By News18,Sahas Mahapatra

Copyright news18

Launched in 2024, ‘Cashless Everywhere’ is a beneficial feature made available to policyholders by the General Insurance Council in consultation with Health Insurance Companies. Since being introduced, the initiative has helped policyholders and patients in urgent need of medical attention get treatment without having to pay upfront, even outside the insurer’s network of hospitals.
Until last year, the cashless facility in health insurance schemes was confined only to the set of hospitals that fell under the insurance company’s network. But, under the ‘cashless everywhere’ initiative, a policyholder can get treated in the hospital they choose and the company will have to provide the due benefits to the person.
Unlike the previous system, policyholders no longer have to pay the medical costs upfront and then apply for their reimbursements after being discharged. Regardless of whether a hospital has a tie-up with the insurance company or not, individuals can now enjoy the cashless facility under the policy acquired.
‘Cashless Everywhere’ Option Subject To Conditions
While greatly beneficial for individuals seeking immediate policy benefits and medical relief, the cashless everywhere option is subject to different conditions that health insurance policyholders must understand.
Before availing the cashless everywhere facility, a policyholder should inform the insurance company at least 48 hours before admission.
In cases of emergency, the customer must inform the insurance provider within 48 hours of their admission for treatment.
Both the claim and the cashless facility sought by the policyholder must be admissible as per the operating guidelines set by the insurance company.
In India, currently around 63 per cent of health insurance policyholders opt for the cashless facility, while the rest still pay upfront and resort to reimbursements later on.

Even though individuals are encouraged to avail the cashless everywhere facility for medical purposes, the initiative isn’t short of its roadblocks. Given that the Insurance Regulatory and Development Authority of India (IRDAI) hasn’t yet issued an official notification regarding the initiative, the cashless everywhere doesn’t fall under any regulatory purview.
Not all hospitals may easily adapt and accept the option. They could insist that patients and family members to make upfront payments before admission for treatment. The slow and reluctant implication of the cashless everywhere facility should be a concern for the General Insurance Council.