Health insurance providers usually tie-up with certain hospitals across the country where policyholders can avail cashless treatment. These medical establishments are called cashless hospitals, network hospitals, or empanelled hospitals. Policyholders can avail cashless treatment at network hospitals for both planned and unplanned/emergency medical procedures.
If the policyholder chooses to undergo cashless treatment at a network hospital, the insurance provider will settle the individual’s medical bills directly with the hospital/healthcare provider. Thus, the policyholder will have to incur minimal out-of-pocket expenses when undergoing a treatment at a network hospital.
The procedure to avail cashless treatment will vary from insurer to insurer. The general procedure to avail cashless treatment at a network hospital is as follows:
A health insurance policy is meant to provide you a cover against necessary medical expenses that you may have to incur in the event of an emergency hospitalisation or if you have to undergo a planned medical treatment. Therefore, there will be certain non-medical expenses that may be billed to you that your cashless health insurance claim will not cover, such as:
Note: The charges mentioned above are not exhaustive. For a full list of exclusions, make sure to check the policy brochure.
Your cashless health insurance claim may be denied by the insurance provider if:
The main advantage of opting for a cashless claim is that it can lower your out-of-pocket expenses in the event of a medical emergency or hospitalisation. However, you should make sure that you are aware of your insurer’s cashless claim process and the terms and conditions governing this in order to avoid any last-minute surprises.
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