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How Does Cashless Hospitalisation Work?

Updated On Jul 08, 2021

A health insurance plan is a tool that not only safeguards you but can also protect your family in case of any medical emergencies. So that you do not have to compromise with any treatment and healthcare facility that you require, it is important to have a health insurance policy. Cashless Hospitalisation is a crucial benefit provided by health insurance plans that are especially helpful during emergencies.

How Does Cashless Hospitalisation Work?

What is a Cashless Hospitalisation Benefit?

A cashless hospitalisation benefit takes care of the costs incurred in a health emergency right off the bat. Under this benefit, the costs of hospitalisation and whatever other medical treatment availed of is directly paid off by the insurance provider. This removes the hassle of filing claims later on and waiting for reimbursement. 

It is especially helpful during emergencies. The lack of a claim procedure and subsequent waiting period ensures that no hurdles come up while hospitalising or during the treatment of the patient. Even if the treatment is a costly one, it can be immediately availed of. The policyholder has to pay nothing on his own, even at the very initial stages.

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How does Cashless Hospitalisation Work?

When a health insurance plan comes with a cashless hospitalisation benefit, it means that the policyholder will not have to pay on his own initially and then wait for reimbursement after filing a claim. A cashless hospitalisation pays for all expenses incurred, from the very get-go. This facility can be availed of in a network hospital of the insurance company.

All insurance providers have a number of network hospitals under them. The more the number of network hospitals, the easier it is in times of emergency. When you avail of treatment and medical attention in such a hospital, the insurance company will directly pay your medical bills under the Cashless Hospitalisation benefit. This ensures that you do not have to pay anything even during admission to the hospital. 
To find out a network hospital under a certain insurance provider, you can check the information provided on their official website. It might change from time to time which is why it is best to check before you go to a certain hospital. The cashless hospitalisation benefit is available only at the network hospitals of an insurance company.

Types of Hospitalisation Available

The cashless hospitalisation benefit is available to policyholders under two circumstances. Here are they:

1. Pre-Planned Hospitalisation

If you are aware that you will need to be hospitalised soon and need to avail of medical treatment, you can notify your insurance provider beforehand. In such a case, you will have to submit a Pre-Authorisation form to your insurance provider before the date of admission to the hospital. After you submit the form, it will be verified for any falsification and subsequently, your claim will be approved or rejected.

2. Emergency Hospitalisation

During an emergency, a cashless hospitalisation especially comes in handy. You can admit the patient first and then fill out the pre-authorisation form within the next 24 hours. Such claims are prioritised and the costs incurred till then is usually reimbursed within the next few hours. Even if you do end up paying out of your own pocket due to lack of time, it can be reimbursed later on by the insurance company.

Must Read: Factors To Consider While Buying The Best Cashless Insurance Policies In India

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Benefits such as cashless hospitalisation make health insurance policies so helpful. Medical treatments and procedures are often costly and in times of emergency, it might get difficult to pay for them. This is why it is important to be mindful of such benefits and make the most of them get adequate medical attention. 

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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