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Puneinvest > Blog > health Insurance > Understanding Hospital Cash Benefit: A Complete Guide
health Insurance

Understanding Hospital Cash Benefit: A Complete Guide

Last updated: 2023/01/29 at 12:07 PM
Rajendra Todkar Published May 30, 2022
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Contents
What is Hospital Daily Cash coverage?What are the benefits of a daily cash plan?Additional expenses covered by a health insurance policy: Compensation for income loss: To be used towards household expenses and miscellaneous costs: Preserving Your No Claim Bonus: What coverage is included in the plan?Sickness Cash Benefit:Accident Cash Benefit:ICU Cash Benefit:Convalescence benefit:Exclusion under Hospital Daily Cash Plan:Standard ExclusionWaiting Period for Hospital CashWho can be insured?Things to consider before Buying Daily Hospital Cash Benefit PolicyRequire  document to buy the Daily Cash Plan?How do I claim Daily Cash Allowance?Claims Process:Reimbursement:Documents required for claim submissionConclusionFAQsWhat is the maximum amount that can be received?Is there an age limit for purchasing Hospital Cash Policy?What is the lowest cash option for hospital daily cash?What is the daily cash benefit amount?

Hospital Cash Benefit is a type of insurance coverage that provides financial support to policyholders during hospitalization. It is designed to help cover the costs of hospital stays, including room and board, as well as other out-of-pocket expenses, such as transportation and lodging for family members.

In this article, we will provide an overview of hospital daily cash plans, including their benefits, coverage, & exclusions.

What is Hospital Daily Cash coverage?

Hospital Daily Cash coverage is a type of Hospital Cash Benefit coverage that provides a daily cash benefit to policyholders who are hospitalized. This type of coverage pays a fixed amount, usually a daily or weekly amount, for each day the policyholder is hospitalized.

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The plan determines the amount that will be paid. It is set at the time you purchase the plan. 

The amount of the benefit can vary depending on the plan and the length of the hospital stay. It is designed to help cover the additional costs of hospitalization such as transportation, lodging, and other out-of-pocket expenses.

Hospital daily cash plans can reduce treatment costs because they cover certain expenses that mediclaim or health insurance do not. 

A Fixed Daily Allowance will be paid for each 24-hour hospitalization. This allowance covers miscellaneous costs incurred during hospitalization.

What are the benefits of a daily cash plan?

This payment is meant to cover additional expenses that are not typically covered by comprehensive health insurance policies, such as consumables and costs associated with accompanying family members.

Let’s look at the many benefits of a daily cash plan:

Additional expenses covered by a health insurance policy: 

While most coverage is for hospital daily expenses, some expenses are not covered. These are consumable expenses such as gloves and PPE kits.

Your daily cash allowance, which you receive once you have been admitted to the hospital, will provide you with a lump sum that you can use as you need it.

Compensation for income loss: 

Daily cash benefits to compensate for income loss due to hospitalization. You will temporarily lose your regular income. Hospital Daily Cash helps you to replace your regular income loss.

To be used towards household expenses and miscellaneous costs: 

If you are the only earner for your family, going to the hospital could put you and your family in financial trouble.

This money will assist your family members in covering household expenditures and other costs if your income is unstable.

Preserving Your No Claim Bonus: 

If you are admitted to the hospital for a minor medical condition, you can use your savings to pay your hospital bills.

For your healthcare expenses, you don’t have to file a claim. This will allow you to keep your job No Claim Bonus, which you may have lost otherwise.

What coverage is included in the plan?

The Basic Plan covers:

Sickness Cash Benefit:

The insurer will pay the daily cash benefit specified in the Policy Schedule if the insured person is hospitalized for medically necessary treatment for an illness during the policy period.

Accident Cash Benefit:

If the insured person is hospitalized for medically necessary treatment because of an injury, during the policy period, for the amount specified in the policy schedule, the insurer will pay the daily cash benefit (a benefit equal to twice the sickness HC benefits) for each continuous, completed period of 24-hours.

ICU Cash Benefit:

For every continuous and complete period of 24 hours of hospitalization, the insured person will be paid the daily cash benefit (benefit ranges between 1-3 times the daily cash benefit).

Convalescence benefit:

The insurer will pay a lump sum amount equal to the daily cash benefit. This amount is calculated from the policy schedule and ranges between 1 and 5 times the daily cash benefit amount every 24 hours. 

This benefit is only available once per insured person and per policy year.

Exclusion under Hospital Daily Cash Plan:

Pre-existing diseases will not be covered until 48 months of continued coverage.

Standard Exclusion

  • Hospitalization resulting from artificial disasters such as war or invasion
  • Surgeries that are performed for the purpose of enhancing facial features, including plastic and dental surgery, as well as surgeries for infertility and congenital disorders
  • Treatment of mental illness
  • General debility, growth hormone therapy, congenital disabilities, genetic disorders, general debility and other similar treatments
  • Treatment for alcoholism and drug addiction resulting from intentional self-injury
  • Hospitalization for medical examinations such as X-rays and other diagnostic tests

Waiting Period for Hospital Cash

This policy requires that you wait for 30 days before making a claim.

Who can be insured?

You can insure yourself, your spouse, dependent parents, and dependent children between the ages of 91 days and 65 years. The policy can be renewed for a lifetime. 

All your family members can be covered, including dependent parents, children, and spouses. The policy can be renewed for life.

Things to consider before Buying Daily Hospital Cash Benefit Policy

When you consider a daily cash benefit from the hospital, there are some things that you should be aware:

  • You must be in the hospital for at least 24 hours to receive daily cash benefits.
  • This facility does not cover Day Care Procedures.
  • In general, the policy limits how many days a patient is hospitalized.
  • Daily cash benefits under health insurance are subject to a Waiting Period.

Require  document to buy the Daily Cash Plan?

  • Proof Of Identity – Aadhaar Card (PAN Card), Passport, Driving License, or Voter ID
  • Proof Of Address Passport, Telephone Bill or Electricity Bill, Ration Card, or Bank Account Statement
  • Proof Of Age – PAN Card (Birth Certificate, Birth Certificate), Passport, Voter ID, and Driving License
  • Income Proof– Form 16 – Salary Slip, Form 16 or Employer Certificate Form
  • Check-up for medical conditions

How do I claim Daily Cash Allowance?

Claims Process:

Step 1 Check Network Hospitals: Contact your preferred network hospitals of Company.

Step 2– Patient Identification: Present Cashless Card, or provide policy number, together with valid ID Proof such as Passport, Voter ID, for verification

Step 3 Cashless Identification Request Form. The form must be completed within 48 hours of being admitted to the hospital in an emergency. The form must be received at least three days before hospitalization if you plan on hospitalization.

Step 4 Hospitalization Request Review: Insurance Company contacts the hospital network. The notification is sent to you via email or SMS.

Step 5 Claim Settlement:  Health Insurance Company will verify the documents and settle the claim.

Reimbursement:

Step 1 – Contact an Insurance Company to start a claim.

Step 2 – Submissions of claim documents.

Step 3 Verify the documents. If necessary, the insurance company might request additional documents. The insurance company will verify the authenticity of all documents before reimbursing the claim.

Documents required for claim submission

  • The hospital will fill out the Claims Form.
  • Copy of a policy or health card
  • KYC documents (Photo ID and Address Proof, Age Proof)
  • Certified Hospital Registration Copy
  • Original discharge card/day care summary/transfer summary/death summary
  • Original hospital bills, receipts, and diagnostic test reports are required.
  • Letter from physician

Conclusion

This plan supplements to your regular health insurance coverage and covers expenses not covered by the Insurance Health Policy.

On the other hand, a health insurance policy will provide you with more comprehensive coverage and benefits. It shouldn’t be impossible. To pay for extra expenses not covered by your current policy, you can add your daily cash allowance to your existing health insurance policy.

FAQs

What is the maximum amount that can be received?

The daily hospital cash benefit amount can vary from Rs. 100 to Rs. 10,000, on average. This benefit is usually included in a health insurance policy.

Is there an age limit for purchasing Hospital Cash Policy?

This policy is available to adults aged 18-65 years. You can also cover dependent children between 91 days and 25 years. 

Some insurance companies allow coverage up to 75 years old.

What is the lowest cash option for hospital daily cash?

The daily hospital cash benefit amount can vary from minimum Rs. 100 to Rs. 10,000, on average.

What is the daily cash benefit amount?

The daily cash benefit is typically between Rs 100 and Rs 10,000, but the exact amount varies depending the insurer. 

It is a good idea to review the limits of the hospital cash plan when purchasing hospital cash insurance.

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