10 Best Cashless Health Insurance Plans: Benefits, Coverage & Claim Settlement Process

Considering the rising medical expenses, it is important to obtain health insurance for yourself and your family. However, to secure your finances during medical emergencies, one prefers cashless health insurance policies rather than a reimbursement plan. 

In this regard, you might want to consider the best cashless health insurance policies available in India. As there are several reputed insurance companies offering a variety of health plans, choosing the right option can seem to be a daunting task. 

To combat this issue, individuals can consider the following list of best mediclaim policies for families. 

10 Best Cashless Health Insurance Plans in India

Cashless health insurance plans	Features
Navi Health Insurance	Network hospitals: 10,000+ Processing time: 20 minutes Claim settlement ratio: 97%
Niva Bupa Health Insurance	Network hospitals: 7600+ Processing time: 30 minutes Claim settlement ratio: 89.46%
Apollo Munich Optima Restore Health Insurance	Network hospitals: 10,000+ Processing time: NA Claim settlement ratio: 91%
Care Health Plan	Network hospitals: 16,500+ Processing time: 2 hours Claim settlement ratio: 95.2%
ICICI Lombard Health Care Plus	Network hospitals: 5,000+ Processing time: NA Claim settlement ratio: 78.67%
Bajaj Allianz Health Insurance Family Floater	Network hospitals: 6,500+ Processing time: NA Claim settlement ratio: 93.68%
Reliance Cashless Health Insurance Policies	Network hospitals: 8000+ Processing time: NA Claim settlement ratio: 94%
New India Assurance Cashless Health Insurance Policies	Network hospitals: 1500+ Processing time: NA Claim settlement ratio: 92.68%
HDFC Cashless Health Insurance Policies	Network hospitals: 10,000+ Processing time: 20 minutes Claim settlement ratio: 86.52%
Aditya Birla Cashless Health Insurance Policies	Network hospitals: 8,000+ Processing time: NA Claim settlement ratio: 70.81%

Benefits of Cashless Health Insurance Plans

Protects savings in times of medical emergencies

Medical emergencies can drain your savings in case you don’t have a proper financial plan. However, if you opt for a cashless insurance policy, you need not pay anything out of your pocket for the treatment costs. Note that a cashless facility is available only when you get treatments from network hospitals. 

No urgency for the arrangement of cash

In case of medical emergencies and hospitalization, arranging funds can become difficult for some. To avoid such a situation, one can opt for a cashless health insurance policy.   

Range of coverage

These insurance policies provide coverage for pre and post hospitalization charges, ambulance costs, expenses incurred for in-patient care, health check-ups, diagnostic tests and more. 

Covers medical emergencies during travel

There might be medical emergencies when you are travelling. In such cases, you might need to part with a significant portion of your savings. However, if you obtain the best cashless health insurance plans, you can get trusted services in case of medical emergencies from any network hospital and need not pay anything for the treatment costs. 

Tax Benefits Under Cashless Health Insurance Plans in India

As per provisions of the Income Tax Act, one can seek tax deductions against the premium paid towards health insurance policies. 

The table below provides the tax benefits that one can seek for different situations: 

Section	Deduction On	Maximum Amount of Tax Deduction
Section 80D	Premiums of health insurance policies	Rs. 1,00,000
Section 80DD	Medical expenses incurred for a dependent disabled relative	Rs. 1,00,000
Section 80DDB	Medical expenses incurred for the treatment of specified diseases	Rs. 1,00,000
Section 80U	Healthcare expenses for a disabled taxpayer	Rs. 1,25,000

Tax benefits

The premium you pay for cashless health insurance plans is eligible for tax benefits as per Section 80D, Income Tax Act. One can obtain benefits up to Rs. 25,000 if they are below 60 years, and for senior citizens, the amount is Rs. 50,000 

Also Read: Family Insurance Plans: Top Reasons To Buy Mediclaim Insurance For Family In India

How Do Cashless Health Insurance Plans Work?

In order to avail of the benefits of cashless health insurance, the insured person has to notify the insurer or the Third Party Administrator (TPA). However, one must remember that insurance providers provide cashless facilities only at network hospitals. 

Follow these steps to get cashless claims at network hospitals:

Step 1: Visit a network hospital to avail of medical treatment.

Step 2: Ask for a pre-authorisation form at the hospital desk. You can also download it from the TPA website.

Step 3: Fill up the pre-authorisation form and submit it at the hospital.

Step 4: TPA will scrutinize the form and sanction the treatment amount. 

Also Read: Third Party Administrator (TPA) In Health Insurance: Roles, Functions & Importance

Things to Consider Before Buying Cashless Health Insurance Plans

Sum insured

The sum insured on your cashless health insurance plans varies across several insurance companies based on your location. For instance, the sum insured for small cities is less compared to that of metro cities. 

Claim settlement ratio

You might expect a hassle-free and seamless claim process when it comes to health insurance policies. In this regard, you might want to check the insurance company’s claim settlement ratio before choosing a plan. 

Network hospitals

You can raise a claim against your cashless health insurance policy from network hospitals. Hence, you might want to consider an insurer with a wide range of network hospitals. 

Lifetime renewability

Generally, you need to renew your health insurance policies to continue being a beneficiary, and the renewability is subject to certain restrictions. However, some of the best cashless health insurance schemes come with lifetime renewability. 

Coverage scope

You might want to ensure that your cashless health insurance policy includes essential coverage such as pre and post hospitalization charges, maternity benefits, daycare costs, etc.

Advantages of Buying Cashless Health Insurance Plans Online

Given below are the advantages of purchasing cashless health insurance policies online:

• Comparison is easy
  One can easily compare the health insurance policies of different insurers, online. After weighing the pros and cons, individuals can purchase a policy that is best suited for their requirements. 

• Easy transaction
  Now, all that one has to do to purchase a health insurance policy, is fill up a form, make the requisite payments and click a few buttons.  

• No middlemen
  Investors can undertake the processes themselves without interference from insurance agents or middlemen. This reduces cost and makes the entire process quick and hassle-free. 

• Transparent terms and conditions
  Insurance providers clearly list the terms and conditions of the policies on the official website. Investors can go through them and make informed decisions before purchasing the insurance policy online. 

• No geographical limitation
  The online purchase facility of medical insurance policies removes geographical barriers. One doesn’t have to worry about visiting the branch office of the company to buy a health insurance plan. 

• Pre and post sales services 
  Investors can avail many pre and post-sales services. They can use premium online calculators provided by insurance companies to compute their premium before the online purchase of a medical insurance policy. Live chat facilities clear doubts of investors. After the purchase, premium receipts and the soft copy of the policy bond are sent to the investor.  

Inclusions Under Best Cashless Health Insurance Plans

The inclusions of some of the best cashless health insurance policies are as follows:

• Pre and post hospitalization expenses

• Emergency ambulance cost expenses

• Organ donor expenses

• In-patient hospitalization expenses

• Domiciliary treatment expenses

• Expenses incurred for daycare procedures

• Value-added services

• No claim bonus

• Pre-existing illness 

• Critical illness cover

• Free health check-ups

• Daily hospital cash allowance

Exclusions Under Cashless Health Insurance Plans

1. Registration or admission fees
2. Toiletries
3. Attendant’s charges
4. Service fees
5. Costs of diapers, oxygen masks, syringes etc.

Factors Influencing Premium of Cashless Mediclaim Insurance Plans

Given below are the factors affecting the premium of a cashless health insurance policy: 

• Age – Young investors have to pay a lower premium compared to older people. 

• Gender – Premium rate is different for men and women. This is because it is generally believed that women tend to take more precautions and preventive measures than men. 

• Profession – Premium charges will be higher if the investor works in an environment where he/she is exposed to hazardous chemicals, dangerous substances, and radiation. 

• Body Mass Index (BMI) – The Premium is higher for people who have a high BMI, as the chances of having diabetes, cardiac problems and joint problems are high for these people. 

• Co-payment – Health insurance policies with a higher co-pay will come with a lower premium. 

• Add-on covers – Add-on covers or additional coverages are bought at an additional cost over and above the premium of the base insurance policy. 

• Family medical history – Genes play an important role in deciding the function of human bodies. Hence, the premium charged will be higher if family members suffer from specific diseases. 

• Pre-existing medical conditions – Generally, insurance providers don’t cover pre-existing diseases of an individual. However, if such diseases are covered by the insurer, the premium will be higher. 

• Lifestyle – Individuals who have the habit of drinking, smoking, and chewing tobacco have to pay higher premiums. This is because there’s every chance of them developing cancer and cardiac problems.

Eligibility Criteria for Applying for Cashless Health Insurance Plans

• Entry age – 18 to 65 years (for adults), 90 days to 25 years (for dependent children)
• Pre-medical screening – Required for individuals above the age of 45 or 55 or 65 years
• Pre-existing disease waiting period – 2 years to 4 years

Steps to File A Claim for Cashless Health Insurance Plans

If you opt for the best cashless mediclaim policy for a family in India, you usually have to follow these steps for a successful claim process:

In case of planned hospitalization, 

1. Fill up the claim form by providing necessary details about your or your family member’s hospitalization. 
2. Submit the form to the insurance company or the Third Party Administration (TPA). 
3. After approval, the insurer or TPA will notify the hospital regarding the claim amount. 
4. Finally, the insurance company settles the payment with the hospital post-treatment. 

Also Read: What Is TPA In Health Insurance? How Does It Work?

In case of emergency hospitalization, 

1. You need to intimate your insurer within 24 hours of hospitalization. 
2. Send the claim form to the respective TPA or insurer for approval. 
3. After approval, they will inform the hospital regarding the claim and settle the payment on your behalf. 

In this regard, you might want to consider the Navi Health insurance policy from the insurance company Navi as they approve claims within 20 minutes. Moreover, owing to their app-based processes, you can raise claims in a hassle-free manner. To avail of such benefits, you just have to download the Navi App and enjoy a seamless cashless facility with regard to health insurance plans. 

What Are the Documents Required for the Cashless Claim Settlement Process?

Given below is a list of all the documents required for the cashless claim settlement process:

• Duly filled out a claim form

• Diagnosis reports

• Medical certificate

• Discharge certificate

• Valid ID proof

• Copy of FIR

Reasons to Buy Cashless Health Insurance Plans from Navi 

• 10,000+ network hospitals across 400+ locations in India
• Paperless application procedure
• Cashless claims in under 20 minutes
• Subscription-based model
• Comprehensive health coverage 
• Low EMI starting from Rs. 240
• 97% claim settlement ratio

Final Word

Cashless health insurance plans allow you to avail of medical services from network hospitals without paying for the treatment costs upfront. This facility enables you to safeguard your savings and avoid financial instability. While you are in your quest for the best cashless health insurance plans in India, you might want to consider the plans in the aforementioned list. 

FAQs on Cashless Health Insurance Plans

Before you go…

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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.