Benefits of the Cashless Anywhere Scheme

If you have ever had to deal with health insurance, you might be familiar with the frustration of finding out that the hospital you need to go to isn't in your insurance company's cashless network. This can lead to out-of-pocket expenses and the hassle of filing for reimbursement later on.

The "cashless anywhere" or "cashless everywhere" scheme is designed to make your life easier when it comes to getting the medical care you need.

Cashless anywhere or cashless everywhere, they're both just different ways of saying the same thing. Let's break it down, When you have health insurance, your provider usually has a list of hospitals where you can get treatment without paying upfront (cashless).

But if you need treatment at a hospital that's not on that list, you might have to pay first and then get reimbursed later.

The good news is that many insurance companies now offer a cashless anywhere scheme. This means you can get treatment at any hospital, even if it's not on the list. Instead of paying upfront and waiting for reimbursement, the insurance company will directly settle the bill with the hospital.

Benefits of the cashless anywhere scheme

1. You can receive medical treatment at any hospital of your choice, regardless of whether it's in your insurance company's network or not.

2. With cashless anywhere, you don't need to worry about paying upfront and then waiting for reimbursement. The insurance company directly settles the bill with the hospital, making the process hassle-free.

3. You have the flexibility to choose the hospital that best suits your medical needs, even if it's not on the list of network hospitals provided by your insurance company.

4. Direct settlement between the insurance company and the hospital helps reduce fraudulent claims, as the treatment can be verified more effectively.

5. The scheme offers coverage at a wide range of hospitals, with over 40,000 hospitals included in the network across India.

6. There are no extra charges for availing of the cashless anywhere scheme. Policyholders pay the same premium as usual, and claims are settled based on the policy terms and conditions.

Cashless Anywhere Scheme Eligibility criteria for hospitals

1. Hospitals must have a minimum 15 bed capacity, to be eligible for inclusion in the cashless anywhere network.

2. Hospitals need to be registered with the state health authority under the Clinical Establishment Act to ensure compliance with regulatory standards and quality of care.

3. Hospitals must not be blacklisted by the insurance company or regulatory authorities. Insurance companies often maintain a list of blacklisted hospitals due to issues such as malpractice or non-compliance with insurance guidelines.

4. Participating hospitals must agree to accept cashless payments from the insurance company for the treatment provided to policyholders under the scheme.

How you can avail of the scheme to the non-cashless network hospital?

If you need treatment at a hospital that is not on the insurer's cashless network, you must inform your insurance company 48 hours before admission (if the treatment is planned) or within 24 hours of admission (in the case of emergencies) by sending mail or by calling company's customer care department.

Are there any additional charges for the cashless anywhere scheme?

No, there are typically no additional charges for availing of the cashless anywhere scheme. Policyholders pay the same premium as they would for their regular health insurance policy. 

FAQs About Cashless Anywhere Scheme

1. What is the cashless anywhere scheme?

   • The cashless anywhere scheme is a feature offered by health insurance companies that allow policyholders to receive medical treatment at any hospital of their choice, even if the hospital is not on the insurer's network list.

2. How does the cashless anywhere scheme work?

   • If you need treatment at a hospital that is not on the insurer's cashless network, you must inform your insurance company 48 hours before admission (if the treatment is planned) or within 24 hours of admission (in the case of emergencies) by sending mail or by calling company's customer care department.

3. Is there any additional charge for availing of the cashless anywhere scheme?

   • No, there are typically no additional charges for availing of the cashless anywhere scheme. Policyholders pay the same premium as they would for their regular health insurance policy. 

4. Which hospitals are eligible for the cashless anywhere scheme?

   • Hospitals eligible for the cashless anywhere scheme must meet certain criteria, including having a minimum 15 bed capacity, registration with the state health authority under the Clinical Establishment Act, and not being blacklisted by the insurance company.