
New India Assurance Cashless Health Insurance Policies Depends on plan Depends on plan Depends on plan Depends on plan
Reliance Cashless Health Insurance Policies 5 – 65 years Starts at INR 3 lakh (depends on plan) 30 days (initial waiting period)

 

2 to 3 years (for PEDs)

INR 243 per month

The Process How Cashless Health Insurance Plans Function 

Most policyholders who are insured under a health insurance policy want to avail cashless facility for hospitalization. A Cashless health insurance plan is one where the insurance company directly settles the hospitalization expenses of the insured. Under this policy, the insured is not required to make any payment from their pocket. However, to avail of the cashless facility, the policyholder is required to undergo treatment at a network/empaneled hospital of the insurer.

The best health Insurance company in India will have a wide list of hospitals under their network to offer cashless facilities to policyholders. If a policyholder goes through hospitalization in any of the network hospitals of the insurance provider, they can avail of the cashless treatment facility.

Here is the process that follows:

  • The insured is required to get admitted to an empaneled hospital of the insurance company
  • The policyholder needs to inform the third-party administrator (TPA) of the insurance company soon about the hospitalization
  • The hospital then gets in touch with the TPA of the insurer to receive pre-authorization to start the treatment
  • Once the approval from the TPA or the insurer is received, the treatment starts.  Depending on the terms and conditions of the insurance company, the policyholder can receive the treatment without paying anything out of pocket.
  • Once the treatment is complete, the insurer pays the bills to the hospital directly. However, the insured may be required to make the payment for the co-pay charges or non-medical charges.

Insurance companies incorporate more empaneled hospitals into their network nationwide to make the list comprehensive. For the policyholder, it is always better to have as many network hospitals as possible to avail of the cashless treatment at the best hospital of their choice.

Read on to know the 10 best cashless health insurance in India from top insurers.

1. Bajaj Allianz Health Guard Family Cover by Bajaj Allianz Health Insurance

When you think of the best cashless medical insurance the first name that comes to mind is Bajaj Allianz Health Guard Family Cover. The plan offers you a sum assured between INR 5 lakhs to INR 50 lakhs. It provides a pre-hospitalization coverage of up to 60 days and a post-hospitalization coverage of up to 90 days. The plan allows you to avail of cashless treatment facilities at over 8000 impaneled hospitals across the country. It also provides coverage for expenses such as:

It also provides coverage for expenses incurred in areas such as the following:

  • Ambulance facility
  • Daycare treatments
  • In-patient hospitalization
  • Advanced treatments
  • Donor transplantation, etc.

The plan comes with a lifelong renewal option as well as the option of co-payment. All these reasons make this policy one of the top 10 health insurance in India. The minimum age of entry in this policy is 18 years and the maximum age is 65 years. The normal waiting period under the policy is 30 days, while the waiting period for pre-existing illnesses is up to three years.

Also Read: Top 10 claim settlement ratio health insurance companies in india

2. Care Plan by Care Health Insurance

The Care Health Insurance Care Plan is also regarded as one of the best cashless health insurance policies available in India. With this policy you will be able to arrange for more-than-adequate healthcare coverage within your financial capability. The maximum sum assured in this policy is INR 75 lakh. If you choose a sum assured of INR 50 lakh, 60 lakh, and 75 lakh in this policy you would also get maternity coverage to the tune of one lakh rupees. This is an inherent part of the policy.

In this policy, if you claim an amount that is higher than the sum assured, the insurer will automatically recharge the amount. If you go five years straight without making any claim on the policy, your sum assured could increase by as much as 150%. This is one particular reason why so many people consider it to be the best cashless mediclaim policy for families in India.

By choosing the floater plan under this policy you can cover your family members. This policy has over 22,900 hospitals in its cashless network!

Also Read: IRDA claim settlement ratio health insurance

3. HDFC ERGO Optima Restore Health Insurance Plan

Which health insurance is best in India?

If you are looking for an answer to the question you can always consider the HDFC (Housing Development Finance Corporation Limited) ERGO Optima Restore Health Insurance Plan to be a viable option in this context. It is a highly appreciated plan among the cashless health insurance policies that are available in India. The plan is available in a couple of variants – Optima Restore family and Optima Restore individual. The plan would restore your sum insured even in the case when you utilize it fully.

So, this is immensely helpful in fulfilling your future needs. Hence, it is regarded as the best cashless medical insurance in India.

When you renew the plan, you remain eligible for health checkups till a maximum amount of INR 5000. For every claim free year under this policy, your sum assured increases by 50%. It also has more than 12,000 hospitals in its cashless network. The plan also provides you with a daily allowance of INR 800 to INR 6000 during hospitalization.

So, this is immensely helpful in fulfilling the needs you may have in this regard in the future. When you renew the plan you remain eligible for health checkups till a maximum amount of 5000 rupees. For every year that you do not make a claim on this policy your sum assured increases by 50%. It also has 10,000 and more hospitals in its cashless network! It provides you with a daily allowance of between 800 rupees and 6000 rupees during hospitalization.

4. Niva Bupa Health Insurance Plan 

If you are looking for an effective option this is one policy that you cannot rule out. The policy offers you the facility of availing cashless treatment in 9100 hospitals. It is a cost-efficient policy that allows coverage for the following:

It is a cost-efficient policy as well where you get coverage for the following:

  • Pre- and post-hospitalization expenses
  • Room rent
  • Domiciliary treatment
  • Advanced methods of treatment
  • In-patient hospitalization

The policy is also available with refill and renewal benefits. No wonder it is regarded by many as the best cashless health insurance policy in the country. In this policy, you get four options in terms of the sum assured amount – INR 5 lakh, 10 lakh, 7.5 lakh, and 12.5 lakh.

It has a term period of a year. If you go for a two-year term period you would get a discount of 12.5% on the premium for the second year. The maximum age of entry in this policy is 65 years and the minimum age is 18 years.

Also Read: List of Diseases Covered Under Health Insurance

5. ICICI Lombard Health Care Plus  

The ICICI (Industrial Credit and Investment Corporation of India) Lombard Health Care Plus is a highly popular plan because it offers you cashless treatment within four hours. It has over 7500 hospitals in its cashless network. It is also flexible when it comes to the sum assured figure. It covers the following expenses and more:

It covers the following expenses and more:

  • Post and pre-hospitalization
  • Room rent
  • Diagnostic expenses
  • Doctor’s fees
  • Daycare treatment

Also Read: Health Insurance vs Medical Insurance

It is the features that make a policy a worthy contender for the title of the best cashless medical insurance in India. The maximum age of entry in this policy is 65 years and the minimum age is five years. You can cover a maximum of two adults under the policy. The person proposing the policy should be at least 18 years old. You can renew the policy till the age of 70 years. If the proposer is older than 56 years, they would have to undergo medical tests. The normal waiting period in the policy is 30 days. In case the insured has a pre-existing disease, it could go up to two years.

6. Navi Health Insurance

Navi cashless health insurance plans come with all-inclusive coverage and many special benefits. These plans are budget-friendly and suit individuals and families alike with a cashless mediclaim facility.

The plan claims to provide quick cashless treatment approval within 20 minutes for a sum assured ranging up to INR 1 crore. They have a network of over 11,000 empaneled hospitals where the policyholders can avail of cashless treatment. They further provide 100% coverage on hospital bills which cover the consumable expenses as well. Navi Health plans are available online with zero paperwork and are easily affordable.

Here are some features:

  • The plan approves cashless claims in a network of 11,000 hospitals in 20-minute
  • The insurer offers 100% paperless purchase and claims
  • They have unlimited consultations with doctors online
  • You can avail of a free health checkup every year
  • You are also eligible for an extra sum insured of 100% in case of accidental injuries

7. Aditya Birla Cashless Health Insurance Policies

The cashless plans of the insurer cover policyholders for cashless hospitalization at its wide-ranging 10,000+ network hospitals. They also provide further benefits such as regular health check-ups, premium waivers, cashless home treatment, NCBs, discounted premiums, and more.

Below are some features:

  • The policy offers an upfront discount for good health
  • The plan comes with a binge refill facility
  • It covers the insured for pre-and-post-hospitalization expenses for 60 and 180 days before and after treatment respectively
  • The policy also covers expenses incurred on Daycare procedures, Ayush treatment, maternity expenses, and more

8. New India Assurance Cashless Medical Insurance Plans

The New India Mediclaim policy is available for people who are within the age group of 18 to 65 years. For dependent children, the age group is within 3 months to 25 years. The policy is available with a lifelong renewability option and the investor can choose a sum insured ranging from INR 1 lakh to 15 Lakhs.

New India Assurance is a renowned and top health insurance provider in the public sector domain and it serves customers with a wide range of health insurance products. The Cashless insurance plans offered by the insurer allow policyholders to avail of treatment at network hospitals spread across the country.

Below are some features:

  • Health check-up in every 3 claim-free years
  • The policy covers newborn babies
  • It allows the cumulative bonus to policyholders of 25% Sum Insured (SI) for a claim-free year and up to 50% of the SI
  • The plan pays the medical costs of an organ transplant
  • AYUSH treatments are also covered up to 25% of the sum insured

9. Reliance Cashless Insurance Plans

Reliance Cashless Health Insurance plans are known for their widespread coverage and for covering exclusive medical expenses of the insured. They are available with numerous benefits and a wide network of cashless hospitals. Reliance has a list of over 8,600 hospitals in its network.

Reliance Health Gain Insurance is one such exclusive policy offered by the insurer which comes with amazing coverage at a cost-effective price. The policy is said to settle claims within 4 hours of cashless claim processing. It is a reliable solution that covers all healthcare needs of the insurer.

The plan covers below features:

  • It offers a 5% discount for single women or girl child
  • Allows tax deductions under section 80D
  • It comes with the option of reinstatement of the base sum insured.  Thus, if your total sum insured gets exhausted, it is reinstated under your cashless medical insurance policy
  • The policy offers coverage for immediate as well as extended family members

10. Apollo Munich (Now HDFC ERGO) Optima Restore Health Insurance

Apollo Munich Health Insurance has been taken over by HDFC Limited and changed to HDFC ERGO Health Insurance Limited. The policy offers several attractive features and is a good plan to choose for your health insurance needs. As the name suggests, the Optima Restore plan allows 100% restoration benefits. The cashless facilities of the plan can be availed at their wide network of 12,000+ hospitals in India.

Here are some features:

  • The policy comes with a lifetime renewal benefit
  • It offers 100% restoration of the sum assured
  • It also comes with a renewal benefit health check-up within 60 days of renewal
  • The customer can gain from tax benefits u/s 80D of the Income Tax Act

Reasons to Buy Cashless Health Insurance Policies Online – Key benefits

When you are young and at the peak of your health, you may not realize the need for a health insurance policy. However, as you grow in age and cross your 40s many illnesses surround you causing you mental distress and financial drain. This is when you feel the need to have a health insurance policy to cover you against medical emergencies.

Buying a health insurance plan at a young age allows many lucrative advantages to a policyholder. However, it is never too late to buy a health plan. Further, buying cashless health insurance online allows the policyholder to avail of many discounts and other benefits.

Here we are discussing some good reasons for you to understand the benefits of buying a cashless health insurance plan online: 

  • Makes comparisons easy: Online buying of health insurance policies has many benefits. One of them is that you get to compare the plans easily. By comparing you can weigh the plan in terms of its pros and cons and make an informed buying decision.
  • Varied payment modes: Online policy buying lets the policyholder buy plans easily and smoothly. Simply fill up the application form duly and choose the options of your choice. Next, submit certain documents and make the payment online using your preferred mode like UPI, Debit/Credit card, and more
  • No Need to Pay the Middlemen: When buying a policy online, there are no middlemen involved in the procedure. This saves a lot of cost for the policyholder that was earlier paid to the middlemen. Also, it reduces the liability on papers as online policies require less paperwork.
  • Transparent Process with good after-sales service: While buying a health insurance policy online from the insurer’s portal, you can go through the terms and conditions of the plan clearly to understand them and to make informed decisions. Further, policyholders can make use of other facilities like online calculators, live chat, and more.
  • Covers health emergencies while traveling: These days most people have jobs that involve a lot of traveling. When you are traveling solo for work and or for any other purpose, it becomes necessary to stay covered under cashless health insurance.

What is Included Under Cashless Health Insurance Policies?

Most comprehensive health insurance policies offer exclusive and exhaustive coverage including OPD expenses, pre- and post-hospitalization, ambulance costs, regular health check-ups, consumables, and more.  As per your policy coverage and features of the plan, you can avail of several benefits under a cashless health plan. Some of them are featured underneath:

  • Coverage against pre-existing diseases
  • Costs sustained for daycare procedures
  • Coverage against critical illnesses
  • Emergency ambulance service expenses
  • Daily cash allowance during the hospital stays of the insured
  • Free and regular health check-ups
  • Cost of treatment for organ donors
  • Pre-and post-hospitalization expenses
  • Cost of in-patient hospitalization
  • Cost of domiciliary treatment
  • No claim bonus (NCB) points

What is Excluded Under Cashless Health Insurance Policies?

When a health emergency strikes like an accident or any sudden ailment, it requires a lot of expenses for treatment. A cashless health insurance policy can save a family from going through such difficult times.

However, you must remember that health policies have many exclusions or things that are not covered under the policy. These exclusions should be taken note of if you want to avoid a situation of getting your claims rejected.

Below are some exclusions under cashless health insurance policies:

  • Expenses incurred on attendants
  • Treatment during the first 30 days of the policy from its purchased date is excluded (except accidental cases)
  • Toiletries charges
  • Expenses of congenital disease treatment
  • Registration and service fees
  • Cost of treatment due to excess consumption or misuse of alcohol or drugs
  • Costs of things like oxygen masks, diapers, syringes and more
  • Doesn’t cover self-inflicted injuries and injuries due to attempted suicide

Are there any factors that impact the premium of Cashless health insurance policies?

The premium of every health insurance plan is affected by several factors. These factors are usually common for both cashless and reimbursement plans. Some of them are underlined below:

  • Age – This is a common factor that influences any health insurance policy. The younger you are the lower the premium charged and vice versa
  • Employment – Policyholders working in hazardous environments with exposure to chemicals, radiation, and other unsafe substances are charged a higher premium as compared to people working in non-hazardous setups
  • Gender – The Premium rate of a cashless policy also varies as per the gender of the insured. Since women are believed to be more caring toward health as compared to men, they may get a plan at a lower premium than their counterparts
  • Add-on Riders – The extra coverage can be bought by an insured by paying some extra charges. Hence, if you avail of add-on covers, it will enhance your premium price
  • Body Mass Index (BMI) – People with a high BMI are more likely to develop diseases like diabetes, heart ailments, and joint problems, etc. Hence, these people might be charged a higher premium
  • Medical history of close relatives – Genes of people play a huge role in the way our body performs. It is expected that people with close family members suffering from a particular disease are more likely to develop the same. Hence, a higher premium is charged if your family members are facing any specific disease

Eligibility to Avail Cashless Health Insurance Plans

Age of entry  18-65 years (adults), 90 days to 25 years (children)
Pre-medical Screening Might be required for individuals above the age of 45
Pre-existing Disease (PED) Waiting Period 1 – 4 years

How to Raise a Claim for Cashless Health Insurance Plans?

Buying cashless health insurance helps the insured to protect savings during health emergencies. When a medical emergency strikes, it drains people of their savings, especially if they don’t have comprehensive medical coverage for themselves and their dependent family members.

Besides, it is also important that the insurance company offers a simple process for filing a claim.  With cashless health insurance, you can easily and conveniently get your claim settled at a network hospital by following the steps below:

Step 1: Go to an empaneled hospital to avail of a treatment

Step 2: Get the pre-authorization form from the help desk of the hospital. Alternatively, you can also download the form from the website of your insurer

Step 3: Duly fill out the form and submit it at the network hospital together with your valid proof of ID

Step 4: Next, the form will be verified by the TPA of your insurer. Once the form is verified and approved, the treatment gets started

Step 5: The insurer directly settles the treatment bill with the hospital on the completion of the treatment

Documents Required for the Cashless Claim Settlement Process

Below are the documents required to avail cashless claim settlement process:

  • Claim form -duly filled
  • Valid ID proof
  • Hospital reports like diagnosis reports
  • Discharge summary
  • Medical certificate
  • Copy of FIR (if required)

Tax Benefits Availed Under Cashless Health Insurance Plans in India

The below table displays the different tax benefits that can be earned on medical insurance under different situations:

Section  Maximum deductions  Deduction on 
Section 80D Up to INR 1 lakh On policy premiums
Section 80DD Up to INR 1 lakh On disabled dependents’ medical expenses
Section 80DDB Up to INR 1 lakh For specific diseases medical expenses
Section 80U Up to INR 1.25 lakh On disabled taxpayers’ medical expenses

Why to buy the Best Cashless Mediclaim Insurance Policy for Family in India? 

Health is something that no one can guarantee. You may be hale and hearty today and weak tomorrow. The harsh reality that everyone has to accept is that our health will not be the same every day.  We would require medical treatment at some point in life to cure some or the other condition of our body. But we also know how costly the medical affair has become. Even regular tests and routine check-ups can cost us a significant amount of our hard-earned money.

For people who have a family of 4-5 members, the expenses of these routine check-ups can go much beyond as compared to what our pocket can endure. Also, unlike in earlier times health conditions are not limited to the older generation anymore. Young and middle-aged people also go through critical illnesses. This is because of many factors like the unhealthy and sedentary lifestyle, the high intake of processed food, the rising pollution levels or environmental hazards, and more.

Thus, you need a medical insurance policy to cover your family well so that if unfortunately, any health emergency strikes, you can focus on getting the person cured rather than worrying about the finances. Hence, it is very important to buy the best health insurance plan for yourself and your family after comparing them online so that you can avail of a comprehensive policy.

Benefits of the Cashless Health Insurance Plans

People are of the view that health insurance plans pay for the expenses only in the event of hospitalization. However, this is not correct. In addition to covering the costs of hospitalization, your health insurance plan also covers many more costs. Some of them are mentioned below:

  • Facility of cashless treatment – So, if you are running out of cash and there is a medical emergency at home, you can rely on your health plan for cashless treatment. You need to get admitted to one of the network hospitals of the insurer to avail of this facility. Once you complete the formalities of paperwork with the concerned hospital, your insurer will clear the bill after verifying the papers and treatment reports.
  • Daily allowance Option – This is another interesting benefit of health insurance plans. With a daily allowance option, the insured can have added support in terms of expenses of medicines as well as many other related expenses. You may note that the daily allowance is in addition to the sum insured and the duration as well as the amount of the allowance might vary as per your policy terms and conditions.
  • Tax benefits – Under section 80D of Income Tax, the insured can claim up to INR 25,000 as a tax exemption for the insurance premium paid. Moreover, if you are paying insurance premiums for your parents in the senior citizen category, you can avail of an added deduction of up to INR 30,000.
  • Coverage against critical diseases – There has been a rise in critical diseases these days. Not only are these diseases life threatening but also expensive in terms of treatment.  So, for people with an average income, it might be difficult to afford such treatment.  However, if you opt for a health insurance plan with critical illness coverage, you can get a lump sum amount to start the treatment.  This critical illness insurance can be availed in the form of a health insurance rider.
  • Added benefits – Many top health insurance plans come with several added benefits such as a no-claim bonus or NCB, AYUSH treatment, top-up option, health check-ups, and more. So, check out for them as well.

Factors to Consider Before Choosing Cashless Health Insurance Plans in India 

With the rising cost of healthcare facilities and treatments, there has surge in the number of families/individuals opting for health insurance plans. Having a good and comprehensive health insurance policy is the best gift that you can offer to your dear ones or yourself.

However, there are some points of consideration when it comes to buying an affordable health insurance plan:

  • Claim Settlement Process – The process of claim settlement along with the ratio of claim settlement of the insurer is important to take note of when it comes to choosing a health insurance plan. The process of claim settlement might vary depending on the particular plan you opt for. However, you must understand it before signing up for the policy so that you can get your claims settled quickly and efficiently.
  • Coverage Amount/ Sum Insured – You must have a good look at the coverage that you can receive from your health plan. The sum insured might vary depending on various factors, which are important to know for the insured. The sum insured is also a factor that influences your monthly premium amount.  So, avail of the sum as per the estimated requirement in terms of medical care and the number of members insured under the policy.
  • Lifetime Renewal – While option for health insurance plans, always go for the ones offering lifetime renewal. If you can’t avail of a lifetime renewal for any reason, you can still go for the maximum policy renewal age.
  • Network hospitals – The more network hospitals offered by the insurer, the better it is for you to get cashless treatment in the most suitable hospital of your choice. Hence, network hospital is another aspect that you should look at while opting for health insurance policies.

It is equally important to read the policy document thoroughly and check for the inclusions and exclusions in your policy. Further, check for other things like waiting periods for pre-existing diseases, coverage flexibility, riders, top-ups, and more.

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FAQs: Best Cashless Health Insurance Plans 2024

Which health insurance company is the best in India?

HDFC ERGO Health Insurance is India's top health insurance company, with a claim settlement ratio (CSR) of 99.8 in FY22.

What is full cashless health insurance?

A cashless health insurance policy is one in which the insured's medical bills are directly settled between the insurance company and the network hospital. It offers cashless hospitalization, which means that the insured does not have to pay cash to receive treatment.

What is not included in cashless health insurance?

The cashless health insurance coverage does not cover self-inflicted injuries, injuries caused by suicide attempts and so forth. Except for accidents, any treatment or medical expenses spent within 30 days of the policy start date are excluded.

How long does it take for cashless health insurance claim?

An emergency situation cannot be predicted. As a result, the insurance company cannot be notified three days before the emergency. As a result, the time limit for emergency mediclaim policy is 24 hours after admission to a hospital.

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Feb 24, 2022
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