Cashless Vs Reimbursement Plans

Understanding the differences between cashless and reimbursement plans is crucial while buying a health insurance policy.

Health insurance policies compensate for your medical expenses either through reimburse mentor a cashless facility. If you are planning to buy a health insurance policy, understanding the difference between the two is imperative.

Cashless facility

In cashless hospitalization schemes, your insurance provider pays for your treatment directly to the hospital. You simply have to notify both the parties about your hospitalization as well as provide the details of your health insurance policy.However, the hospital should be registered with the health insurance company as a network hospital, and the disease should be covered under the health insurance policy. The verification of the illness and basic documentation is done as soon as the treatment commences.

Cashless hospitalization schemes are convenient. Your insurance provider pays for your treatment directly to the hospital.

Reimbursement plans

In a reimbursement plan, the patient can be admitted in any hospital, which may or may not be in the network hospitals list, wherein the money spent on the treatment is compensated by the insurance company at a later stage. To make a reimbursement claim, documents related to the treatment like bills, original test reports, etc.have to be produced while filing a claim. The health insurance provider then starts processing the claim and determines the amount that will be reimbursed.

To seek reimbursement from your health insurance provider, you have to submit the following documents:

  • Discharge summary
  • Hospital and pharmacy bills
  • Doctor's prescriptions
  • Diagnosis reports

Hence, policies with cashless hospitalization enable the policy holder to receive immediate medical attention without having to worry about payments and processing.However, the hospitals one can go to need to be within the network of the insurance company. In the case of reimbursement plans, one can go to any hospital, but at a later stage, the reimbursement needs to be filed for and claimed.

While both forms of health insurance policies are common today, the cashless hospitalization facility is a more convenient way to combat medical emergencies.


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