A cashless health insurance is specifically designed with the purpose of providing relief from financial stress at the time of hospitalization. This is usually done through the process of an arrangement and agreement between the insurance company and the hospital which is a part of their network of hospitals as per the policy. The agreement of these health insurance policies states that the claims are settled between the insurance company and the hospital without the involvement of the insured. The liaison between the company and hospital is the Third Party Administrator (TPS) which helps in the settlement of the claim. They usually have a desk set up at the hospital which helps in facilitating a smooth process of settlement.
The key features of a cashless policy are decided by the insurance company and hence tend to vary from policy to policy but there are some standard features that are common throughout. Some of the standard features that are almost always present across companies are listed below:
- Cover for services of an ambulance.
- Medical expenditures of pre and post hospitalization.
- Facility of a no claim bonus
- In patient care
- Cover for domiciliary treatment
- Daily cash benefits
- Facility of medical checkups and diagnostic tests on a complimentary basis.
- Cover for illnesses that are critical in nature like heart attack, heart stroke, cancer etc.
- Offer of a free-look period.
- Benefits against tax under the Income Tax Act, 1961.
Apart from the features that the cashless policy offers, there are certain advantages as well that are associated with this. Some of these are spoken about below:
- Anything that is not planned for in advance causes certain amount of stress and hassle for the individual or family, and the case of an expected as well as unexpected medical emergency is no different. This is mainly because of the huge financial strain that it causes due to the sky high prices of medical facilities. A cashless claims helps in saving time that otherwise might have to be spent by the family in arranging for finances. All the family has to do in order to claim this benefit is show their cashless policy card to the hospital authorities.
- This acts as a huge source of relief because it gives the assurance that one will not have to worry about finances when a medical emergency arises. The focus can solely be on the treatment of the patient without the stress about money.
- A cashless policy provides a range of comprehensive coverage under its wing like ambulance expenses, hospitalization expenses, free medical checkup and others that have been mentioned above.
- With a cashless policy, medical services can be availed at network hospitals when someone is travelling and faces a medical emergency. This can be done without having to worry about arranging for good medical treatment and the expenses related to it.
- Like other policies, holders of a cashless policy are eligible for certain tax benefits under the under the section 80D of the Income Tax Act, 1961. The benefit usually goes up to an amount of Rs. 25,000 for people below the age of 60 years and up to Rs. 50,000 for people above the age of 60 years or senior citizens.
There are various types of cashless policies that one can opt for based on their needs and requirements. Having a basic knowledge of knowing what to expect helps ease the process.