Under Cashless Hospitalization the patient does not settle the hospitalization expenses at the time of discharge from hospital. The settlement is done directly by the Third-Party Administrator (TPA) on behalf of the health insurer. However, prior approval is required from the TPA before the patient is admitted into the hospital. In case of emergency hospitalization, approval can be obtained post-admission. This facility is available only at the network hospitals of the TPA.
Health Insurance covers all diagnostic test like X- ray, MRI, etc., as long they are associated with the patient’s stay in the hospital for at least one night. Any diagnostic tests which have been prescribed in the OPD are generally not covered.
Naturopathy and Homeopathy treatments are not covered under a standard health policy. The coverage is available only for allopathic treatments in recognized hospitals and nursing homes.
Yes, you can cover the entire family under one policy. Your health insurance policy is in force across India. You need to verify whether there are any network hospitals (of the insurer) near to your as well as your family's place of residence. Network Hospitals are the hospitals that have tied up with the TPA(Third Party Administrator) for cashless settlement for expenses incurred there. If there are no network hospitals at the place of your residence, you could opt for reimbursement mode of settlement.
Coverage amount is the maximum amount payable in the event of a claim. It is also known as “sum insured” or SI. The premium of the policy is dependent on the coverage amount chosen by you. The sum insured, is the maximum amount that you can claim for your insurance, and is the most important criteria in your choice of insurance plan.
