Health insurance new rule Cashless Everywhere: Cashless treatment at any hospital; how to get it, charges

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ET Wealth Online explains.

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Cashless hospitalisation under health insurance: What is going to change?

Till now, a health insurance policyholder can get cashless treatment only at network hospitals with whom the insurance company has tied up. The insurance company settles medical expenses directly with the network hospital. If it is a non-network hospital, the policyholder has to pay the entire amount from his pocket and then go through the cumbersome claim reimbursement process.
The General Insurance Council in consultation with general and health insurance companies has launched "Cashless Everywhere" to extend the cashless treatment at all hospitals.

Cashless Everywhere: How to get cashless medical treatment at a non-network hospital?

Now, how to avail «Cashless Everywhere» facility at a non-empanelled hospital? There are three conditions that health insurance policyholders need to keep in mind:

1) For elective procedures, the customer should inform the insurance company at least 48 hours before the admission.
2) For emergency treatment, the customer should inform the insurance company within 48 hours of admission.
3) The claim should be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the insurance company.

Do keep in mind that the charges will be based on the rates of existing empanelled insurers.

Hospitals with 15 beds, and registered with the respective state health authorities under the Clinical Establishment Act can offer cashless hospitalisation now.

ET Wealth Online first reported about it on December 23, 2023.

Cashless Everywhere facility: How will it benefit