How Does Cashless Mediclaim Work?

What is Cashless Mediclaim?

Cashless mediclaim is a service where the medical bills are settled directly between the health insurance company and the hospital. When you purchase a health insurance plan, your insurer offers a cashless claim feature. Under this feature, you can get medical treatment and services without having to pay upfront charges. The bills are settled by your insurer, so you can focus on getting timely treatment rather than worrying about bills.

Did you know that the General Insurance Council of India introduced the “Cashless Everywhere” facility under which you can claim cashless settlement at both network and non-network hospitals?

Cashless Mediclaim: How It Works?

If you are wondering what the cashless mediclaim procedure is in the practical aspect, here’s how it works:

Purchase a Health Plan

To enjoy cashless claim services, you need to purchase a reliable health insurance plan. Ensure that the policy offers cashless claim settlement.

Admission at an Authorised Hospital

Admission to an authorised hospital is mandatory. An authorised hospital is any hospital where a cashless claim can be available, even if it is not a registered network hospital under the insurance company.

Inform the Insurance Company

If hospitalisation is planned, inform your insurer beforehand for a hassle-free authorisation and claim settlement. In case of an emergency hospitalisation, make sure your insurer is informed within the stipulated time or as early as possible.

Submit the Healthcare Card

To initiate cashless claim settlement, you need to provide your healthcare card. A health card is issued by the insurance company under your name at the time of purchasing the policy.

Fill the Pre Authorisation Form

If it is a planned hospitalisation, you need to complete the pre-authorisation form with relevant details such as your name, policy details, required medical treatments, etc. The hospital sends this form to the insurance company, and the bills are settled between them. In case of an emergency hospitalisation, the hospital can start the treatment without waiting for approval on the form.

Enjoy Cashless Claim Settlement

Once the insurer has approved the claim, your medical bills are settled, and you can enjoy cashless treatment.

Things You Must Know About Cashless Medical Insurance

Cashless mediclaim is a reliable and efficient feature under health insurance that makes healthcare accessible and affordable. Before you step in to raise a claim, here are a few things you must be mindful of:

Mandatory Deductibles

Know that when you purchase a cashless mediclaim policy for family or yourself, it comes with mandatory deductibles. This means that even with covered services and cashless claim settlement, you might have to handle minimal out-of-pocket expenses. These usually include non-medical expenses.

What are Deductibles? A deductible is a pre-defined amount that you have to pay before your health insurance provider steps in to settle the remaining amount. This amount is informed to you when you purchase the policy.

Co-Payment Feature

If you have opted for the co-payment feature, you first have to pay the co-payment amount before your insurer steps in to offer cashless claim settlement.

What is Co-Payment? Co-payment is a voluntary deductible amount that you agreed to pay out of your pocket at the time of claim settlement. This feature is usually opted for to reduce the premium amount.

Claim Settlement Process

Make sure to understand the claim settlement process of your health insurance provider. This includes knowing the authorisation process, documents required, deductible amount, etc.

Pro Tip: Ensure to check the claim settlement report of insurance companies issued by the Insurance Regulatory and Development Authority of India before buying a health plan.

Cashless Mediclaim: How Does It Benefit You?

Cashless mediclaim is one of the most beneficial features under a reliable health insurance plan. If you are still wondering how it benefits you, then take a look at some of its benefits that you get to enjoy:

Easy Access to Medical Services and Treatment

Cashless mediclaim ensures that you can get medical services and treatment without having to worry about the high medical bills. It serves as financial protection, whether you have a medical emergency or a planned hospitalisation.

Access to Top Quality Healthcare Centres

Insurance companies partner with top healthcare centres and hospitals in the country, where you can get cashless mediclaim. So, you have access to the best hospitals and medical facilities in the country.

A Hassle-Free Experience

Cashless mediclaim is designed to make hospitalisation a smooth and seamless experience. Therefore, to avail the service, you just have to submit your healthcare card. You are no longer required to undergo a tedious documentation and approval process.

Brings Peace of Mind

When you have financial protection for medical emergencies and planned treatments, it brings peace of mind that is unmatchable. Additionally, with cashless medical insurance for family, the focus can be on a stress-free recovery rather than worrying about medical bills.

To Sum Up

Cashless mediclaim is a feature offered by health insurance companies to remove the financial stress of availing medical services in India. By almost eliminating the need for a high upfront payment, cashless mediclaim ensures timely treatment for all. To learn more about coverage under health plans and pick a plan that is suitable for your medical needs, head to Jio Insurance Broking.

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