You Need To Know: What Happens When You Choose ‘Cashless’ For Outpatient Services


62%. This figure is the out-of-pocket expenses’ share, according to a study, of healthcare costs of an individual. Medical inflation which is to the tune of 15-20% per annum bumps up the cost of medicines, health checkups, lab tests, dental consultation etc.  Outpatient services, when stockpiled over a period of time draws a major chunk of your finances. Therefore, an insurance policy with OPD cover acts as the safety net for your fortune.

It’s true that hospitalization expenses, when pitted against an outpatient service, overshadows the latter. But outpatient services, when stockpiled over a period of time draws a major chunk of your finances. Therefore, an insurance policy with OPD cover acts as the safety net for your fortune.

How Does The ‘Cashless’ Feature Work?

In the case of cashless, the insured must first approach the provider that falls under the insurer’s provider network. In other words, the insurer must have a tie-up with the provider where outpatient services are sought. When a cashless request is raised, the TPA gets the estimated cost, applies your policy’s terms and conditions, and gives you the expected cost.

Once you get the green signal, you can go ahead and avail service(s),  while the hospital sends all documents — related to your treatment — to the TPA for final settlement.    

Why Should You Choose Cashless for Outpatient Services?

As mentioned earlier, reimbursements have been around and will continue to show its presence in the years to come. Cashless, however, has recently become a favourite due to multiple benefits it has to offer. Here are 4:

  • The “Digital” Edge of Cashless

There can be times when you might have a medical emergency away from home. Medical checks, lab tests, consultations and more (as advised by the doctor) may be required; and the costs for these is something you can’t estimate, which ultimately strains your finite travel budget.

You may not have acquaintances in the unfamiliar area which adds to the strain. But you need medical attention. And you need it at the earliest. The ‘cashless’ contingency can be your way out, where you get the care you require without having to run around.

Take MediBuddy as a prime exhibit. With a few taps on the MediBuddy app, you can book health checks in 100 cities, lab tests in 58 cities, order medicines in 343 cities and more. They also possess a provider network which has over 17,000 hospitals and diagnostic centres.

  • Be Gone Financial Burden

Cashless OPD cover does handle the costs incurred from consultations, health checks, tests etc., but it also provides breathing room for families and individuals who are burdened with pharmacy-related expenses; especially those who carry chronic illnesses.

Moreover, cashless OPD cover opens the door to offers and discounts on services which actually help in conserving the sum insured. Also, some insurers offer a discount on the OPD premium upon renewal of the policy.

  • When You Get More Than You Expect

The premium for a policy with in-built — or add-on — OPD coverage may be higher but it actually offers value for money in the long run. The insured can file multiple cashless claims as long as the policy is active.

So long as we’re on the topic of the ‘extra’ you have to pay on your premium for OPD, you should know that OPD plans offer more tax benefits as compared to a basic health insurance policy. As per Section 80D of the Income Tax Act, 1961 cashless OPD claims are eligible for tax benefits.

  • And Finally, Peace of Mind

Perhaps the biggest advantage of cashless benefits is the time you get. Time to focus on the right treatment, time to recover from your ailment, and time to break away from the headaches of paying medical bills.

Cashless also enables online claims submission, tracking, document upload and settlement reconciliation. In other words, the paperless utilization of health insurance customer wait time at the medical facility.

Cashless OP cover offers much respite to an insured, even though the premium may attract an extra cost. You can get the care you want without worrying about crippling your finances or using up your savings.

Outpatient services on MediBuddy are rendered by a wide network of
hospitals, medical and diagnostic centres that you trust. The country-
wide spread of this network allows you the assurance of quality health-
care, wherever you are.

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