Things to Consider About Cashless Network Hospitals in India
Introduction
The sky-scaling expense of treatment and incomprehensive hospital bills never fail to raise an eyebrow. More than anything, people are worried about being able to afford the healthcare of their near and dear ones. The more the list of life-threatening diseases keeps on piling, greater is the cost of the treatment required. In situations like this, cashless health insurance has emerged as the last ray of hope for innumerable families all across the country. A cashless mediclaim policy is supported by a network of hospitals. If any policyholder seeks medical help from the list of hospitals mentioned in the policy, the treatment will be directly funded by the insuring company. Hence, the policy owner shall have to pay nothing at the time of treatment. Since the process does not involve any transaction of cash, it has been rightly termed as cashless health policy. However, the bill will be covered only up to the amount submitted by the policy bearer as per the policy. Cashless mediclaim is exceptionally helpful during stressful times or emergency situations when arranging money urgently becomes extremely difficult. A cashless mediclaim policy is generally termed costlier for people availing them at an older age, especially above 40.
When do you have to Pay the Amount to the Insurer?
The expense of the treatment or the hospital bills is completely covered from the assured sum of the policy availed. After getting discharged, the patient should submit the prescriptions, test reports, surgical reports (if any), bills of medicines, residential bills and everything that is related to the treatment of the patient for reimbursement purposes. Besides, the amount required for additional medical facilities or medicines is transferred by the insurer to the patient's account post-verification. The expense of the hospital is, however, directly covered by the insurer. The terms and conditions for every cashless mediclaim policy is different and should be understood thoroughly by the policy owner.
Benefits of Cashless Mediclaim Insurance
- Cashless health insurance plans provide much-needed relaxation in terms of financial stress in case of hospital emergencies. The policy owner can successfully receive treatment without worrying about the bills. Even if it is a minor injury, the bills are directly settled between the cashless hospital and the insurer.
- The treatments can be availed at any place in India. Anyone can fall sick away from home or meet with an unfortunate accident which might require immediate medical attention. In such cases, the individual can seek treatment from any of the cashless hospitals or nursing homes listed on the policy without having to pay them immediately.
- A number of policy insuring companies do not require the owners to produce papers of discharge or hospital expenses during the course of treatment. This is usually required in case of reimbursement.
Limitations and Demerits of Cashless Medical Insurance
- Cashless hospitals do not approve any cost of the treatment involved in self-harming suicidal attempts.
- The benefits will not be provided by the hospital in criminal cases that require police involvement. This also includes wounds due to various kinds of weapons.
- The cashless mediclaim policy cannot be claimed in case of any injury during wars or nuclear radiation.
- Supply of spectacles, tooth braces, or any kind of other supplies shall not be funded by the insuring company.
- If not mentioned in the cashless mediclaim policy, no hospital shall approve treatment for mental disability, AIDS, etc.
Requirements to Avail Treatment at Cashless Hospital
Treatment in a cashless hospital is absolutely hassle-free due to the prior settlements with your policy insurer. The patient or the policy owner needs to visit the hospital by themselves or in an ambulance (if need be), and produce the listed ID proof, policy paper or medical card concerned at the insurer’s TPA desk. The TPA will then process the documents and intimate the insurer of the cashless claim. Once the insurer initiates the claim processing, the hospital might verify the authenticity of the document within a few minutes and commence the treatment as soon as the patient gets admitted.
Conclusion
Cashless health insurance is one of the most favoured policies opted by people. Such a policy allows the policyholder to claim all the necessary benefits, from the concerned hospitals or nursing homes, without stressing their nerves for financial turbulence during emergency situations. However, certain rules of the policies might be particularly different from company to company. Hence, the individuals looking for a cashless Mediclaim are highly advised to thoroughly search the internet for the various policies available and the benefits offered by them, and only choose the one that suits the best.