A cashless health insurance involves a health insurance company directly settling your bills with the healthcare provider, which can either be a hospital or a nursing home. These kinds of insurance policies reduce the burden on the insured individual at the time of hospitalisation. The amount of total expenses that occur in the bill raised by the healthcare provider is directly settled by the cashless health insurance company through a Third-Party Administrator (TPA). The insured person can avail of the cashless facility with proper documentation at the time of admission.
Health insurance companies have tie-ups with various hospitals across the country. One can avail this facility at a hospital that falls under the health insurance company’s Preferred Provider Network. Cashless health insurance comes as a great help during medical emergencies. However, there are a few things that you need to keep in mind while you invest in cashless health insurance policies.
Do’s
• Know about your policy: Read your policy documents carefully to know what is covered and what isn't. Make a list of healthcare providers that fall under the Preferred Provider Network of your health insurance company. The company’s website must mention all the hospitals under this network.
• Be prepared: Keep all your health policy documents, IDs cards, etc. ready at a safe place so that they are easily accessible, in case of hospitalisation. You do not want to keep looking for them during the time of emergencies.
• Maintain a decent contingency fund: Even if you get your cashless insurance approved, hospitals might ask you for a refundable deposit at the time of hospitalisation which can range somewhere between Rs.10000 to Rs.30000. keep in mind that these policies do not cover expenses like registration fees.
• Fill the form properly: Make sure you fill all the details in your form carefully and mention your cell phone number and pre-authorisation request so that the Third-Party Administrator can contact you immediately.
• Maintain a folder: During hospitalisation, keep all the medical reports, lab/diagnostics bills, etc. in a folder safely. You will be required to submit the same to the insurer after the claim.
Don’ts
• Planned hospitalisation: In the case of planned hospitalisation, do not wait for the very last moment. Send the cashless approval request in advance so that everything is ready before time.
• Keep a copy of all the documents: Do not forget to keep a copy of all set of records, which include medical reports, diagnostic bills, etc. for later references.
• Do not cover: Do not hide anything related to your health condition. It can hamper with your claim settlement.
• Keep in mind your approved upper limit: Do not opt for facilities in the hospitals that exceed your approved upper limit.
• Do not forget to renew your policy every year: This is one of the most important things that one needs to keep in mind when claiming cashless health insurance. Failing to do can terminate your medical insurance policy.
