Jan 6, 2018

Why Reimbursement Health Insurance is better than Cashless?


Health insurance Worldwide has a high significance  in present  days scenario. 

First let us understand difference here:

In case of Reimbursement health insurance option you will have to pay all the bills at the Hospital and later on claim it from the insurance agent (i.e. TPA) after submitting required bills and relevant list of documents; whereas in case of Cashless health insurance you will have to pay no cash at hospital and the insurance agent (TPA) settles your bills directly with the hospital. Now we know the difference here, let's understand why Reimbursement health insurance is better.

Why you should choose Reimbursement over Cashless?

In case of Emergency :

In case of emergency, you cannot take a risk of getting the insured into the nearest hospital when it’s not on network hospital list on Your Cashless health insurance. But if you are holding Reimbursement health insurance you access the nearest hospital without wasting any valuable time and saving the life of insured and can claim for reimbursement later.

Lower premium rates :

Reimbursement insurance provides an option to choose a cheaper / reasonable hospital as insured is paying the money himself at the time of treatment, and hence the premium will be lower as compared to cashless health insurance. On the other hand insurer will have to pay a higher premium in case of Cashless since the hospital with high quality treatment will have expensive offerings.

No hassle of carrying insurance documents :

For cashless health insurance, insurer need to carry the card number, TPA (Third Party Administrator) details at all times, without which cashless insurance policy is useless. If you do not have any of these details at the required time then cashless service will fail to execute, while reimbursement does not require any such details and provides flexibility.

Reliability :

In case of Reimbursement you just need to collect the required medical reports, bills Doctor’s Certification and apply to TPA once the treatment is completed and apply for reimbursement with TPA / agent and get reimbursement within a matter of days. However in case of Cashless it can get rejected at the last minute at the insurer network hospital and i.e. cannot be relied on always.

Choice of hospital :

Reimbursement provides liberty to choose any hospital of your choice whereas cashless health insurance service is offered at selected hospitals that fall in the network of the insurance agents (TPA) which can be very expensive as well.
Further to add that the reimbursement health insurance works better if you have money to pay at the time of treatment. 

Primarily what matters is getting the patient or insured to the nearest hospital on time and giving the required treatment and here the reimbursement health insurance is definitely has an advantage.


2 comments:

  1. Good thoughts however for reimbursement we should always have cash in hand how do we manage. Secondly risk is also high incase of insurance company cause any kind of issue how do we tackle same

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  2. Thanks for writing Sir.

    1. The condition of availability of cash is already mentioned in article.

    2. We can always do thorough discussion with our Insurance agent while buying an Insurance policy and in case of emergency which hospital is better, reasonable and within our reach, whether the hospital is capable enough of handling particular types of diseases / emergency services are available or not.

    With these checklist type of discussion in advance with an agent may reduce the risk of claims getting rejected.

    I hope these points made clear your queries.

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