Cashless vs reimbursement: what families should know before admission

Transcript

In cashless, the insurer pays the hospital directly.

In reimbursement, the family pays and the insurer repays later.

Here is how each works.

General information, not financial advice; your policy wording decides.

Under the insurance regulator's 2024 rules, insurers must decide cashless authorisation within one hour of the request, and give final discharge authorisation within three hours.

Check the hospital is in network, or accepts cashless.

Inform the insurer or TPA in time: forty eight hours ahead for planned care.

Then the hospital's insurance desk sends the pre-authorisation request.

Either way, some costs remain with the family.

A room above the policy limit can trigger proportionate deductions across linked charges.

Many consumables and admin charges are non-payable.

And co-payments and sub-limits apply if the policy has them.

Ask the hospital insurance desk for the reason in writing, escalate to the insurer's grievance team, and then to the Insurance Ombudsman if needed.

The full guide, with sources, is on gauravphogat.com.

The link is in the description.