Hospital Cash

A health insurance policy covers the expenses relating to in-patient hospitalisation and other treatments as per the coverage mentioned in it. It provides compensation up to the maximum sum insured amount. However, during hospitalisation, there are certain kinds of expenses that become a big financial burden, but are not covered by the health insurance plan. These costs can be covered by taking a hospital daily cash add-on which is a fixed benefit plan frequently opted with standard health insurance plans.

A hospital daily cash add-on is an addition to the coverage of your existing health insurance policy under which, a fixed amount is paid to the policyholder each day to manage certain expenses during hospitalisation that are not covered by the base plan. The amount to be paid is ascertained at the time of issuing the policy and that does not change even if the actual daily expenses exceed that limit. The plan can be taken as a stand-alone policy or as a rider or as an additional benefit with the base plan.

What is Covered under Hospital Daily Cash Add-on?

Apart from the cost of treatment, there are various other expenses borne at the time of hospitalisation. Hospital daily cash benefit can be utilised to get coverage of the following kind:

• Cost of the syringe, scans, pharmacy bills, etc.
• Travelling expenses (to and fro from the hospital)
• Attendant expenses

Note: Coverage may vary with each insurance provider.

Features Of Hospital Daily Cash Add-on

Some of the key features of hospital cash insurance include:

1. Daily Cash Payouts

A stipulated amount of money is paid to the policyholder during the entire period of hospital stay, for a stipulated period. The period is predetermined and could vary from one insurer to another. The cash is meant for tackling the financial burden associated with hospitalization.

2. Cash Benefits on ICU Admission

If your hospital admission includes ICU admission as well, enhanced cash benefits would be awarded for that period. While some insurers offer double the benefits, others provide enhancements in payouts for the days spent in ICU as part of your hospital cash insurance plan.

3. Individual and Family Plans on Offer

Both individual and family hospital cash insurance plans are available. Consider choosing one that suits you the best. While adults are entitled to 100% of the sum assured, children are offered 50% of the sum assured.

4. Entry Age

Normally, the entry age for adults could be anywhere between 18 to about 65 years. Children should be between 2 and 21 years of age to be eligible for hospital cash insurance.

Cash Benefits: Guaranteed cash benefits are offered, subject to the fact that the claim is admissible as per the policy.

5. Policy Tenure Options

Some insurers also provide customers with a policy tenure of about two years, as well as discounts on the premiums.

Claim Process for Hospital Daily Cash Add-on

In case of planned hospitalization, inform the insurance company well in advance so as to get pre-authorization without any delay. In case of emergency hospitalization, inform the insurance company as soon as possible.

1. Cashless Claims

The authorization will be given at the time of admission for which you will have to produce your health card and/or policy document

At the time of discharge, you will be required to pay only the deductible amount and the remaining amount will be settled between the hospital and the insurance company

2. Reimbursement Claims

The process will start post-release from the hospital where you will be required to submit all the asked documents along with a claim form to the insurance company. Post-verification of documents claim amount shall be released

Documents Required for Claim Process

Following documents are needed when claiming hospital daily cash benefit:

• Claim Form (duly filled & signed)
• Health card or policy document
• Medical reports
• Hospital bills, day care summary, discharge certificate, etc.
• Prescription from certified medical practitioner
• Know Your Customer (KYC) documents (Photo ID Proof, Age Proof and Address Proof)
• Exclusions under Hospital Daily Cash

There are certain cases in which a hospital daily cash benefit is not applicable, like:

1. Pre-Existing Disease

• Hospitalization during the waiting period
• Treatment received outside India, unless stated otherwise in the policy document
• Treatment taken in Out-Patient Department (OPD)
• Treatment resulting directly or indirectly from war perils, nuclear reaction, terrorism, etc.

Note: This is not an exhaustive list and thus, coverage will vary with the insurance provider.

2. Hospital Daily Cash Renewal

Most of the separate hospital cash benefit plans come with lifelong renewability with a grace period of 30 days in which one can renew the policy if not done in the original mentioned period.

Important Aspects

Some of the important aspects of hospital daily cash as a cover or as a stand-alone policy are:

• Maximum benefit payable is limited to a period of 30-60 days
• Deductible of one day of hospitalization is levied
• If taken as a policy, make sure to renew it timely to carry on with the benefits
• There is usually a waiting period of 30 days from the date of issuance during which benefit will not be extended

Advantages of Hospital Daily Cash Add-on in Health Insurance

Here are some advantages of buying a hospital daily cash plan:

• For each completed set of 24 hours admitted in hospital
• Twice or thrice the benefit in case of ICU admission
• Hospitalization due to accidental bodily injury Convalescence Benefit – Lump sum payment for hospitalization beyond 20 days
• No pre-admission medical test required
• Tax benefits as per the rules laid out by Income Tax Act