4 days ago

Cashless Health Insurance Still Leaves Policyholders With Out-of-Pocket Costs

Health insurance helps pay medical bills, but it does not always pay the whole bill.

Cashless treatment usually means the insurer pays the eligible amount directly to a network hospital.

You may still need to pay for excluded items, expensive rooms, deductibles or co-payments.

A family floater policy also has one shared amount for the whole family.

Medical treatment has become more expensive, so an old policy may no longer be large enough.

The right amount depends on your family, city, health needs and preferred hospitals.

Experts suggest checking your policy every two or three years.

A super top-up can add protection, but its rules and deductible should be understood first.

Key facts

Healthcare inflation: Average healthcare inflation was estimated at 10.8% between 2018 and 2024, including 14% in 2024.
Coverage review: Policyholders should review their health cover at least once every two to three years, or sooner after major changes in income, family size, location or medical needs.
Suggested individual cover: Rohan Goel says Rs 10 lakh can be a reasonable starting point for an individual in many cases.
Family floater: The sum insured is shared by all covered family members rather than being available separately to each person.
Insurance coverage rates: The National Statistical Office’s 80th Round survey found coverage of 47.4% of rural residents and 44.3% of urban residents.
Cashless limitations: Cashless treatment is generally available only at eligible network hospitals and does not cover expenses outside policy terms.
Possible additional protection: Super top-up policies may provide a larger financial cushion at a lower cost than substantially increasing the base policy, subject to their deductibles and conditions.

financialexpress.com · 4 days ago