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Emergencies can come anytime unannounced. The same holds true for medical emergencies as well. Such times can be quite demanding, both in terms of time as well as money. There may arise an immediate need for money to be spent on hospitalization or urgent treatment for the patient. Such situations can create quite a panic if not prepared for in advance. This is why health insurance presents an extremely beneficial feature for the convenience of policyholders. It is known as cashless mediclaim.
Here we’ll talk all about a cashless mediclaim policy, how it works, what it covers and excludes, and also share the top insurance companies offering the cashless mediclaim feature. So let’s begin.
As the name suggests, a cashless health insurance allows the policyholder to avail the benefit of hospitalization without paying immediate cash during a medical emergency. In other words, when an urgent need arises for a treatment at hospital, the policyholder can get hospitalized without having to pay for it immediately, with the benefit of a cashless mediclaim policy.
Also Read: What is Health Insurance with OPD Cover?
We learned what is cashless insurance in the section above. Now let us quickly understand the different types of cashless mediclaim policies that exist in India:
Read More: 8 Best Health Insurance for Cancer Patients
Now that we know what cashless treatment is, let us look at some of its key features:
A cashless mediclaim plan can be used to seek coverage for both:
A cashless claim process can be followed in both of the above cases to file a claim for cost coverage on the expenses incurred. The insurance company has a collaboration with a wide network of hospitals and the policyholder can choose to get treatment done at any of those hospitals on the cashless treatment facility. In case of emergency hospitalization too, the patient can be taken to any of the network hospitals and get admitted without having to pay anything from their pocket.
Read More: Online Mediclaim Policy Premium Calculator
There are certain features that are not included in cashless treatment health insurance. Let us look at some of them:
So a cashless mediclaim plan does sound appealing but there are some pointers to keep note of before investing in one. Here are some of them:
With so many benefits to enjoy under cashless insurance, it’s only wise to invest in one. If you’re keen on doing so, here are at least 5 insurance companies that offer some of the best cashless treatment health insurance plans in India:
|Name of the Plan||Eligible Age||Sum Insured||Coverage Provided||Waiting Period|
|Care Health Plan||5-18 years||Rs. 3 lakh – Rs. 6 crore||Pre and Post Hospitalization Expenses||Pre-existing diseases covered after 4 years of the date of commencement of the policy|
|Bajaj Allianz Health Insurance Family Floater||18-65 years||Rs. 1.5-50 lakh||Pre and Post Hospitalization Expenses||Pre-existing diseases covered after 2 years|
|Apollo Munich Optima Restore Health Insurance||5-65 years||Minimum Rs. 3 lakh||Pre and Post Hospitalization Expenses||Pre-existing diseases covered after 3 years|
|Niva Bupa Health Insurance||18-65 years||Rs. 5 lakh||Pre and Post Hospitalization Expenses||Pre-existing diseases covered after 2 years|
|ICICI Lombard Health Care Plus||5-65 years||Up to Rs. 20 lakh||Pre and Post Hospitalization Expenses||Pre-existing diseases covered after 4 years|
Cashless mediclaim policy has a number of benefits for the policyholder, the most important being cashless hospitalization during medical emergencies. For more information on cashless mediclaim or various other health insurance plans in India, visit PayBima.
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What is the procedure for cashless mediclaim? To file a claim with the insurer under the cashless mediclaim plan, follow the steps as below: Within 24 hours of hospital admission, call your insurance company or third-party administrator (TPA). Is cashless claim good? A cashless claim is generally better than a reimbursement claim because it is far more convenient than the latter. The patient can be immediately hospitalized without having to pay a penny from their pocket. What happens if cashless claim is rejected? In case your claim gets rejected by the insurer, introspect and determine any errors that may be present in your claim form submitted to the insurance company. If determined, fix those errors and resubmit the form. You can also take the help of a Third-Party Administrator representative who would help you with the submission of accurate form and relevant documents.
FAQs on Cashless Mediclaim Policy, Their Types, Key Features, Inclusions and Exclusions
The insurer will issue you a claim intimation/reference number for your filed claim.
Make sure that the hospital authorities fill out and submit the cashless claim form to the insurance company.
What is the procedure for cashless mediclaim?
To file a claim with the insurer under the cashless mediclaim plan, follow the steps as below:
Within 24 hours of hospital admission, call your insurance company or third-party administrator (TPA).
Is cashless claim good?
A cashless claim is generally better than a reimbursement claim because it is far more convenient than the latter. The patient can be immediately hospitalized without having to pay a penny from their pocket.
What happens if cashless claim is rejected?
In case your claim gets rejected by the insurer, introspect and determine any errors that may be present in your claim form submitted to the insurance company. If determined, fix those errors and resubmit the form. You can also take the help of a Third-Party Administrator representative who would help you with the submission of accurate form and relevant documents.
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
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