Cashless mediclaim policy is a service offered by a number of insurance providers in the country. This service presents users with a convenient solution to protect themselves against the ever-growing medical expenses in the event of hospitalisation, without having to suffer any out-of-pocket expenses. 

For this feature, insurance providers collaborate with a number of hospitals across the country to activate the cashless facility. These partner hospitals are also known as ‘network hospitals’. When you go for treatment at any of these network hospitals, your insurance provider steps in to settle all your medical bills directly. 

In the event of a medical emergency, cashless mediclaim policy plays a huge role in relieving stress by giving you complete financial assistance. It is an easier process than dealing with reimbursements where you need to pay your medical bills first out of your pocket and then get them reimbursed from your insurance company.

Types Of Cashless Mediclaim Policies In India:

There are a number of cashless mediclaim policies available in the country today. These include:

Individual cashless mediclaim policy:

This type of cashless mediclaim policy offers financial assistance to the individual that has purchased the policy. A specific amount of medical coverage is provided as per the insurance plan which can be claimed for hospitalization expenses whenever needed.

Family floater cashless mediclaim policy:

This type of cashless mediclaim policy offers cover for all members of the family a single policy with one fixed sum insured. This financial assistance provided under the family floater policy can be used by the insured members for hospitalisation expenses during the policy term.

Senior citizen cashless mediclaim policy:

This type of cashless mediclaim policy provides financial assistance for senior citizens. The senior citizen cashless mediclaim policy is curated to assist in handling of their hospitalisation expenses at the most crucial stages.

Challenges Related To Cashless Mediclaim Plan:

While the cashless mediclaim policy system is a great advancement in the insurance sector, there are still a few kinks that need to be ironed out. Some of the challenges associated with opting for this feature include :

Unavailability of network hospitals: 

To get the benefit of using the cashless mediclaim service, you need to go to only those hospitals registered as a network hospital. That is why you need to be aware of all the hospitals on this list, otherwise you can face trouble during a medical emergency.

Partial claim settlement: 

In some cases, the insurance company only provides part of the payment in the form of cashless settlement. The rest is left for reimbursement, which means you have to pay out of your pocket to cover the rest of the expenses during the emergency.

Time taken to process the claim: 

In some emergency cases, you need to get an approval from a Third Party Administrator, which could put your claim on hold. This can only get financial assistance once they give you the go-ahead to facilitate cashless mediclaim. At these times, you can be asked by the insurance company to bear the cost at first, and get it reimbursed later.

Exclusions: 

There are a number of treatment expenses that are not covered under your medical insurance. This could include things like registration fees, diet and toiletries charges, documentation expenses, dental procedures and more. That is why you need to carefully go through all the terms and conditions of your plan while buying it, so you do not get shocked later. 

To learn more about cashless mediclaim policies, head to Coverfox - one of India’s leading insurance broking portals. Their team of seasoned experts are on hand to guide you through every step of your insurance buying journey.