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Daily Hospital Cash

In the case of hospitalization, there can be a lot of unforeseen costs. While the health insurance of the insured person may cover the majority of these, some costs might be excluded from coverage. Examples of such expenses include transportation, food, and consumables. These expenses can mount up to a substantial sum that keeps rising each day you are hospitalized. With the Daily Hospital Cash feature, one can be in control in such situations. It provides the insured person with a fixed benefit for each day of hospitalization, irrespective of the actual medical cost. It provides him/her with additional protection & takes care of extra expenses.

Moreover, the daily hospital cash benefit is doubled in case of ICU admissions. This benefit is either provided as an inclusion to the basic plan or can be purchased as an additional cover with the basic health plan. It acts as a cushion to the standard health insurance policy as it helps to meet the miscellaneous expenses during the period of hospitalization. To know more about this, have a look at the following mentions.

Key Features and Benefits of Daily Hospital Cash

Daily Hospital Cash feature has come up with a sack full of benefits as it offers an additional amount of money that can be used to meet the additional expenses that a standard health insurance policy does not cover during the course of hospitalization. 

Sickness Hospital Cash:

Daily hospital cash due to sickness is provided up to the hospital cash amount for the maximum number of days chosen by the insured. 

Accident Hospital Cash:

Daily hospital cash due to accidents is provided up to 150% (depending on the insurer) of the hospital cash amount opted by the insured person for the maximum number of days chosen by the insured.

ICU Hospital Cash:

Daily hospital cash for ICU expenses due to sickness or injury is provided up to 200% (depending on the insurer) of the hospital cash amount opted by the insured person. The maximum number of hospital cash days varies between individual and floater policies.

Convalescence Hospital Cash:

In case of hospitalization beyond 5 consecutive days, a one-day additional hospital cash amount is provided as convalescence hospital cash.

Child Birth Hospital Cash:

Female insured persons are eligible to avail of daily hospital cash benefits towards childbirth after a certain waiting period from the first commencement of this policy.

Worldwide Hospital Cash:

In case of hospitalization towards illness or injury outside India, 200% of daily hospital cash amount subject to a maximum number of days chosen by the insured person is provided.

Day Care Procedures:

Expenses incurred for the specified day care treatments mentioned in the policy clause are covered up to a certain time in a policy year. 

Convalescence Expenses:

Convalescence expenses up to a certain limit depending on the insurer and the policy type will be provided by the policy to the insurer. 

Modern Treatment Methods and Advancement in Technologies:

This policy will pay the Daily cash benefit for each day of hospitalization or One day Daily Cash benefit (depending upon the nature of the procedure), up to the benefit period specified in the policy schedule, during the policy period for the specified procedures. 

How does Daily Hospital Cash work?

Daily hospital cash is a health insurance benefit that offers a lump sum allowance to the insured during the hospitalization. When hospitalised, health insurance policies, despite having exhaustive coverage do not cover some admissible expenses such as X-ray charges, surgical accessories, and daily expenses incurred by the family members of the insured or hospitalised member. Only then this benefit kicks in. This also includes money spent on food, commuting/travelling, lodging and so on.

The amount is predetermined at the time of the policy’s issuance and remains unchanged. One can view this as a defined benefit plan, as it pays a fixed sum regardless of the actual expenses. For instance, when one buys health insurance and chooses a plan with a daily cash allowance of Rs. 1,000, the insurer will pay the insured person this amount for each day he/she stays in the hospital, even if his/her actual medical expenses are Rs. 500 or Rs. 1,100 a day. Since the expenses in an ICU are higher, this allowance usually doubles or even quadruples, depending on the policy. For instance, if the daily hospital cash under your policy is INR 2,000 in a general ward, it may increase to INR 4,000 if you are admitted to an ICU. Some policies also provide a lump sum if the insured needs to undergo surgery.

The daily hospital payment allocation may occasionally be described as a proportion of the insured amount. For instance, if the health insurance policy provides a daily hospital cash benefit of 1% of the total sum insured, which is INR 3 lakhs, the daily cash benefit he/she would receive in the case of his/her hospitalisation would be INR 3,000.

What are the exclusions of Daily Hospital Cash?

A Daily Hospital Cash offers benefits and facilities to the insured person. However, it also comes with certain exclusions for which it does not provide any coverage. To understand a policy comprehensively and to avoid future complications, it is important to go through the exclusions of the policy thoroughly. Therefore, the company will not pay for any claim caused by, or arising out of any of the following:

  • Any claim if the hospitalization relates to treatment for correction of eyesight due to refractive error less than 7.5 dioptres.
  • Any claim of hospitalization for Dental treatment or other dental examination and/or tests not incidental to the treatment or diagnosis of an injury, sickness, or disease.
  • Any claim for hospitalization relating to sterility and infertility. This includes:
    • Any type of contraception, sterilization
    • Assisted Reproduction services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI
    • Gestational Surrogacy
    • Reversal of sterilization
  • Any claim for hospitalization relating to –
    • Childbirth (including complicated deliveries and cesarean sections incurred during hospitalization) except ectopic pregnancy;
    • Miscarriage (unless due to an accident) and lawful medical termination of pregnancy during the policy period.
    • Sleep disorder, Parkinson’s and Alzheimer’s disease, general debility, or exhaustion (“run-down condition”); or growth hormone therapy.
  • Venereal disease, sexually transmitted disease, or illness except for HIV/AIDS.
  • Change of Gender – Any claim relating to hospitalization of treatment, including surgical management, to change characteristics of the body to those of the opposite sex.
  • Circumcisions, unless required as a part of the treatment of an illness or injury.
  • Intentional self-injury, suicide, or attempted suicide.
  • War (whether declared or not) and war-like occurrence or invasion, acts of foreign enemies, hostilities, civil war, rebellion, revolutions, insurrections, mutiny, military or usurped power, seizure, capture, arrest, restraints, and detainment of all kinds.
  • Nuclear, chemical, or biological attack or weapons contributed to, caused by, resulting from, or from any other cause or event contributing concurrently or in any other sequence to the loss, claim, or expense.
  • Breach of Law – Any claim for hospitalization if treatment arises from or is consequent upon any insured person committing or attempting to commit a breach of law with criminal intent.
  • Treatment of alcoholism, drug or substance abuse, or any addictive condition and consequences thereof.
  • Hazardous or Adventure Sports: Any claim if the hospitalization is necessitated due to participation as a professional in hazardous or adventure sports, including but not limited to, para-jumping, rock climbing, mountaineering, rafting, motor racing, horse racing or scuba diving, hand gliding, sky diving, deep-sea diving.
  • Participation in a naval, military, air force, or law enforcement operation.
  • Any sporting risk in so far as they involve, the training or participation in competitions of professional or semi-professional sportsmen or women or riding or driving in any form of race or competition.
  • Unproven Treatments – Any claim for hospitalization relating to any unproven treatment, services, and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures, or supplies that lack significant medical documentation to support their effectiveness.
  • Investigation, Prevention & Evaluation – Any claim if admission in hospital is primarily for diagnostics, preventive and evaluation purposes which are not related or not incidental to the current diagnosis and treatment.
  • Narcotics used by the Insured Person unless taken as prescribed by a registered Medical Practitioner.
  • Any external congenital anomaly or external birth defects.

Best Daily Hospital Cash Insurance Plans in India

Almost all the popular health insurance companies have come up with Daily Hospital Cash benefits. A few of them have been mentioned below for your reference.

Name of the insurance companyAge at entryMaximum benefit payable
SBI General Insurance Company

Minimum – 18 years

Maximum – 65 years

Child – From 3 months

30 to 60 days within the policy period
Star Health Insurance Company

Adults:

Minimum – 18 years

Maximum – 65 years

Dependent children:

Minimum – 91 days

Maximum – 25 years

Basic plan – 30 to 180 days

Enhanced plan – 90 to 180 days

IFFCO TOKIO General Insurance18 yearsUp to 15, 30, 60, 90, and 180 days, depending on the plan variant.
Aditya Birla Capital Health Insurance

Minimum – 55 years

Maximum – 80 years

A daily cash allowance of between Rs. 500 to Rs. 10,000 for each day (up to 24 hours) of hospitalization.
Bajaj Allianz General Insurance

Minimum – 18 years

Maximum – 65 years

Dependent child – 6 months

Up to 180 days

What are the waiting periods for Daily Hospital Cash feature?

The followings are the general waiting periods for Daily Hospital Cash. However, it may vary from one insurer to another.

  1. Pre-existing Diseases – Any claim for hospitalization relating to a pre-existing Disease (PED) and its direct complications will be excluded until the expiry of 48 months of continuous coverage after the date of inception of the first policy with an insurer.
  1. 30-day waiting period – The general waiting period is 30 days from the first policy commencement date, except for claims arising due to an accident.
  1. Specified disease/procedure waiting period-
    1. Any claim for hospitalization relating to the treatment of the listed Conditions, surgeries/treatments shall be excluded until the expiry of 24/48 months of continuous coverage after the date of inception of the first policy with us. This exclusion shall not be applicable for claims arising due to an accident.
    1. If any of the specified diseases/procedures falls under the waiting period specified for pre-Existing diseases, then the length of the two waiting periods will apply.
    1. If the Insured Person is continuously covered without any break as defined under the applicable norms on portability stipulated by IRDAI, then the waiting period for the same would be reduced to the extent of prior coverage.

Coverage limits under the Daily Hospital Cash

Daily Cash Benefit usually range from Rs. 100 to Rs. 10,000. However, the actual amount will vary from one insurer to another. It would be highly advisable to check the hospital cash plan limit mentioned in the policy wording, or at the time of purchasing this policy as a separate plan. it can be possible that the daily hospital cash benefit is the in-built benefit in the health insurance policy. In that case, the coverage is provided on a percentage basis, that is, the percentage of the sum insured opted by the insured person. This coverage limit totally depends on the insurer. It can also be possible that the insured person has purchased the daily hospital cash benefit as a separate insurance policy added to the basic health policy to get additional coverage. In that case, the policy schedule can give a clear knowledge of the coverage limit of the policy.

Frequently Asked Questions

Generally, a daily hospital cash benefit policy is available for 15 days to 45 days. In case the insured person gets hospitalized for 10 days consecutively, then he/she can also be eligible to receive this benefit for 30 days during the policy terms. It would be recommended to go through the policy wording to find out the actual number of days for the tenure of the policy or benefit. 

The premium amount for this policy or benefit can be influenced by the level of coverage chosen and the number of family members.

The required documents are as follows:

  • Duly signed and filled out a claim form
  • The hospital bill or receipt is attached to the form
  • Policy details
  • Other documents as requested by the insurer. 

The following modern treatments are covered under the Daily Hospital Cash benefit. However, it may differ from one insurer to another.

  1. Uterine Artery Embolization and HIFU (High intensity focused ultrasound)
  2. Balloon Sinuplasty
  3. Deep Brain stimulation
  4. Oral chemotherapy
  5. Immunotherapy- Monoclonal Antibody to be given as an injection
  6. Intra vitreal injections
  7. Robotic surgeries
  8. Stereotactic radio surgeries
  9. Bronchial Thermoplastic
  10. Vaporization of the prostrate (Green laser treatment or holmium laser treatment)
  11. IONM – (Intra Operative Neuro Monitoring)
  12. Stem cell therapy: Hematopoietic stem cells for bone marrow transplant for hematological conditions to be covered.

The minimum age to buy hospital cash benefit is the same as the age limit mentioned in the base health insurance plan.

The followings are mentioned:

  • Benign ENT disorders
  • Tonsillectomy
  • Adenoidectomy
  • Mastoidectomy
  • Tympanoplasty
  • Hysterectomy
  • All internal and external benign tumors, cysts, and polyps of any kind, including benign breast lumps.
  • Benign prostate hypertrophy
  • Cataract and age-related eye ailments
  • Gastric/ Duodenal Ulcer
  • Gout and Rheumatism
  • Hernia of all types
  • Hydrocele
  • Non-Infective Arthritis
  • Piles, Fissures and Fistula in anus
  • Pilonidal sinus, Sinusitis, and related disorders
  • Prolapse inter Vertebral Disc and Spinal Diseases unless arising from the accident.
  • Calculi in the urinary system, Gall Bladder, and Bile duct, excluding malignancy.
  • Varicose Veins and Varicose Ulcers.
  • Internal Congenital Anomalies
  • Treatment for joint replacement unless arising from an accident
  • Age-related Osteoarthritis & Osteoporosis

Yes, for a Daily Hospital Cash, you are eligible for a tax benefit under Income Tax under Section 80D. 

The documents required for daily hospital cash are mentioned below:

  • Proof of admission or hospitalization along with the duration of stay.
  • Discharge summary from the hospital, for admissibility of the claim.

Owing to the fact that in an ICU, the expenses are much higher, health insurers usually double the daily cash benefit amount if the insured is admitted to an ICU. For instance, if the daily hospital cash in a regular room under your policy is Rs.1000 when admitted to an ICU, that will become Rs. 2000.

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