One of the benefits that health insurance companies in India highlight while selling an insurance plan is the cashless scheme feature. Under this feature, the policyholders do not have to spend any amount of money from their pockets in case of hospitalization, since the network hospital would recover the medical expenses directly from the insurer.
But, before signing a policy documents, do not forget to check the list of network hospitals or is really convenient for you during medical emergencies, is part of the hospital’s cashless network. A few years back, public sector health insurance companies in India had stopped cashless plans citing over-billing by hospitals in case of such insurers.
While the matter has been resolved to some extent and then PSU insurance companies have again begun giving cashless facility, the list of network hospitals has drastically fall down. The biggest advantage of this feature is that hospital expenses which tend to be lower than in case where the buyer has to claim reimbursement.
The list of network hospital can change any time because it is an agreement between the hospital and the insurer. In case at any time the insurer wants to opt for a specific hospital out of its mentioned list, it can.
Remember to check policy documents in case the hospital that insured opt for is part of the company’s preferred list before purchasing cashless health insurance. But, it might happen that the network hospital was included in the list when person bought the policy but the tie-up ended by the time he or she required medical help.
Customers don’t have any option to make sure that the cashless feature with the hospital will be available in case they actually need it. Under group policies, buyer doesn’t have this choice.
Generally, in most cases, policyholder doesn’t even know the policy details like coverage amount, the list of network hospitals etc. Therefore, those who want to get treated at high-end hospitals; it is possible that the hospital may not be included in the list of network hospital offered by insurer.
In this scenario, person needs to pay his medical expenses from his own pocket and then claim the money from the insurer. But, this situation is available with a set of problems such as complicated enquiry cycle by the insurer, claim delay etc.