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Insurance Article

Cashless Hospitalization Facility For Your Health Insurance Claim

May 20 2013

You don't have anything else in mind that rushing her to the nearest hospital. But the hospital authorities deny admission without submission of a sum evaluated for the treatment. They ask for cash deposit

You inform them that you are covered under a health insurance facility. However, the hospital authorities are not interested in such claims. They still demand payment upfront. Now you are left with only one option to rush to the nearest ATM centre to get cash. The ATM too has a cash limit you can withdraw within 24 hours.

Your wife is admitted after you deposit cash. In the next few days you need to spend more money for an emergency operation, hospital room charges and medications. Since you have already withdrawn some cash the day before, you sell a few shares you have in hand despite the present condition of the market.

Of course, you will get all of the money reimbursed by the health insurance company after you make a claim and submit the bills. However, at the moment you don't have any other option left than exhausting your savings or even selling your investments without a guarantee for profits. You need to lose out on all that you have currently unless you're the type to hoard heaps of cash in your secret treasure box or under the mattress!

So what's the solution?
A cashless hospitalization facility would have saved you from the hassles.
It would have saved your energy as you don't require running from pillar to post to gather instant cash.
It would have saved you from exhausting all of your current savings.
It would have saved your future investments from going down the drain.
The cashless hospitalization facility is a life saver under emergency situations.

Cashless hospitalization was introduced into health insurance industry with an aim. The insurance companies wanted to help their customers avail of health plans without hassles in case of an emergency. The facility for getting health insurance claim without giving to pay cash for initial medical services seemed to click with customers. And it gained popularity around the nation.

The cashless hospitalization facility can be of great help during emergencies. In fact, it is a vital feature of any mediclaim policy offered in India. Sudden or even planned hospitalization of a loved one can be really disturbing. The rising costs of health treatment have made it really tough for people to pay for an unplanned treatment. Under such situations, cashless hospitalization can come handy.

The cashless facility is usually offered by a health insurance provider or their third party administrators (TPAs). This facilitates you to receive medical treatment in a hospital without paying cash. The facility can prove to be a life saver especially in case of an emergency. This is the time when you don't carry adequate cash for the prescribed treatment.

To be more precise cashless hospitalization is a facility offered by a health insurance company that facilitates the insured to get required medical treatment sans paying cash.

So is it possible to get treatment at a hospital of your choice?
This is something most people wish to know when buying a health insurance especially if they have the cashless facility in mind. Well, you may get treatment from your preferred hospital provided it is listed with the network of your health insurance company.

How cashless hospitalization works?
Under the cashless facility, the hospital (listed under the network of health insurance for cashless hospitalization) coordinates directly with the insurance organization. In some cases, the hospital connects with the TPA to settle bills.

Hospitalization - Planned and Unplanned
The cashless facility can be availed under two conditions; planned and unplanned hospitalization:

Planned Hospitalization Here, you require informing the insurance company or its TPA beforehand about the cause for the hospitalization.

Unplanned Hospitalization In case, of an unplanned health emergency, you may inform the insurance company or its TPA almost immediately after the hospitalization.

Things to Know about Cashless Health Insurance Facility The Cashless Hospital List
Since you can avail medical treatment only at the hospital listed under the health insurance cashless network, it is important to have a detailed look at the cashless hospital list before buying insurance policy. This will help you know about the hospitals and medical centres where you can get treatment when required.

The Cashless Cover
Apart from going through the cashless hospital list you should also know about the expenses that are excluded under cashless facility. These expenses will be borne by you. The key is to study about the exclusions in the policy and applicable conditions in detail before signing the dotted line.

Understanding your Cashless Facility
There are certain things you require keeping in mind when availing of a cashless hospitalization facility:

All medical insurance plans do not come with cashless facility. Hence, prior to assuming you are offered one automatically with a plan, you need to check out with the insurance company about what's offered. Make sure you are offered this policy prior to buying a plan.

As already discussed, cashless facility can be availed only at hospitals and medical centres that are listed under an insurance company's list of network. Hence, you need to make sure that your health insurance policy covers hospitals near your locality. This really helps in case, of emergency when you have to rush the patient to the nearest hospital.

Do you know about the illnesses the insurance company will not pay for under cashless hospitalization? Well, this may put into serious trouble. It is crucial to know about the health conditions that are exempt from cashless hospitalization facility. You should learn about these exclusions prior to buying a health insurance plan.

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