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Know Exactly How Cashless Health Insurance Works

There is nothing as disturbing and heartbreaking as watching a family member getting hospitalized unexpectedly. Aside from enduring the emotional trauma, you additionally experience intense financial stress. This is where health insurance acts as your dependable 'Samaritan.'

When you have a health insurance plan, you are reimbursed for the amount you pay for the medical bills and other expenses related to hospitalization. However, in this case, you are required to pay the amount out of your pocket, which may not be a suitable scenario, specifically when the hospital bills are high.

This is where cashless health insurance comes to your rescue and is of great advantage during emergencies.

How Does Cashless Insurance Work?

When you have a cashless health insurance plan, your medical bills are directly paid by your insurer to the hospital or healthcare provider. Therefore, it removes the hassles of:

  • Having to pay the medical bills out of your pocket at the time of need
  • Claiming reimbursement later

Health insurance companies have a list of network hospitals across India where they offer cashless benefit. Put simply, when you avail treatment at these network hospitals, you don't have to pay the bills out of your pocket.

There are two different ways you can avail cashless hospitalization service:

Planned Hospitalization:

When you know about the hospitalization at least 2-3 days ahead of time, it’s called planned hospitalization. In such a case, you must take the pre-authorization before the planned treatment. You can easily obtain the ‘pre-authorization form’ from the hospital desk.

Emergency Hospitalization:

When an insured individual requires immediate hospitalization either because of an accident or any disease, at that point, it is known as emergency hospitalization. Subsequently, it is vital that you inform the insurer within 24 hours of hospitalization to avail the benefit of cashless insurance.

Process of Cashless Health Insurance

To avail the benefit of cashless insurance, it is basic to know whether the concerned hospital is present in the list of network hospitals of the insurer. For this, you may check the insurer’s website or check the list of Third Party Administrators (TPA) present in your policy. Here are the next few steps to follow:

  • Visit the network hospital and ask for a pre-authorization form. You can get this form from the insurance desk of the hospital, or you may download it from the TPA’s website
  • Submit the duly filled form to the insurance desk. Your form is then processed by the TPA, and upon successful verification, you get complete treatment without making any payments

Advantages of Cashless Health Insurance Plans

One of the most significant benefits of cashless health insurance is that it’s a boon for individuals who are low on cash as it eliminates the need to arrange cash in case of medical emergencies. Other advantages include:

  • The process is less cumbersome as you are not required to submit reports, documents, discharge summary for claim
  • Cashless health insurance policies offer coverage for pre and post-hospitalization expenses as well.
  • You can choose the best healthcare provider from the wide range of network hospitals and avail the benefit of the cashless facility. We offer fast cashless coverage at 4500+ network hospitals
  • The premium paid towards your health insurance plan is eligible for tax benefits u/s 80D of IT Act, 1961
  • It offers peace of mind knowing that you will receive quality treatment without having to worry about medical bills. Thus, you can focus on your speedy recovery instead

There's no predicting when a medical emergency will strike. However, with Bharti AXA GI’s Smart health Insurance policy by your side, you can take the burden off your shoulders and focus on receiving complete health care.