Why are Cashless Claims Important for Critical Illnesses?

• Written by Mudit Handa

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At times, life presents us with unforeseen challenges that are beyond our control. A critical illness is one such challenge that can hamper anyone’s life. Being prepared for it and planning for the medical expenses is the only thing you can control. If you have a family history of critical illnesses or are at risk of a critical illness, it is best to invest in a dedicated critical illness health insurance plan rather than just rely on your existing health insurance plan. 

The Super Mediclaim plan offered by Care Health Insurance offers comprehensive coverage of up to Rs. 1 crore  for a wide range of critical illnesses with the benefits of cashless hospitalisation.

Care Critical Mediclaim: Cashless Mediclaim Policy For Family

Care Critical Mediclaim is one of the top 10 cashless health insurance in India for critical illnesses. The plan offers extensive coverage for 32 specified critical illnesses at a wide network of around 24000+ hospitals worldwide. The indemnity plan covers the medical expenses of treatment if the policyholder is diagnosed with a critical illness listed in the policy. Some major highlights of the plan include;

• The high-sum insured options protect your savings and investments in case you or your loved ones are diagnosed with a critical illness.
• The plan provides coverage for advanced procedures like chemotherapy and radiotherapy.
• The plan provides coverage on an indemnity basis that covers the actual costs of the treatment.

How Cashless Hospitalisation Works?

Cashless hospitalisation is a hospitalisation facility where the policyholder is not required to pay the bills for his hospitalisation. This service is made available by a health insurance company to its policyholders who avail treatment at a network hospital of the insurance company. The hospitalisation bills are settled by the insurance company directly provided the policyholder informs the company about the hospitalisation within the defined timelines. There are two types of cashless hospitalisation;

Planned hospitalisation

In this type, the hospitalisation is already planned to avail of treatment prescribed by the doctor, and the insured needs to inform the insurer 48 hours before the hospitalisation to avail of cashless treatment.

Unplanned or Emergency hospitalisation

In this type, hospitalisation is unplanned and is required due to an emergency and the insured needs to inform the insurer within 24 hours of hospitalisation to avail of a cashless facility.

What Are The Benefits of Cashless Hospitalisation?

Care critical mediclaim plan is the best cashless mediclaim policy for family in India. The cashless hospitalisation facility under the plan offers many benefits to the policyholder in the hour of the need.

Financial support during hospitalisation

Whether planned or unplanned, hospitalisation due to a critical illness requires huge amounts of money. A cashless hospitalisation facility provides financial support during hospitalisation as you need not worry about the hospital bill payment.

Access to quality medical care

The cashless facility allows you to get treatment at the best hospitals that are part of the insurance company’s network which otherwise would have been out of your reach due to high medical costs.

Large network of hospitals

The Care health insurance cashless hospital list includes hospitals with the best medical infrastructure where you can get all advanced treatments for any critical illness. The policyholder gets a wide range of options to choose from the network. 

Reduced paperwork

With cashless hospitalisation, you do not need to do the cumbersome paperwork required for the claim process, the insurer directly deals with the hospital for bill settlement making the claim process fast and efficient.

Claim Process For Cashless Hospitalisation

It is important to understand the claim process of cashless hospitalisation to avoid your claim getting rejected. 

1. Locate your nearest network hospital by visiting the Care health insurance website or through the Carehealth customer app.
2. Contact the hospital's insurance helpdesk or the billing counter with the patient’s insurance card and pre-authorisation form with your ID proof. You can also download your e-health card from the Carehealth app.
3. The hospital billing desk or the TPA shares the document submitted by you with the insurance company for pre-authorisation approval.
4. In case of any discrepancy or missing information, the insurance company contacts the hospital or the TPA.
5. After the review of the policy terms and conditions, the pre-authorisation is approved.
6. Once the patient is discharged, the hospital submits the discharge summary and other treatment-related documents to the insurance company.
7. After assessing the bills according to the policy terms and sum insured, the insurance company settles the bill directly with the hospital.

Important Points To Note Before Filing A Cashless Claim

Even after having the best cashless health insurance your claim can get rejected if you do not take care of certain important points.

1. Compare the estimated cost of your treatment with your coverage amount. If the treatment cost is more than the coverage amount, you will have to pay the excess amount from your pocket. Alternatively, you can apply for a super top-up mediclaim to enhance your coverage.
2. Check the waiting periods specified in the policy. If you file a claim during the waiting period it will be rejected.
3. Understand the inclusions and exclusions of your policy. Certain illnesses are covered only as defined in the policy and not beyond the scope of coverage.
4. Always maintain a copy of hospital bills and treatment-related documents even if you are availing of a cashless treatment.

Conclusion

Cashless hospitalisation is a saviour for families dealing with critical illnesses. Since many people do not understand the concept and process of cashless hospitalisation they fail to get its benefits. Care health insurance offers a hassle-free cashless insurance claim facility through its huge network of hospitals. 

>> Also Read: Benefits of Critical Illness Health Insurance

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.