Healthcare is becoming increasingly expensive, making an emergency medical situation a troublesome burden on finances and budgets. Thus, one of the most essential parts of financial planning is health insurance, which can help you deal with unforeseen expenses and assure access to quality healthcare.
In this regard, cashless health insurance has become extremely popular in India as it enables individuals to gain treatment without any upfront costs. This guide provides a detailed insight into how cashless health insurance works, as well as its types and other aspects, allowing you to make an informed decision.
Continue reading to learn more!
What is Cashless Health Insurance?
Cashless health insurance allows you to obtain healthcare services from any network hospital without making upfront payments. Claims with cashless insurance are settled directly with the hospital, unlike traditional insurance plans, where you get reimbursed for the expenses incurred.
Thus, in case of a medical emergency, the insurer pays the hospital directly for the policyholder’s medical bills, including hospital bills, ambulance charges, etc. This negates the individual’s requirement to arrange funds during a critical health scenario, ensuring timely access to medical treatment.
How Does Cashless Health Insurance Work?
Following is an overview of how cashless health insurance works:
- Choose the Right Coverage
When selecting a health insurance plan, see if it has cashless hospitalization facilities. Also, check the type of coverage offered by the plan, its limits, inclusions and exclusions and other details.
Additionally, check the premium amount to ensure that you can make timely payments without straining your finances.
- Make Payment
After selecting the right plan, pay the premium to activate your health insurance. Ensure regular premium payments to avoid any hassle during the claim process.
- Find Network Hospitals
Cashless claim settlements work only at the network hospitals listed under your health insurance plan. Make sure to check if there’s any network hospital available near your residence to get timely medical care during emergencies.
- Produce Your Insurance Card
The Network hospital will request a pre-authorization from your insurance provider for the treatment required for your medical condition. Bring your insurance card and other required details to the hospital for cashless claims.
- Receive Treatment
After your insurer approves the pre-authorization, cashless claims will allow treatment to be conducted at the hospital without advance payment. At the same time, the insurer will make a direct settlement with the hospital.
- Check the Insurance Payout Agreement
Ensure to check out the insurance payout agreement to have a clear idea of how much the insurer can cover your medical bills. Any expenses that fall outside the approved amount need to be paid by the policyholder.
- Focus on Recovery
Cashless claims do not impose financial responsibility on the patient for emergencies. Thus, they and their family members can fully focus on recovery without having to deal with the stress of arranging funds.
What are the Different Types of Cashless Health Insurance Plans?
The following section contains the various types of cashless health insurance plans to help you make an informed decision:
- Individual Health Insurance Policies
These insurance policies cover medical expenses incurred due to illnesses, accidents, or injuries. It provides coverage to a single policyholder by enabling them to avail themselves of cashless medical treatment at any of the network hospitals.
- Family Floater Health Insurance Policies
A family is covered under a single policy that includes the policyholder, their spouse, children, and parents (in some cases). The age of the oldest family member determines the premium, and the policy will provide cashless medical treatment to all insured members at network hospitals.
- Senior Citizen Health Insurance Policies
These policies are for senior citizens aged 60 years and above. It ensures ease of accessing treatment without delay to address the health issues that usually affect elderly individuals.
- Maternity Health Insurance Policies
These policies are designed to cover the healthcare needs of expecting women, ranging from delivery expenses to pre-and post-natal care. They also provide newborn coverage, along with the vaccination expenses for the child, making the delivery experience stress-free.
- Group Health Insurance Policies
Group Health Insurance policies cover a group of individuals. They are mostly used in corporate organizations, where employees are generally covered under one plan. In such cases, cashless treatment is available to employees at network hospitals, reducing financial burdens on their end.
- Personal Accident Insurance Policies
Such policies facilitate financial cover in case of disability or death due to an accident. With cashless accident insurance included, medical treatment would come to your rescue and save you from the trouble of upfront payments, ensuring prompt healthcare during emergencies.
- Disease-specific Health Insurance Policies
These specific health insurance policies have been authorized to cover certain sicknesses, e.g., cardiovascular disease or cancer. The cashless claim facility enables policyholders to promptly opt for advanced treatment and other medical procedures without facing the hassles of immediately arranging funds.
This provides them peace of mind, enabling individuals to fully focus on their recovery.
What are the Advantages of Cashless Health Insurance?
Here are the benefits of opting for a cashless health insurance plan:
- Offering Immediate Access to Health Services
Cashless medical claims will allow easy access to medical services anytime, even when you have no money during emergencies. For such cases, network hospitals contact the insurer to ask permission to perform treatments covered by your insurance policy.
- Simple to Use
Cashless claims remove the need to pay out-of-pocket and the hassles of filing paperwork for reimbursements. Instead, the hospital directly contacts the insurer to settle all hospital expenses.
- Access to Quality Health Care
The insured person can gain access to the finest healthcare without worrying about finances or any formalities. Same-day access to treatment ensures speedy recovery and the best medical treatment.
- Minimal Documentation
Unlike reimbursement claims, cashless claims do not require extensive documentation and paperwork for claim settlement. After the insurance company approves the authorization request, the hospital will take care of the documentation process and its associated paperwork.
- Pre-approved Treatment
In the case of pre-planned admissions, prior treatment cost approval can be acquired a few days before the date of hospitalization. Therefore, one gets sufficient time to arrange for funds to cater to those expenses which are not covered under their health insurance plan.
- Financial Shield
Cashless health insurance makes one financially secure in case of emergency medical treatment. You do not need to pay beforehand or follow up on the claim process, as your provider settles the bill directly with the network hospital.
- Peace of Mind
Cashless health insurance offers peace of mind as patients do not have to worry about arranging funds in the event of a medical emergency. This brings immense relief to both the policyholder and their family, enabling them to focus solely on recovery.
Looking for a reliable cashless health insurance plan? Enjoy peace of mind and comprehensive coverage with Star Health’s Super Star plan, offering cashless treatment at 14,000+ network hospitals across India with over 97% cashless final approvals within 3 hours.
Contact us today to secure your health and finances!
