Will going 100% cashless raise my health insurance premium?

livemint.com:

—Name withheld on request

Going 100% cashless is a very positive development taken by the regulator. This allows policyholders to avail cashless treatment across many hospitals and comes at no additional cost.

So, your premium would not increase. To avail this facility, the policyholder is required to intimate the insurer 48 hours in advance, giving it sufficient time to make arrangements with the hospital.

The network of an insurer represents the list of hospitals with pre-existing tie-ups. This allows for direct settlement between the insurer and the hospital, on an agreed tariff. An existing arrangement would also allow for faster turnaround of cashless approval. Also, the agreed tariff is generally lower than the open tariff of the hospital. The lower tariff gets passed onto the policyholder as a lower utilization of their sum assured.

The service quality of an insurer is determined by several parameters, including transparency in policy terms, claim settlement approach and process, and overall responsiveness. For instance, in a cashless claim, the manner of coordination between the hospital and insurer would define the policyholder experience. Within their existing network hospital, the turnaround time of cashless approval varies substantially across insurers. Some provide approval within 30 minutes; others take around 4 hours. The back-and-forth on insurer queries regarding treatment papers and final approval after discharge will still vary across insurers. While the regulator is putting in place a framework to ensure a minimum level of service quality experience across insurers, execution quality is likely going to vary.

—Name withheld on request

The recent changes do not affect the eligibility of an employee