What is Mediclaim policy and how does it work?

By: GeraldOchoa

Cashless Mediclaim refers to a policy where the hospitalization and medical expenses are paid directly between the network hospital and the insurance company. The policyholder doesn’t have to pay cash. This benefit allows you to skip the reimbursement process at any network hospital.

A cashless Mediclaim policy can be used to provide the best care without having to arrange any cash. Let’s now see how it works, and what you need to know about cashless Mediclaim policies.

What is Cashless Mediclaim?

The insurance company offers the option of cashless claims when you buy a Mediclaim policy. This means that you won’t have to pay cash for any hospitalization or medical treatment at the insurance company’s network hospitals. The insurance company will handle all expenditures.

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The patient must be admitted to one of the network hospitals in order to receive cashless Mediclaim. These hospitals are able to offer cashless treatment through a partnership with insurance companies. The policy terms and conditions will allow policyholders to approve cashless claims after they have been verified.

What are the types of cashless Mediclaims in India?

India offers many different types of cashless Mediclam policies. Let’s take a look at three types of cashless insurances for India:

1* Individual Health Insurance that is Cashless

Only one person is covered by the cashless Mediclaim policy. This policy covers all medical expenses and includes all benefits of cashless hospitalization.

2* Cashless Family Health Insurance

This type of cashless Mediclaim policy covers your entire family for a low premium. A cashless Mediclaim policy is more affordable than an individual plan.

3* Cashless Senior Citizen Health Insurance

This type of cashless Mediclaim, as the name implies, offers senior citizens coverage and benefits. The policy provides cashless benefits to seniors for hospitalizations, ambulance costs and other expenses.

Exclusions from Cashless Mediclaim

When purchasing a cashless Mediclaim insurance policy for your family, be sure to read all exclusions. You will be ready for any eventuality that may arise in the future. Exclusions are situations in which you might not be eligible for a claim under the policy.

  • These are just a few of the exclusions.
  • The cashless mediclaim policy doesn’t cover self-inflicted injury, attempted suicide injuries, etc.
  • Except for accidents, any treatment or medical expenses that are incurred within the first 30 days of the policy’s start date are excluded.
  • The cashless Mediclaim policy does not cover congenital disorders.
  • Also excluded are expenses that can be traced back to the misuse or consumption of alcohol or other drugs.
  • Different cashless Mediclaim policies may have different exclusions. A claim can be rejected if it is raised for any exclusion.

Do You Need Cashless Mediclaim?

Unexpected events, such as a medical emergency can cause stress. However, it is possible to arrange finances to pay large sums of money for treatment. You can protect yourself against financial stress by using the services provided under the cashless Mediclaim policy. These are just a few of the reasons you should consider cashless Mediclaim.

1 Immediate Care

The right cashless Mediclaim policy will allow you to avoid the hassle of having to arrange cash for medical expenses. In an emergency, you will need to notify the hospital’s helpdesk and customer service within 24 hours and 48 hours if you are planning hospitalization.

2 Hassle-Free

Family members can enjoy hassle-free access to network hospitals with the cashless Mediclaim policy. All medical expenses are paid directly between the hospital and the insurance company. The process is simplified by not requiring lengthy documentation or paperwork.

3 Travel Insurance

Traveling can lead to medical emergencies, such as injury or illness. It can be difficult to arrange funds in these situations. If you have a cashless Mediclaim policy, which covers a large network of hospitals throughout the country, you can make cashless claims while you travel.

4 Tax Benefits

The income tax act of India exempts premiums for cashless Mediclaim policies for senior citizens, family members, and individuals. This policy can help you save money on taxes.

Disclaimer: Tax deductions will be subject to the tax laws in force at the time you pay premiums or receive benefits.

5 Peace of Mind

You can rest assured that the Cashless Mediclaim will provide you with peace of mind. This policy can protect you in any emergency. This policy will provide you with comprehensive benefits, including hospitalization, ambulance coverage and daily cash allowance.