Does my cashless admission medical card cover all my hospital expenses?

We wrote previously that the number one feature of medical plans is the cashless admission feature. This entitles you to a medical card that allows you to be admitted with your hospital expenses being paid directly by your insurer without you needing to come up with any cash.

But customers often ask me, does a medical card cover all their hospital expenses? The answer is no. There are some important exceptions where you have to pay out of your own pocket first, and then claim from the insurance company later. So here’s a guide on what cashless admission does not cover.

1. Admission to a non-panel hospital

   This is key. If you use a non-panel hospital, you will have to pay first, and then claim from your insurance company. So do make sure that you know which hospital is part of your insurance company’s panel.

   For AXA's medical policies distributed by our sister company Fi Select cover most popular hospitals but do make note of their definitive list of panel hospitals.

2. Daycare surgery

   If you are admitted to hospital to do a day surgery without staying overnight, your insurance plan might require you to pay first and claim later. But do check your insurance policy details on this, the practice might differ between different insurance companies.

3. Outpatient treatment

   Most outpatient treatment, including pre and post-hospitalisation ones, will require you to pay first and claim later. This includes emergency accident outpatient treatment, as well as outpatient kidney dialysis.

   However, for AXA's policies that we distribute, outpatient cancer treatment qualifies for cashless admission.

4. Ambulance fees

   You are likely to have to pay upfront for your ambulance fees to the hospital. If you are hospitalised after your arrival, you can claim the ambulance fees from your insurance company later.

   Further, if your condition does not require hospitalisation, you will not be able to claim the ambulance fees.

   For AXA's policies that we distribute, if you are stricken by a serious medical condition whilst overseas, do call AXA to seek their international emergency evacuation and repatriation service. If approved, the emergency evacuation services will be paid directly by AXA.

5. Home nursing

   If your medical policy has a home nursing benefit, you are likely to have to pay upfront first for your medically necessary home nursing fees. However, you can claim them back (up to your insurance company limits) afterwards.

Anything else?

Beyond whether something qualifies for cashless admission or not, please note that there are some expenses that are completely excluded, like treatments that are not medically necessary, tests or medication that are not consistent with your diagnosis (including vitamins and supplements) or additional hospital toiletry kits.

Also please note that notwithstanding your cashless admission medical card, many private hospitals might still require you to put up a deposit to be paid prior to admission as a safety net for expenses that might not be paid by your insurer, like what we outlined above.

Our sincere wishes that there will be no adverse situation that will require you to use your medical insurance. But we’ll be here to assist if you need to.

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Yours truly,
Harvin Sidhu