Posted by A severe lack of hospital beds was experienced by the healthcare industry during the second wave of Covid-19. Additionally, people were hesitant to receive medical care in hospitals due to anxiety over re-infection. As a result, many patients endured hospitalization while staying in their own homes, where they could receive the required care and treatment while still being safe. Hospitalization at home for an insured person is referred to as domiciliary hospitalization. Many Covid-19 patients have undoubtedly found it to be helpful given that hospitals had to turn them away because of a lack of beds, oxygen, medications, etc.
Whether you have Covid-19 or not, you or a member of your family may rarely get critically ill or injured to the point where they cannot be transported to the hospital and instead must receive care at home. You may be wondering whether and under what circumstances your health insurance will pay for the costs associated with such hospitalization.
Benefits Of Health Insurance That Cover Home Treatment
- Domiciliary Hospitalization benefit
- Home care treatment benefits
What Is The Domiciliary Hospitalization Benefit
Domiciliary hospitalization refers to medical care for illnesses or injuries that need to be treated right away at a hospital but are instead received at home due to one of the following circumstances: –
There are no beds available at hospitals in the patient’s area or the patient is very ill or injured and cannot be transported to a hospital.
Things To Keep In Mind While Evaluating The Domiciliary Hospitalization Benefits
- the amount insured for in-home care as part of the total amount assured under your health insurance policy
- the particular requirements that must be met for you to be eligible to receive the benefit of home hospitalization
- the waiting period for hospitalization at home for particular illnesses and conditions
- The steps involved in filing a claim for a home hospitalization, along with the deadlines and paperwork needed.
Some health insurance plans pay for hospitalization costs incurred at home. You’ll need to read your policy document carefully to see if domiciliary care is covered; if it isn’t, your plan won’t. However, if it is stated, the coverage will only be effective if certain requirements are satisfied.
General Conditions For Coverage Of Domiciliary Hospitalization
Here are some general terms to be aware of when purchasing health insurance in India with a domestic policy.
- There Should Be A Separate Limit For Domiciliary Hospitalization
There will be a specified limit for home hospitalization costs mentioned in your health insurance policy. Your insurance will only cover up to this amount if you ever receive home medical care. You will be responsible for covering any unexpected costs that arise.
For instance, your policy’s defined limit for domestic hospitalization costs is INR 1 lakh, and you have a health insurance plan worth INR 10 lakh. Let’s say you receive home medical care for INR 1.5 lakh. Your health insurance will only cover domestic medical expenses up to a maximum of INR 1 lakh in this situation; the remaining INR 50,000 must be paid out of pocket.
- Treatment Should Be Continued For 3 Consecutive Days
The domiciliary hospitalization charges are typically only covered by health insurance plans if you receive treatment at home for at least three consecutive days.
Certain plans don’t meet this requirement:
Liberty General, IFFCO Tokio (Family Health Protector Plan), and IFFCO Tokio (Individual Health Protector Plan) (Health Connect Plan)
- Pre And Post-Hospitalization Expenses Are Not Covered
Most health insurance policies do not always provide coverage under the “domiciliary benefit” for costs incurred before or after hospitalization at home, including tests and x-rays taken for diagnostic and observation purposes, etc.
However, some insurance plans will pay for pre- and post-hospitalization costs for treatments received at home. These are:
- Aditya Birla Health(Activ assure plan)
- Aditya Birla Health(Active sure Plan)
- HDFC Ergo(Optima Restore Plan )
- Many Treatments And Diseases May Not Be Covered
For the treatment of illnesses like diabetes, diarrhea, respiratory issues, etc., some insurance companies don’t offer domiciliary benefits. Others might choose not to cover the costs of infertility or maternity care at home. Ayurveda, Unani, Siddha, homeopathy, naturopathy, and other alternative therapies may not be covered by all insurance coverage when it comes to home hospitalization expenses.
What Is Home Care Treatment?
Home care therapies, also known as domiciliary treatments, are medical procedures done in the patient’s home to treat an illness or injury. There are no requirements that must be met under the home care treatment benefit, unlike domiciliary treatments, where you receive hospital care at home because you are too sick or injured to be transported to the hospital or because there are no beds available there.
Policies that offer home care treatment benefits:
- HDFC Ergo Optima Secure
- Max Bupa’s health reassure
- Aditya Birla Activ Health