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Cashless vs Reimbursement Claims in Health Insurance

IamCheated.com Research Team | July 06, 2019  6:31:pm

Cashless vs Reimbursement Claims in Health Insurance

Availing health insurance plan is a very important step in financial planning. A health insurance plan makes sure your medical expenses are not paid out of pocket. As medical costs rise each day, health insurance is a must. Many people have understood the need for health insurance plan and are coming forward to avail it. 

A lot of people who avail health insurance plan don’t make a claim, as they are not aware of the process.  But, in reality, making a health insurance claim is easy if you know the steps involved. So, it is very important to understand the claim settlement process under health insurance plan. You must understand this process even before you avail a policy.

There are two types of claims in health insurance: They are cashless claim and reimbursement claim. In this blog, we discuss reimbursement and cashless claims in detail.

See Also: How not to get cheated while claiming health insurance?

Cashless vs Reimbursement Claims in Health Insurance

What is a cashless claim?

A cashless claim is the most convenient and preferred mode of making a health insurance claim. Under cashless claim, your hospital bill is directly settled by the insurance company with the hospital. In order to avail cashless claim facility, you must avail treatment at a network hospital. Network hospital is one which has a tie-up with the insurance company.  In the case of cashless claim, you don’t have the burden of paying the medical bills out of your pocket.

What is the reimbursement claim?

Under the reimbursement claim, you avail treatment, pay the hospital bills and then get them reimbursed from the insurer. After you are discharged from the hospital, you can get the expenses reimbursed by submitting all your hospital bills along with the discharge summary.

Difference between cashless claim and reimbursement claim

1. In case of cashless claims, you don’t have the burden of medical bills as they are directly settled by the hospital with the insurer. On the other hand, in case of reimbursement claim, you have to bear the hospitalization expenses and then claim the reimbursement.

2. Under the cashless claim, you have to avail treatment only at the network hospital. But, in the case of reimbursement claim, you can avail treatment at any hospital.

3. The cashless claim is settled instantly. Reimbursement claims take time.

Which one is better?

It is normally believed that the cashless claim is better as you don’t have the financial burden of bearing the hospital bills. But, in case of reimbursement, you have to bear the hospital bills first, which can be difficult and cause financial stress.  Cashless claims are hassle-free, but reimbursement is heavy on the pocket as you have to claim the reimbursement after paying the hospital bills.

See Also: How To Claim Health Insurance?

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