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Identity and membership
- Insurance e-card or policy card
- Policy number and member ID
- Government photo ID
- Employee ID for a corporate policy
- Patient and proposer contact details
Cashless · Insurance · TPA · CGHS
Good care deserves clearer paperwork.
JEWCC helps eligible patients prepare and submit cashless documentation for planned treatment. We explain the process and coordinate records; the insurer, TPA or government scheme makes the final authorisation decision.
Cashless is conditionalPolicy eligibility and final authorisation apply.
Approval has a limitOnly the sanctioned, admissible amount is cashless.
Bring originalsPhysical verification may still be requested.
The cashless journey
Five steps from policy card to final authorisation.
For a planned procedure, start early. A complete request is easier to process, while an insurer query, policy mismatch or missing investigation can delay a decision.
- 01
Share your policy
Send the policy card, member ID and proposed treatment details before the planned procedure. The team checks the insurer, TPA and applicable centre.
- 02
Clinical assessment
The doctor confirms the diagnosis, medical need and treatment plan. An estimate can then be prepared for pre-authorisation.
- 03
Pre-authorisation
The hospital or centre submits the request and supporting records. The insurer or TPA may approve, query, modify or decline it.
- 04
Treatment and updates
If approved, treatment proceeds within the authorisation conditions. A revision may be requested if the clinical plan or cost changes.
- 05
Final authorisation
At discharge, the final bill and clinical documents are submitted. The patient settles non-payable items, co-pay, deductible or any amount outside approval.
What the current IRDAI framework says
For a complete cashless request, insurers are expected to decide pre-authorisation immediately and within one hour, and final discharge authorisation within three hours of receiving the hospital request. Missing information, queries or policy issues can still affect the actual journey.
Read the IRDAI health-insurance guidance Documents checklist
Send clear copies. Carry the originals.
The exact checklist varies by policy and procedure. The treating team prepares the clinical plan and estimate; the patient or attendant should ensure membership and identity details match the policy.
02
Medical information
- Doctor’s advice or prescription
- Diagnosis and proposed procedure
- Recent test and investigation reports
- Previous treatment or operation records
- Current medicines and relevant medical history
03
Authorisation papers
- Completed and signed pre-authorisation form
- Hospital estimate and planned date
- Insurer or TPA forms requested for the policy
- Referral or permission letter where a scheme requires it
- Any query response or additional document requested
At final billing
Documents generally completed by the clinical or billing team
Final bill and break-up, discharge summary or procedure notes, prescriptions, investigation reports, pharmacy bills and—where relevant—implant or intraocular-lens sticker and invoice. Keep a copy of the approval and every document submitted.
What you may still pay
Approval and final payment are not always identical.
The insurer can approve less than the estimate or apply policy conditions. Ask for the approved amount and exclusions before treatment whenever possible.
- Co-payThe percentage the policy requires you to pay.
- DeductibleThe fixed amount payable before the policy contributes.
- Sub-limitA cap for cataract, lens, procedure, disease or room category.
- Non-payablesItems excluded under policy rules or the final authorisation.
- UpgradesThe difference for a non-approved lens, room or service choice.
Insurers and TPAs
A broad coordination network—with policy-level confirmation.
Names are separated by role: an insurer issues or underwrites the policy; a TPA may administer its health claims. Company names and panels change, so call with the exact name printed on your current card.
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Health and general insurers
Current names are used, with familiar former names where helpful.
- ACKO General Insurance
- Aditya Birla Health Insurance
- Bajaj Allianz General Insurance
- Care Health Insurance
- Cholamandalam MS General Insurance
- Generali Central Insurance (formerly Future Generali)
- Galaxy Health Insurance
- Go Digit General Insurance
- HDFC ERGO General Insurance
- ICICI Lombard General Insurance
- IFFCO Tokio General Insurance
- IndusInd General Insurance (formerly Reliance General)
- Liberty General Insurance
- Magma General Insurance (formerly Magma HDI)
- ManipalCigna Health Insurance
- Narayana Health Insurance
- National Insurance
- Navi General Insurance
- Niva Bupa Health Insurance
- The New India Assurance
- The Oriental Insurance
- Raheja QBE General Insurance
- Royal Sundaram General Insurance
- SBI General Insurance
- Shriram General Insurance
- Star Health & Allied Insurance
- Tata AIG General Insurance
- United India Insurance
- Universal Sompo General Insurance
- Zuno General Insurance
- Zurich Kotak General Insurance
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Third-party administrators
The TPA shown on your e-card may handle the authorisation.
- AKNA Health Insurance TPA
- Ericson Insurance TPA
- Family Health Plan Insurance TPA (FHPL)
- Genins India Insurance TPA
- Good Health Insurance TPA
- Health India Insurance TPA Services
- Health Insurance TPA of India
- Heritage Health Insurance TPA
- Link-K Insurance TPA
- MDIndia Health Insurance TPA
- Medi Assist Insurance TPA
- Medsave Health Insurance TPA
- Paramount Health Services & Insurance TPA
- Park Mediclaim Insurance TPA
- Safeway Insurance TPA
- Vidal Health Insurance TPA
- Volo Health Insurance TPA
Please confirm before treatment: inclusion in this directory does not guarantee cashless approval for every policy, branch, procedure or date. Network status, product conditions and authorisation must be checked for the individual patient.
Central Government Health Scheme
CGHS care needs the right beneficiary pathway.
CGHS supports eligible serving and retired Central Government beneficiaries and dependants. The route can differ according to beneficiary category, referral, whether the procedure is listed, and the facility where care is delivered.
Contact JEWCC before the planned visit with the CGHS card and referral or prescription. We can check what is needed for the proposed eye-care service; final eligibility remains subject to prevailing CGHS rules and the applicable empanelment.
Bring or send
- Valid CGHS beneficiary card or digital card
- Government photo identification
- CGHS Wellness Centre or Government specialist referral/prescription where applicable
- Previous reports and the advised procedure
- Permission for an unlisted procedure, if required
Panel expansion
More routes are being added.
JEWCC is working toward additional institutional and government-linked pathways, including GIPSA/PPN and ESIC-related processes. Details will be published only after empanelment, eligible locations and documentation requirements are confirmed.
Until then, these should not be assumed to be active cashless panels. Please call for the latest status. Cashless FAQs
Know what approval does—and does not—mean.
01Does cashless mean the entire bill is free?
No. Cashless means the approved admissible amount is settled directly by the insurer or TPA. Co-pay, deductible, non-medical items, package or sub-limit differences, upgrades and any amount outside the final authorisation remain payable by the patient.
02Is every eye procedure covered?
Coverage depends on medical necessity and the exact policy. Waiting periods, exclusions, cataract or procedure sub-limits, room-category rules and lens limits may apply. The insurer or TPA—not the hospital—makes the final coverage decision.
03How early should planned surgery documents be submitted?
Contact JEWCC as soon as surgery is advised and preferably several working days before the planned date. Queries or additional-document requests can extend the process even though complete cashless requests have regulatory turnaround expectations.
04What if pre-authorisation is declined?
A declined cashless request does not always mean the medical treatment itself is unnecessary. Ask for the reason. Depending on the policy and clinical urgency, options may include responding with more records, self-payment followed by reimbursement, changing the date or discussing another treatment plan.
05Can I use two health policies for one admission?
A policyholder may choose a primary indemnity policy. If its available cover is insufficient, the primary insurer can coordinate with another insurer subject to both policies and the applicable process. Share all active policy details early.
06Is CGHS treatment automatically cashless for every cardholder?
No. The required referral or prescription, beneficiary category, listed procedure, empanelled facility and prevailing CGHS rules must all be checked. Serving employees and pensioners may follow different payment or permission pathways.