An Introduction To Cashless Mediclaim
India has made tremendous progress in medical sectors still a majority of population has not direct accessibility to such quality medical facilities as they are too expensive to afford. People really face a tough time at critical medical situation requiring a person subsequent hospitalisation. Sometimes the medical treatment drains out substantial money from the patient, making him almost broke. Had the patient insured with one of the medical insurance, he/she wouldn’t have to bear all the medical expenses. Rather, they would have been compensated by the health plan itself. Considering the very importance of health insurance policy, people, representing different social backgrounds purchase one of the medical policies to ensure their well being from unforeseen medical emergency.
One of the most striking features of health insurance plan is facility of cashless treatment. So to say, this sort of medical policy covers medical expenses such as hospitalisation, surgery, room charge, and doctor’s fees as per the term of the policy. Since the insurance company is responsible to pay these expenses, the insured person doesn’t have to pay anything in this regard. In addition, your cashless mediclaim remains effective provided that you are hospitalised at network hospital of your insurance service provider.
How cashless mediclaim work?
First of all, as mentioned above, the cashless mediclaim functions if the insured person is admitted to one of the network hospitals of insurance company. This will help you avail cashless treatment during hospitalisation thus helping you save a lot of money. The cashless treatment won’t be effective if you get admitted at a non-network hospital of your company. In that case, whatever preliminary medical expenses you incur will be born by you and not the company; however, the company will reimburse those expenses later on.
TPA (third-party administrator) is a representative of your insurance company and during any pre-hospitalisation case; you are supposed to phone or inform the TPA in this regard. It functions as intermediary between your company and the assumed hospital where you will get medical treatment. Thus the TPA facilitates claims on your behalf without requiring you do anything. Hence better inform your TPA before any pre-hospitalisation case.
Adding further, like any insurance policy, the functionality of health plan is subject to certain conditions too. Before signing up the insurance documents, better study all the terms and conditions associated with your plan. This is very crucial thing to do as more often than not, people, owing to lack of knowledge end up availing substandard health plan. In the case of cashless insurance policy, the insured person doesn’t need to pay anything to the concerned hospital regarding any medical expenses.
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