Best Cashless Health Insurance Plans in India 2024: Top 5 Plans Reviewed

Cashless health insurance has become the go-to choice for many Indian policyholders in 2024, thanks to its convenience during medical emergencies and otherwise. Through cashless hospitalisation, you can receive medical treatment at network hospitals without having to pay upfront. This is because the insurer settles the bills directly with the hospital.

As the demand for cashless hospitalisation continues to grow, insurers are expanding their network of hospitals to provide policyholders with wider access and better service.

Top 5 Cashless Health Insurance Plans in India 2024

*PED WP = Pre-Existing Disease Waiting Period

NCB = No-Claim Bonus

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What is Cashless Health Insurance?

Cashless health insurance is a type of policy that allows policyholders to receive treatment at hospitals without making any upfront payment. However, the catch is that the hospital must either be in the insurer’s network or a part of the Preferred Provider Network. This is nothing but the insurer having agreements with these hospitals that enable direct claim settlement. Here's how it works:

• Network Hospitals: To avail of cashless benefits, you must choose hospitals that are part of the insurer’s network. These hospitals have pre-existing agreements with the insurer for direct billing.
• Claim Process: When you are hospitalised, you or your family must notify the insurer in advance for planned treatments or within 24 hours upon emergency admission. The insurer then authorises an amount up to which they will settle the bill in a cashless manner and directly pay the hospital. Here’s a detailed article on how to make a health insurance claim.
• Partial Cashless Settlement: If the treatment exceeds the pre-authorised amount, you must pay the difference and have the insurer reimburse you.

The primary benefit of cashless health insurance is the financial relief it provides, as you do not have to arrange funds at the time of admission. It also reduces paperwork, making the claim process faster and easier. In contrast, reimbursement claims require the policyholder to pay for medical treatment upfront and then submit bills and documents to the insurer for reimbursement. This process can be time-consuming and may involve gruelling paperwork.

Criteria for Selecting Cashless Health Insurance Plans

When selecting a cashless health insurance plan, consider the following factors:

1. Number of Network Hospitals or GIPSA-compliant Hospitals: The wider the network of hospitals, the easier it is to avail cashless services. GIPSA-compliant hospitals ensure consistent quality, cost, and seamless service.
2. Claim Settlement Ratio (CSR) and Incurred Claim Ratio (ICR): High CSR indicates that the insurer is efficient in settling claims, while a balanced ICR shows financial stability in paying claims.
3. Complaint Volume: Low complaint volume is a positive indicator of customer satisfaction and reliability of services.
4. Pre- and Post-Hospitalisation Cover: While pre-hospitalisation expenses are reimbursed, having good coverage for both pre- and post-hospitalisation ensures better financial protection. Note that while post-hospitalisation expenses may be cashless, pre-hospitalisation expenses are always on a reimbursement basis.

Top 5 Cashless Health Insurance Plans in India Reviewed

1. HDFC ERGO Optima Secure: HDFC ERGO Optima Secure is a comprehensive health insurance plan that stands out for its best-in-class features. It offers 2x the cover amount right from day one, thanks to its Secure Benefit. The policy covers 90 and 180 days of pre- and post-hospitalisation expenses respectively, and has no room rent limits or co-payments, making it an excellent choice for senior citizens. While the premium might be slightly higher than standard plans, its extensive coverage and add-ons make it worth considering for those who need a solid health insurance plan.
2. Aditya Birla Activ One Max: Aditya Birla Activ One Max offers extensive cashless coverage across India, including Preferred Provider Network (PPN) hospitals, which ensures affordable and transparent billing. The plan focuses on wellness benefits and provides a smooth claims process, making it a good option for policyholders seeking quick cashless approvals. This plan also has wellness benefits that offer discounts on renewal. Sometimes, up to 100%. As an insurer, Aditya Birla has a large network of over 11k hospitals offering cashless treatments and has a good claim settlement ratio and incurred claim ratio.
3. Care Supreme: Care Supreme offers extensive cashless coverage at more than 16k hospitals across India, making it one of the most accessible plans in terms of network reach. The insurer does not impose any loading charges, room rent restrictions or disease-specific sub-limits, ensuring you can focus on recovery without worrying about hospital charges. It also includes annual health check-ups and coverage for AYUSH treatments, which seniors may find appealing. One of its unique features is the super No-Claim Bonus (NCB), which increases the sum insured every year by 100%, up to 500%. However, Care’s slightly higher complaint volume may raise concerns for some.
4. Bajaj Allianz Health Guard Gold: Bajaj Allianz has a wide network of hospitals and offers add-ons such as coverage for critical illnesses, annual health check-ups etc. Bajaj Allianz’s strong customer support and efficient claims handling make the Health-Guard Gold plan a good choice if you’re looking for cashless coverage. However, as a plan, we feel Health Guard Gold can have better features, compared to its peers.
5. Tata AIG Medicare Premier: Tata AIG Medicare Premier is known for its reliable cashless services and a wide network of over 10k hospitals. This plan includes coverage for day-care procedures, good pre- and post-hospitalisation, and has only a 2-year waiting period for pre-existing diseases. It also provides OPD coverage up to ₹5,000 per year (varies as per the sum insured) and even dental coverage (with sub-lits that vary based on the chosen sum insured). Tata AIG’s Medicare Premier plan offers an all-round cashless insurance experience, backed by efficient customer service and strong claims support.

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How to Avail Cashless Benefits in Health Insurance at Network Hospitals?

Here’s a step-by-step guide to help policyholders avail cashless benefits during hospitalisation:

1. Choose a Network Hospital: Make sure the hospital you select is part of the insurer’s network to ensure cashless treatment.
2. Inform the Insurer: Notify the insurer about the planned hospitalisation at least 3-4 days in advance, or as soon as possible in case of an emergency.
3. Submit Pre-Authorisation Form: At the hospital, fill out a pre-authorisation form provided by the hospital’s insurance desk, which will be sent to the insurer for approval.
4. Wait for Approval: The insurer will review the form and approve the claim, usually within a few hours for emergencies or a day for planned treatments.
5. Receive Treatment: Once the claim is approved, the insurer directly settles the hospital bills, excluding non-covered expenses like consumables or personal expenses.

Tips for Choosing the Best Cashless Health Insurance Plan in 2024

To choose the best cashless health insurance plan in 2024, consider the following:

• Hospital Network: Opt for insurers with a large network of hospitals, especially GIPSA-compliant hospitals, to ensure consistent cashless services.
• Claim Approval Speed: Check the insurer’s average claim approval speed to ensure timely authorisation during emergencies.
• Take a look at the credibility metrics of the insurer: The approached health insurance provider must be credible. To ensure that the insurer will be willing to offer a seamless cashless service, you need to take a look at its Claim Settlement Ratio to ensure its claim settlement track record, Incurred Claim Ratio to analyse the company’s future financial stability and sustenance, and complaint volume to gauge the company’s seamless settlement process. So, make sure that the CSR is 90 or above, ICR is between 50 and 70, and complaint volume is as low as possible. Here’s a quick look at the CSR, ICR, and complaint volume of all the health insurance providers as per 2024 (avg of 3 years) -

• Additional Benefits: Look for plans that offer pre- and post-hospitalisation coverage, day-care procedures, and wellness benefits to enhance overall protection.

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Conclusion

Cashless health insurance is becoming a preferred option for policyholders in India due to its convenience and efficiency. Almost all health insurance plans offer cashless coverage, making them the top choices for 2024. By considering factors like network hospitals, claim settlement ratio, and overall benefits, policyholders can select the best cashless plan to suit their healthcare needs.

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