Cashless or reimbursement: what actually happens at the hospital counter
The route you take decides how much cash you need on the day and how long the money takes to come back.
Both routes end with the insurer paying. They differ in who pays first and how much paperwork sits with you.
Cashless
Available only at a hospital in your insurer network. The hospital insurance desk sends a pre-authorisation request to the insurer or third party administrator, who responds with an approved amount. You settle the excluded items at discharge.
- Planned admission: raise pre-authorisation 48 to 72 hours in advance
- Emergency: intimate within 24 hours of admission
- Carry the health card and a photo identity document
Reimbursement
Any hospital. You pay first and claim afterwards with original documents. Slower, but not restricted to a network, and often the only option in a smaller town.
- Discharge summary and final itemised bill with breakup
- All investigation reports and prescriptions
- Payment receipts and the bank details for settlement
- Submit inside the timeline the policy states - late submission is a common rejection
The practical answer
Check whether the hospitals you would actually use are in the network before you buy, not after. A wide network on paper matters less than the two or three hospitals near your home being on it.