Hey, if you’ve taken health insurance, the best feature is cashless treatment! This means you can get discharged from the hospital without worrying about the bill.
But how exactly does this cashless system work? Which hospitals offer it? And what happens if you go to the wrong hospital? Today, we’ll explain everything clearly, step by step. Let’s get started!
What is a Cashless Network?
Health insurance companies tie up with many hospitals. These hospitals are called network hospitals. These hospitals have an agreement with the company that they will treat patients and collect the bill directly from the insurance company. The patient doesn’t have to pay anything (or only a small amount for non-covered items). This is what a cashless claim is!
If a hospital is not in the network, it’s called a non-network hospital. There, you have to pay the money yourself first, and then claim reimbursement from the company โ that takes some time and involves more paperwork.
How to Get Cashless Treatment Step by Step?
In an emergency:
Take the patient directly to a network hospital. Show your insurance card at the admission desk and fill out the pre-authorization form. The hospital will call the company for approval.
For planned treatment (like an operation):
First, call the insurance company or submit a request through their app. They will approve it, and then you will get cashless treatment upon admission to the hospital.
The hospital will settle the bill directly with the company. You only pay for things that are not covered in the policy (like extra room charges or non-medical items).
Approval can take 2-4 hours in an emergency, and 1-2 days for planned treatment.
How to Check for Network Hospitals?
The insurance company’s app or website has a hospital locator. Enter your city, and a list will appear.
Call the helpline number โ they will tell you the nearest network hospital.
The policy document also contains a list, but the online one is the most up-to-date because the network keeps changing. Large companies like HDFC Ergo, Star Health, or ICICI Lombard have more than 10,000-15,000 network hospitals across India.
What if there is no space in a network hospital?
In an emergency, you can go to the closest non-network hospital, but you will have to claim reimbursement later. In some policies, emergency reimbursement is fast.
Advantages and Disadvantages of Cashless
Advantages:
- No need to pay from your pocket โ a great relief in emergencies.
- Less paperwork at the hospital.
- Full cover up to the approved amount.
Disadvantages:
- Full cashless facility is only available at network hospitals.
- Some hospitals may charge extra (like for consumables).
- Approval may be rejected if policy conditions are not met.
| Feature | Description |
|---|---|
| Cashless Claim | Direct settlement at network hospitals |
| Network Hospitals | 10,000+ (depends on the company) |
| Approval Time | Emergency: 2-4 hours, Planned: 1-2 days |
| Reimbursement | Pay yourself at non-network hospitals, then claim |
| Required Documents | Insurance card, ID proof, Pre-authorization form |
Pros and Cons
Pros:
- No financial worries during emergencies.
- Easy and fast paperwork.
- Most major hospitals are in the network.
- Full cover up to the approved amount.
Cons:
- Full cashless facility only at network hospitals.
- Approval may sometimes be delayed.
- You may have to pay extra charges yourself.
- Network may be limited in smaller cities.
Conclusion
The biggest advantage of cashless network health insurance is that it is very useful in emergencies! When buying a policy, be sure to check the list of network hospitals, especially in your city.
If you choose a company with a large network (like big private insurers), you will have less to worry about. If you have any doubts, ask in the comments โ which company’s insurance do you have and what is its network like? Stay safe and healthy!
