Hospital Daily Cash: Coverage, Claim & Exclusions

A health insurance policy covers the expenses regarding hospitalisation and treatment. It provides compensation up to the maximum 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 plan, a fixed benefit plan.

What is Hospital Daily Cash Plan?

A hospital daily cash insurance plan is a part of the health insurance policy that offers extra coverage. As part of this plan, 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 an additional benefit with the base plan.

What is Covered under Hospital Daily Cash?

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

Note: Coverage may vary with each insurance provider.

Claim Process for Hospital Daily Cash

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.

Cashless claims

• 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 insurance company

Reimbursement claims

• The process will start post release from the hospital where you will be required to submit all the asked documents along with 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 hospital daily cash benefit is not applicable, viz.:

• 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.

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.

Also Know: SBI General Hospital Daily Cash – Claim & Renewal

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 Plan

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

FAQs

Q1. What is the maximum number of days for which I can get hospital daily cash benefit?

Depending on the insurance provider, this limit can range from 30 days – 180 days.

Q2. Will I get daily cash benefit for maternity and childbirth?

It depends on the insurance provider. If your health insurance plan has maternity cover, hospital daily cash may be provided.

Q3. Are there any separate hospital cash plans available?

Yes. Companies like SBI General and Aditya Birla Capital do provide stand-alone hospital cash allowance.

Q4. Do I need hospital daily cash cover separately if I have a mediclaim policy already?

If your mediclaim policy already has an inbuilt hospital daily cash cover, you can skip it. But if your policy does not provide daily cash benefit, purchasing a stand-alone cover will prove beneficial.

Q5. Will I get daily cash benefit in case of heart or kidney related treatment?

No. These treatments are usually covered under the critical illness insurance plan and thus the expenses incurred for the same are not covered under a hospital daily cash plan or cover, unless stated otherwise in the respective policy document.

Q6. Is there any age limit for buying a hospital daily cash plan?

Proposer must be of 18 years of age at least to purchase the policy. Rest of the details depend on the insurance company.

Q7. I am 52 years old. Do I need to provide medical test before applying for the hospital daily cash plan?

Yes. For people aged 45 years or more, medical screening is required.