Alyssa Lane
With healthcare costs in India rising by 14% annually, cashless health insurance is becoming increasingly necessary. This type of insurance allows individuals to receive medical treatment at designated hospitals without paying upfront. Instead of the individual, the insurance provider directly settles the expenses with the hospital. In this paragraph, we will explore the best cashless medical insurance plans in India, each designed to cater to different needs and situations.
| Characteristics | Values |
|---|---|
| Type | There are two types of health insurance in India: reimbursement-based and cashless policies. |
| Cashless Policies | Cashless health insurance is a type of claims procedure that can be chosen instead of a reimbursement claim. |
| Reimbursement-based Policies | The insured pays for hospital expenses out of pocket and later submits bills to the insurer for reimbursement. |
| Cashless Everywhere | With the introduction of the cashless everywhere facility, policyholders can avail cashless treatment at any hospital across India, including both network and non-network hospitals. |
| Cashless Individual Health Insurance | Only a single person covered in the policy can avail of cashless treatments. |
| Cashless Family Health Insurance | The whole family of the policyholder can avail of cashless treatment under one policy. |
| Top Cashless Health Insurance Plans in India | ICICI Lombard, HDFC Ergo, Tata AIG, ManipalCigna, Acko General Insurance, Onsurity, Bajaj Allianz, Reliance, and New India Assurance. |
| Benefits | No reimbursement delays, no financial strain, immediate access to medical care, and stress-free recovery. |
| Documents Required | Health insurance card or policy details, ID proof, and doctor's prescription. |
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What You'll Learn
Cashless health insurance plans with the highest claim settlement ratios
When choosing a cashless health insurance plan, it is essential to consider the claim settlement ratio (CSR) of the insurance company. The CSR is the ratio between the number of claims resolved and the total number of claims in a financial year. A CSR of more than 85% is considered good.
Care Health Insurance
Formerly known as Religare Health Insurance, Care Health Insurance offers cashless treatment worldwide and has maintained a good claim settlement record. In the year 2021-2022, it had a 100% claim settlement ratio, the highest of any company that year.
Star Health & Allied Insurance
Star Health & Allied Insurance has a claims settlement ratio of 99.21%. They offer a variety of health insurance plans covering hospitalisation expenses, critical illnesses, medical check-ups, ambulance charges, and maternity expenses.
ICICI Lombard
ICICI Lombard has an extensive chain of 6700+ network hospitals and is renowned for its industry-best claims processing filing, healthcare services, and other insurance schemes.
HDFC Ergo
HDFC Ergo has over 1.5 crore customers and offers a 20-minute cash claim approval system. It is considered one of the best claim settlement ratios in health insurance.
National Insurance
National Insurance is a leading name in the public sector of the health insurance industry. It is one of the oldest insurers with a trusted network of customers and quick claim settlement records.
ManipalCigna
ManipalCigna offers cashless claim settlement at 8700+ network hospitals, coverage for pre and post-hospitalisation expenses, daycare procedures, and AYUSH treatment coverage.
Acko General Insurance
Acko General Insurance has a network of more than 14,500 hospitals across India, providing policyholders with the convenience of cashless hospitalisation. Their plans offer benefits like lifetime renewability, grace periods, doctor-on-call services, and critical illness cover.
It is important to note that the availability and specifics of insurance plans can vary based on location and time, so be sure to check with the insurance companies directly for the most accurate and up-to-date information.
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The cashless everywhere facility
Traditionally, cashless health insurance was limited to a network of hospitals tied up with the insurance company. However, with the introduction of the cashless everywhere facility, policyholders are no longer restricted to specific hospitals and can seek treatment at their preferred healthcare facility. This enhances convenience and accessibility to healthcare services, ensuring that individuals receive quality medical care without financial constraints.
The process of availing cashless treatment under this facility is straightforward. When hospitalized, the insured individual files a cashless claim and obtains authorization from the insurer. Upon discharge, the insurance company or its Third-Party Administrator (TPA) coordinates directly with the hospital to settle the bill. This relieves the policyholder from the burden of managing reimbursement claims and streamlines the overall medical experience.
When considering the cashless everywhere facility, it is essential to review the claim procedures, required documents, and policy terms and conditions. Understanding these aspects ensures a smooth and hassle-free experience during medical emergencies. By opting for this facility, individuals can have peace of mind knowing that their financial and medical needs are taken care of, allowing them to focus solely on their health and recovery.
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Documents required for cashless hospitalisation
Cashless health insurance in India allows policyholders to receive treatment without paying any fees beforehand. The insurance company settles the medical bills directly with the hospital. This is extremely beneficial for people, especially in emergency situations, as it saves them from the hassle of paying the hospital bill upfront.
To avail of cashless treatment, it is mandatory to inform your insurer 48 hours before planned treatment and within 24 hours for emergency hospitalisation. You must also inform the hospital during hospitalisation that you have health insurance.
The documents required for filing a cashless claim include:
- Health insurance card or policy document for verification
- Valid government-issued ID such as an Aadhar card, driving license, PAN card, passport, or voter ID
- Pre-authorisation form provided by the insurance company
- Doctor's prescription
- Admission letter
- Medical reports or prescriptions related to the current illness or injury
- Lab or imaging reports that support the diagnosis and treatment plan
- For employer-provided insurance, a letter from your employer confirming your coverage details
Some insurers may also require:
- Original bills and receipts for expenses incurred before hospitalisation, such as doctor's visits, diagnostic tests, or medicines
- Discharge summary, including diagnosis, treatment, and recommendations
- Original bills and receipts for post-hospitalisation expenses, such as follow-up consultations, medications, or rehabilitation services
- Medical certificates or reports related to post-hospitalisation care
- Reimbursement form provided by the insurance company
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Top 5 cashless health insurance plans in India
With healthcare costs in India rising by 14% annually, cashless health insurance is becoming increasingly necessary. These plans allow you to receive swift and hassle-free medical care without the financial strain of upfront payments. Here are the top 5 cashless health insurance plans in India:
- ICICI Lombard: ICICI Lombard has an extensive chain of 6700+ network hospitals and is renowned for industry-best claims processing, healthcare services, and other insurance schemes. Coverage starts from Rs. 1 Lakh up to Rs. 50 Lakh, with premiums for ICICI cashless plans being nominal.
- Onsurity: Onsurity's Super App allows quick hospital searches for cashless claims. They offer a range of plans with benefits like cashless claim settlement at 8700+ network hospitals, coverage for pre and post-hospitalization expenses, daycare procedures, and critical illness cover.
- HDFC Ergo: HDFC Ergo has a high claim settlement ratio and offers cashless treatments at network hospitals across India.
- Tata AIG: Tata AIG offers cashless claims benefits at any applicable network or non-network hospital across India. They provide benefits such as pre and post-hospitalization coverage, ambulance cover, etc.
- ManipalCigna Health Insurance: A collaboration between the Manipal Group and Cigna Corporation, ManipalCigna offers cashless claim settlement at 8700+ network hospitals, coverage for pre and post-hospitalization expenses, daycare procedures, and AYUSH treatment coverage.
When choosing a cashless health insurance plan, it is important to consider the network hospitals available, the coverage options, and the claim procedures outlined in the policy.
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Additional features to look for in a cashless health insurance policy
When considering a cashless health insurance policy in India, it is important to look beyond the basic features and consider additional benefits to ensure comprehensive coverage. Here are some key additional features to look for when choosing a cashless health insurance policy:
Coverage and Benefits:
When selecting a policy, check the specific medical expenses covered. Basic policies may cover hospitalisation and doctor's fees, but comprehensive plans may also include medicines, outpatient treatments, consultations, diagnostic tests, and critical illnesses like cancer or heart disease.
Network Hospitals:
Ensure the policy provides access to a vast network of hospitals across India where you can avail of cashless treatments. A wider network of hospitals means easier access to cashless facilities when needed, especially in emergency situations. Some reputable insurers with extensive hospital networks include ICICI Lombard, HDFC Ergo, and New India Assurance.
Claim Process:
Understand the cashless claim process and opt for policies with a simple, quick, and convenient settlement process. Check the insurer's claim settlement ratio, which indicates how efficiently they handle and approve claims. Also, be mindful of waiting periods specified in the policy, as claims made within these periods may not be honoured.
Pre-existing Conditions:
Verify if the policy covers pre-existing illnesses and understand the applicable waiting period. Longer waiting periods may not be advantageous, so choose wisely based on your specific health needs.
Premium and Cost:
Compare premiums for similar coverage across different insurers to get the best value. Additionally, consider the overall cost implications, including out-of-pocket expenses that may be required during treatment.
Additional Financial Support:
Look for policies that offer financial protection during critical health events and provide additional financial support beyond the initial sum insured. This can be crucial in mitigating financial strain during medical emergencies.
Remember to conduct thorough research, compare features and benefits, and customise the plan to suit your specific needs and requirements.
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Frequently asked questions
Cashless health insurance is a type of medical insurance where policyholders can receive treatment at designated hospitals without paying any fees. The insurer settles the amount directly with the hospital.
In India, cashless mediclaim policies offer financial relief during medical emergencies. The insurance provider directly settles the expenses with the hospital as long as they are on their list of providers. The insured does not have to pay upfront for the treatment obtained.
Cashless health insurance provides cashless hospitalization facilities to the insured without the hassle of managing cash or dealing with reimbursement hassles. It also provides immediate access to medical care without worrying about immediate funds.
Some of the best cashless health insurance plans in India include ICICI Lombard, HDFC Ergo, New India Assurance, Onsurity, Bajaj Allianz, Reliance, Tata AIG, and Acko General Insurance.
