Here are the three reasons why cashless health insurance should be adopted by every family:
- Reduces tension in face of medical emergencies – In case of an emergency, the insured is not required to make any major payments towards hospitalization from his pocket. As a result of tie-ups with hospitals, insurance companies offer negotiated rates for various treatments which in turn help the insured to save on the sum insured under the health insurance policy.
- Hassle free process- Not only does the cashless facility provide you with financial relief, it also enables smooth functioning in terms of documentation, since all coordination takes place between the hospital and the insurance company through TPAs. TPAs coordinate with the hospitals to furnish details such as bills, reports and prescription to the insurance company.
- Retain emergency funds- We all make some investments as an emergency fund to meet emergencies. These could be in the form of FDs, bonds or mutual funds. Since cashless insurance takes care of such emergencies, these investments can be rotated to earn better returns.
To make effective utilization of cashless health insurance policies, policyholders should be aware of the following dos and don’ts:
Dos:
- As cashless service is only available in network hospitals, check the hospitals in the PPN of your insurance company at the time of taking the policy.
- Be aware of the non-admissible charges under your insurance policy cover, such as service charges, administration charges, registration charges, private nurse expenses, telephone calls, laundry charges, amongst others.
- In case of planned claim, inform your TPA before getting hospitalized. In case of emergencies, inform the TPAs within 24 hours of hospitalization.
- Carry your cashless insurance ID card as proof at the time of hospitalization.
- Furnish all the details required in the pre-authorization form within the requisite time frame so that the same is not rejected by the TPAs.
- As with all health insurance policies, reveal all pertinent details at the time of applying for a policy including any pre-existing condition. It might increase the premium amount slightly, but make sure that your claim is not rejected later.
- Ensure that you are fully aware of what are the various limits as per your policy. These limits could be in the form of a flat amount on certain types of expenditure or a certain percentage of sum insured. This awareness will enable you to decide what kind of room and facilities you can avail at the hospital and what will be paid for by the insurer.
Don’ts
- Do not submit any fraudulent claims. It may not only lead to cancellation of your insurance plan but also make it difficult apply for a policy in future.
- Avoid submitting small-budget claims, repeatedly to the insurance company as it will increase the premium amount to be.
- Delay in intimating TPAs about hospitalization and furnishing incomplete pre-authorization form would work against the policyholder. Avoid doing that.