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India health insurance with Cashless Hospitalization, Best cashless mediclaim policy

India health insurance with Cashless Hospitalization, Best cashless mediclaim policy

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Cashless Hospitalization is a feature/service given by the Insurance Companies in India where an active customer/policy holder can get admitted in the insurance company’s network hospitals anywhere across India and undergo the required treatment without any payment (except the policy deductible/co-payment) for medical expenditure. In other words the insured can get medical treatment at the best hospitals (in the network) anywhere in India, without paying for the same from his/her pocket.

The eligible medical expense incurred for a covered benefit will be settled directly with the hospital by the Insurance Company with the required prior approval of the TPA (Third-Party Administrator). All of insurance companies in India offer cashless hospitalization facility in their respective TPA approved hospital network. So cashless mediclaim service can be availed only in approved network hospitals of the insurers. The insurance company issues a Mediclaim Card for all insureds which needs to be produced at the hospital at the time of admission to avail of Cashless treatment.

Cashless Mediclaim or Hospitalisation can be of two types:

Planned Hospitalisation - This health insurance plan is a comprehensive plan that is specific for families with coverage available for self, spouse and upto 4 children. It is similar to individual health plans in its application but the important difference is that the Sum Insured under the policy is for all members of the family. Also the family floater health insurance has options with higher sum insured than individual health plans.
Emergency Hospitalisation - One of the principles of this plan is that all members of a family are never found to fall sick or require hospitalisation at the same time and hence, in case one of the family member gets sick and is hospitalised, the total sum insured of the policy can be utilised for treatment of the sick hospitalised member of the family.

One should note the following while availing the cashless facility:

Carry Mediclaim Card of the family member/ patient, as proof at the time of hospitalization
Inform your TPA before getting admitted or while being admitted to a hospital
Carry all previous medical records to ensure the treating doctor is aware of the patient’s medical consition
Provide detailed information to the insurer by filling claim intimation form completely and transparently

The process of cashless treatment approval is predominantly common for all insurance companies.

Some of the senior citizen plans offering Cashless Hospitalization are below :

Insurance Company + Plan Name	Eligibility Criteria / Age	Sum Insured Options	Medical Check-up
Apollo Munich Health Insurance - Optima Senior	Any person whose age is 61 years and above. No Maximum Entry Age. Lifelong Renewal	2, 3, 5 lacs	Insured will be called for a medical check-up on the basis of your age, health declaration and cover opted for.
Star Health - Senior Citizen Red Carpet Health Insurance Plan	Any person between 60 and 75 years of age at the time of entry can take this insurance policy.	1,2, 3, 4, 5, 7.5, 10, 15, 20, 25 lacs	No pre-acceptance medical test required However if following medical records of the person proposed for insurance are submitted, a discount of 10% of is allowed. - Stress Thallium Report - BP Report - Sugar (blood & urine) (Fasting / Postprandial) - Blood urea & creatinine
HDFC Ergo – Silver / Gold Plan	Any person whose age is 61 years and above. No Maximum Entry Age. Lifelong Renewal	3, 4, 5, 7.5, 10, 15 lacs	Persons opting for a policy for the first time have to undergo a detailed prescribed Pre Health check up from an empanelled doctor in HDFC Ergo Network.
Bajaj Allianz - Silver Health Plan for Senior Citizens	This policy covers members up to from 46 to 70 years of age Renewal age upto 75 years	50,000 - 5 lacs	Pre Policy Medical Check up required for this plan
Tata AIG - MediSenior Health Insurance	Insureds of the age 61 and above No Maximum Entry Age. Lifelong Renewal	1, 3, 5 lacs	PPC Required and to be done at Tata AIG Authorised centres. 50% reimbursement of cost after proposal acceptance.
New India - Senior Citizen Mediclaim Policy	60 - 80 years (renewable up to 90 years of age Lifelong Renewal	Two Options of 1, 1.50 lacs	Persons opting for a policy for the first time have to undergo prescribed Pre Health check up from an empanelled doctor. Cost of check up has to be borne by the proposer.
Religare Health – Care Senior	Individual: 61 years and above Floater: 2 Adult (Self, Spouse, Father, Mother) Entry Age Maximum : Lifelong Lifelong Renewal	3, 5, 7, 10 lacs	No Pre Policy Medical Check up

One should note the following while availing the cashless facility:

Carry Mediclaim Card of the family member/ patient, as proof at the time of hospitalization.
Inform your TPA before getting admitted or while being admitted to a hospital.
Carry all previous medical records to ensure the treating doctor is aware of the patient’s medical consition.
Provide detailed information to the insurer by filling claim intimation form completely and transparently.

The process of cashless treatment approval is predominantly common for all insurance companies. All of insurance companies in India offer cashless hospitalization facility in their respective TPA approved hospital network.