Things to know about cashless mediclaim policy
Posted: Oct 05, 2013
Well, for all the health insurance benefits associated with your investment in medical health insurance, there are things to know about cashless mediclaim policy – things that would save you of unnecessary and avoidable surprises just when it matters the most.
Health Insurance Benefits: One of the obvious health insurance benefits associated with cashless mediclaim policy is that you would not have to shell out any payment at the hospital – rather, you could have the hospitalisation amounts settled from your insurance provider or TPA, which makes your visit cashless. However, there are strings attached with cashless mediclaim policy.
List of hospitals: Insurance providers that are in the business of health insurance would have tied up with a network of approved hospitals. You would have to approach only those hospitals that are in the approved network. In essence, the hospital that you approach for treatment should have tie-ups with the insurance provider. You could get a list of hospitals that are approved from your health insurance provider, which should help you with health insurance benefits from your cashless mediclaim policy.
Inform your hospital: Are you rushing to your hospital, knowing well that the hospital is in the approved list of network hospitals? Great! However, remember to inform the hospital right at the time of admission that you hold cashless mediclaim policy. And yes, you may not have to take cash along, but do remember to take your insurance card along with you.
Inform the TPA: The TPA is to be informed of an unplanned admission within 24 hours of admission. If it is a planned admission, you would be expected to inform our health insurance provider or TPA before 48 hours of the planned admission.
What else do you need? There is something called a pre-authorisation form. This needs to be filled in by the person who is insured under cashless mediclaim policy and handed over to the hospital. You do not have to worry about it any further than that, since the rest of it would be taken care of by the hospital.
Your claim needs to be approved. That, of course, is not just the last step, but is also a crucial one. Approval of your cashless mediclaim policy enables you to enjoy health insurance benefits associated with your health insurance policy. The health insurance provider would then be in touch with the hospital, advising them of the decision as well as the limits in terms of expenses to be incurred.
If you are unhappy about the services, you do have the option of health insurance portability, of course. With health insurance portability, you would not lose the continuity of your health insurance policy. However, if you follow the steps involved in cashless mediclaim policy, you should have no problems enjoying the associated health insurance benefits.
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