Cashless Health Insurance

To understand cashless health insurance an understanding of health insurance in general is necessary. Health insurance is an instrument that can be used to ensure that, in case of a medical emergency, policyholders are able to provide their families with the best medical help possible. 

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There are times when this medical help might be too expensive for some people and that is where a health insurance policy steps in to help pay the bills. The cashless mediclaim policy is a type of insurance where policyholders can be hospitalized, get the relevant treatment and be discharged without having to pay anything from their pockets.

Top Health Insurance Policies with Cashless Hospitalization

1. Niva Bupa Health Insurance

  1. It is a comprehensive family floater health insurance plan 
  2. Offers cover for hospitalisation, hospital accommodation, pre and post hospitalisation medical expenses and day care treatments 
  3. Offers cashless facility at your nearest network hospital 
  4. Direct claim settlement 
  5. Offers tax benefits 

2. Apollo Munich Health Insurance

  1. Offers a wide range of cover 
  2. Offers restore benefit 
  3. Offers everyday cash for shared accommodation 
  4. Comes with tax benefits under section 80C of the Income Tax Act 
  5. Multiplier benefit 

3. Reliance Health Insurance

  1. It is a general health insurance policy offered by Reliance 
  2. Provides different plans including family floater plan and individual plan 
  3. Cashless hospitalisation in over 4000 plus network hospitals 
  4. Lifelong renewal of the health insurance policy 
  5. Quick and hassle-free claim settlements 

4. ICICI Lombard Health Insurance

  1. Individual health insurance cover for each member of the family 
  2. Flexible sum insured 
  3. Flexible deductibles 
  4. Offers cashless facility 
  5. Long term cover 

5. Religare Health Insurance

  1. Health insurance policy with comprehensive coverage 
  2. Speedy claim settlement 
  3. Cashless treatment at 4600+ hospitals & Daily allowance 
  4. Auto recharge of policy sum insured if it has exhausted 
  5. Lifetime renewability 

6. New India Assurance Health Insurance

  1. It is a health insurance policy offering a wide cover 
  2. Offers cashless benefit 
  3. Offers critical care benefit 
  4. Hassle free claim process 

7. Future Generali Health Insurance

  1. It is an individual health insurance policy 
  2. Pre acceptance medical tests up to 40 years 
  3. Offers additional accidental hospitalisation 
  4. Provides cashless hospitalisation 
  5. 30 days renewal policy 

Key Features of Cashless Health Insurance

Cashless Health Insurance Benefits

The features of any cashless policy will depend on the insurer who provides the insurance but some of the most common features are:

  1. Pre & Post Hospitalization Medical Expenses
  2. In-patient Care
  3. No-claim bonus
  4. Complementary health check up
  5. Daily cash benefits
  6. Cover for ambulance charges
  7. Cover for domiciliary treatment
  8. Cover for critical illnesses like cancer, heart attack, stroke, etc.
  9. Tax benefits
  10. Free-look periods

Advantages of Cashless Medical Insurance

Cashless health insurance policies offer policyholders a wealth of benefits like:

  1. With this policy in effect, policyholders don't have to have ready cash to cover medical expenses.
  2. Some cashless health insurance policies will be valid outside India as well. This is more of a feature and will depend on the insurer.
  3. It will provide for tax benefits under section 80D of the Income Tax Act 1961. The limits defined are Rs. 20,000 per year for senior citizens and Rs. 15,000 for all others.
  4. Some of the insurers will also provide policyholders free medical check-ups at regular intervals.

What is not Covered under Cashless Health Insurance?

While health insurance plans do offer to cover most of the medical emergencies and conditions, the cover is subject to exclusions. These exclusion are of two types, temporary and permanent. Temporary exclusions are expenses that the policy won't cover for a period defined by the insurers while permanent exclusions are expenses that the policy will never cover. These things could be:

  1. Pre-existing illnesses
  2. Congenital disease
  3. HIV/AIDS
  4. Non-medical expenses
  5. Injuries or ailments acquired in the course of conducting illegal activities
  6. Routine medical exams
  7. Dental procedures
  8. Joint replacements unless it is necessitated by an accident
  9. Experimental treatments
  10. Injuries or medical conditions caused by terrorist acts or wars

Who should Buy Cashless Medical Insurance?

Just the convenience of cashless insurance is enough to convince anyone of buying this policy but those that could benefit the most from these policies are self-employed individuals where there is no regular income coming in. For such people a cashless policy could make a lot of difference in case of an emergency. The same can be said for individuals who cannot afford the cost of expensive medical treatments. A cashless policy could also be of great help if the person plans on traveling abroad as some companies offer health insurance cover outside India too.

GST rate of 18% applicable for all financial services effective July 1, 2017.

Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

FAQs on Cashless Health Insurance

  • What is cashless hospitalisation?

    What is meant by cashless hospitalisation is that when you get admitted in the hospital for treatment, for an illness covered by your health insurance policy, you don't have to pay for the treatment from your own pocket.

  • How does cashless hospitalisation work?

    Health insurance providers enter into agreements with various hospitals which state that patients holding cashless mediclaim policies won't have to pay the hospital for treatment. The charges will be paid directly to the hospital by the insurer.  

  • Is there anything that the policy will not pay for?

    These policies generally cover only the expense of the treatment. This could include cost of medicines, medical procedures, fee for anaesthesiologist and surgeons, ambulances, rooms, etc. They will not cover expenses that are non-medical in nature. Most insurers provide lists of items that the policy won't pay for and should be consulted by policyholder. The list could include items like tissue paper, air conditioning, television, etc.

  • Why is it important to take cashless health insurance?

    If you were to need hospitalisation for something and did not have enough money to pay for the treatment, or even a part of the treatment, your options for proper medical care would be severely limited. With cashless health insurance you can be assured of the best possible treatment even if you don't have the money to pay for it.

  • Is it different from other policies like family floater, individual, etc.?

    No, a cashless policy is essentially the same as an individual policy or a family floater policy. It will even provide the same benefits as them and have the same exclusions. The best way to describe it would be to say that the cashless part of a health insurance policy is actually a benefit or a feature rather than a type of policy.

  • How is it different from co-pay?

    In co-pay policies, policyholders and insurance providers share the hospital expenses. A certain percentage of the medical bills are paid by the policyholder while the remainder, the lion's share, is paid by the insurance company.  

  • How is it different from reimbursement?

    If you go for treatment to a hospital that is not a part of the network hospitals, you need to make the payments from your pocket and then submit the bills to get a reimbursement from the insurer. In a cashless policy, the payment is made directly by the insurance company if treatment is done in a network hospital.

  • What is the tenure of the cashless health insurance policy?

    Cashless health insurance policies, like most health insurance products, come with a standard tenure of 1 year. They need to be renewed every year. Some insurers, however, do offer tenures of 2 years at a time.

  • How long can I renew the policy for?

    Most cashless mediclaim policies can be renewed throughout the lifetime of the policyholders.

  • What if I fail to renew the policy in time?

    In case you fail to make the payment for the policy by the due date, you will be given a grace period of 15 days. However, it must be noted that in most cases, insurance policies are not active during the grace period.

  • Is this type of a policy transferable?

      Yes, these health insurance policies can be transferred from one insurer to another.

  • Do these policies cover pre-existing illnesses?

    Yes some insurers may offer cashless policies for pre-existing conditions however, this facility may be subject to conditions set forth by the insurer.

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