Is health insurance really cashless?

Is health insurance really cashless?

Having a health insurance plan in today’s times can prove to be useful in several ways. Be it a working professional,a business person, or a housewife, healthcare services and medical treatment are required by all at some point in time. We all know the expensive side of today’s healthcare and medical services. Even a normal disease can make a dent in your wallet. For this reason, it is better to equip yourself and your family members with a well-designed health insurance plan. You must have heard that cashless health insurance plans are the best ones. But, is health insurance really cashless? Let us find out.

What is a cashless policy?

Before we get into the discussion, let us first understand the concept of cashless policy. When a policy is cashless, you do not have to pay anything at the hospital. The process is simple-

  1. Visit one of the network hospitals provided by your health insurance provider, where a cashless treatment facility is available.
  2. Get in touch with the customer support executive assigned in that particular hospital. You can find him/her at the TPA helpdesk.
  3. In most of the cases, you have to submit the request at least three days before the treatment date.

After you submit the request, the network hospital will get in touch with the insurer to validate the same. Once verified, the patient can be admitted to the hospital, and he/she can avail cashless treatment without worrying about the huge medical bills. After the treatment, the network hospital would settle the bill amount directly with your insurer. So, this is how it works.

What are the conditions you need to be aware of?


Just like any other form of insurance policy, there are some limitations in the case of cashless policy as well. First of all, the cashless benefit can be availed only when you get the treatment in one of the network hospitals. When you visit a network hospital, it is the onus of the TPA to share accurate and sufficient details of your case with the insurance company. Failing to do so can lead to the rejection of your claim. Likewise, if the ailment you are suffering from isn’t listed in the list of inclusions, your cashless claim will not be accepted. To sum up, two things determine whether you can avail of the advantage of cashless treatment- network hospitals and ailment type.

In addition to that, there are a few other aspects you need to be aware of. The cashless policies do not cover some types of expenses. Some of them are- oxygen masks, ambulance charges, nebulizers, etc. Some policies do not include documentation charges too. For this reason, before you buy a cashless health insurance plan, you must carefully go through the terms and conditions. Comparing the list of inclusions and exclusions can provide you with a better idea of which cashless policy to go with.

So, what are the benefits of having a cashless health insurance policy?

The biggest advantage of having a cashless policy is that you don’t have to worry about arranging the funds. In times of medical emergencies, it becomes quite difficult for almost all of us to arrange a big chunk of liquid money. But when you have a cashless plan, you do not have to think about these things. You do not have to pay anything at the hospital before or after the treatment. If you are the only breadwinner of your family, having a cashless policy becomes even more important for you. In case you fall terribly sick and need medical treatment as soon as possible, all you have to do is visit the nearest network hospitals.

Another advantage is that you don’t have to go through the cumbersome process of reimbursement. Even though every health insurance provider makes tall claims about their easy reimbursement process, the truth is completely different. It easily takes at least a week to complete this process. After spending a big amount on your treatment, if you do not have much left in your bank account, it can make things difficult for you. So, it is certainly better to get a cashless health insurance policy and stay away from the hassles of reimbursement.

Clare Louise