Hospital Cash Benefit – All you need to know


Comprehensive health insurance policies cover most of your hospitalization costs.

Some medical expenses are not covered by the policy and are called inadmissible costs. These expenses include consumables and costs associated with accompanying family members.

What is Hospital Cash coverage?

The hospital’s daily cash plan provides a guaranteed amount of money every day that the insured is admitted to the hospital. 

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

Fixed benefit plans pay a fixed amount regardless of actual expenses. This benefit pays for incidental expenses incurred while the insured is hospitalized. 

Hospital 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?

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 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 Cash helps you to replace your regular income loss.

To be used towards household expenses and miscellaneous costs: 

If your family is the sole breadwinner, you too may have financial difficulties in the event of hospitalization. 

If your income isn’t stable, this allowance will help your family members pay household expenses and miscellaneous costs.

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 Cash Plan:

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

Standard Exclusion

  • artificial disasters such as war, invasion, and so on.
  • Surgery that enhances facial features, such as plastic and dental surgery, or surgeries for infertility and congenital disorders, is available.
  • Treatment of mental illness
  • General debility, growth hormone therapy, congenital disabilities, genetic disorders, general debility, etc.
  • Treatment for alcoholism and drug addiction through intentional self-injury
  • Hospitalization for medical examinations such as X-rays

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 Hospital: Contact your preferred network hospital 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)
  • Copy of the Hospital Registration Certificate
  • 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

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.

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.

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

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.