Work out cashless claim estimate instantly with clear inputs, formula shown and shareable results.
Under cashless treatment the insurer settles the approved amount directly with the hospital and you pay the balance at discharge: non-medical items, the copayment, and anything above the pre-authorised limit unless an enhancement is approved before discharge.
Insurer's share
Insurer share = (Final bill - Non-medical expenses) x (1 - Copayment %)
Payable at discharge
You pay = Final bill - min(Insurer share, Pre-authorised amount)
Indicative estimate only. Fees, entitlements, limits and formulas vary by jurisdiction, statute, policy wording and the facts of the case. This is not legal, tax, insurance or financial advice — confirm with a qualified professional or the relevant authority.
The hospital's insurance desk must request an enhancement before discharge. Requests after discharge are usually refused and become a reimbursement claim.
Only at network hospitals, and subject to the pre-authorisation being approved. Always confirm network status before admission.