Are home treatments covered under your Health Insurance Policy?

With such a large influx of patients during the devastating COVID-19 pandemic, there was a shortage of hospital beds. People must understand the need for home treatment options provided by health insurance. Due to a sharp increase in the number of omicron variant cases in India, health insurance firms are now providing policyholders with domiciliary hospitalization coverage. Because of the massive influx of patients in the epidemic, we have decided to highlight the relevance of home treatment facilities in health insurance coverage.

When an insured person receives medical treatment at home, this is called domiciliary hospitalization. It has undoubtedly proven beneficial to many Covid-19 patients since hospitals were obligated to turn them away due to a lack of beds, oxygen, and medications, among other things. The demand for personal accident insurance has increased over the years. These pandemic sufferers had little alternative but to seek treatment at home. Because there were no beds available, several of them were left gasping for air.

When should a patient be admitted to a domiciliary hospital?

It’s required when:

  • Instead of hospitalization, your doctor recommends that you receive treatment at home.
  • If a patient is unable to obtain or does not have access to a hospital bed despite their best efforts,

Due to pre-existing diseases and co-morbidities, certain patients cannot be admitted to the hospital. Home Care reimbursement is a benefit that some health insurance plans offer as an in-built component, while others offer it as an add-on cover. Because this is not a required or standard component in medical insurance plans, the coverage provided varies from plan to plan and insurer to insurer.

What medical expenses will be covered?

You’re probably wondering what expenses are covered by the home care service. Technically, it covers all costs associated with domiciliary hospitalization, such as medical equipment, drugs, doctor’s consultation fees, and even oxygen cylinders, as in the case of Corona Kavach health insurance policies. COVID-19 home treatment is covered under this policy for 14 days.

Domiciliary Reimbursement Sub-limits

Sub-limits relate to the percentage of the total sum covered that the insurer will pay. Some health plans cover domiciliary treatment up to a particular proportion of the coverage amount, while others only offer it as an add-on benefit. If diagnosed with a severe illness such as cancer or a heart attack, the insured receives a lump sum payment (equivalent to the sum insured) under a critical illness plan. The necessary illness insurance policy provides a lump sum pay out to cover the costs of disease care and treatment and recovery prices. 

For instance, if your health insurance policy covers Rs 10 lakh and the coverage limit for domiciliary hospitalization is 15% of the sum insured, the insurer’s actual reimbursement will be Rs 1.5 lakh. Remember that cashless services are not accessible during home care treatment, but if your policy covers domiciliary hospitalization, you can file a claim to reimburse your treatment costs.

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