Health Insurance
Domiciliary Hospitalization In Health Insurance

As We all know, the importance of health in our life. And this corona period has taught us the value of health and the importance of health insurance. We all have heard this adage, "Health is wealth…

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As We all know, the importance of health in our life. And this corona period has taught us the value of health and the importance of health insurance. We all have heard this adage, "Health is wealth", but are we taking this slogan as a priceless life lesson? What if you or your loved ones face an unexpected medical emergency and you cannot find a hospital bed at this critical moment. Also, you don't have enough money to pay for the necessary treatment? Isn't this a scary thought?

That's where health insurance comes into play. A health insurance policy provides various benefits that provide peace of mind in a medical emergency. A health plan covers hospitalization costs, daycare treatment, AYUSH treatment benefits, organ donor expenses, and mental health care. Another significant benefit that a health insurance plan offers is domiciliary hospitalization treatment.

Domiciliary Hospitalization meaning

Domiciliary hospitalization or Home hospitalization is one of the most important features of health insurance. It allows policyholders to get treatment at home if they are unable to reach the hospital or find medical facilities for a specific treatment. This usually happens when a policyholder is unable to visit the hospital due to their medical condition or when beds are not available in hospitals. But there are some situations when the doctor advises the patient to take domiciliary treatment. In such cases, the health insurance companies will bear the total medical expenses of the policyholder's treatment.

Available coverage type under Domiciliary Hospitalization

There are 2 types of coverage offered under domiciliary hospitalization by health insurance companies. Customers should know about these coverage types before buying a health insurance plan in India:

  • Offered as a coverage benefit in your health plan: Domiciliary hospitalization is offered as a coverage benefit in the health insurance plan by various health insurance companies.
  • Offered as an add-on rider: Some insurance companies offered domiciliary hospitalization as an add-on rider at some additional premium.

Eligibility Criteria for Domiciliary Hospitalization

Below-mentioned are the conditions that you need to fulfill to get the benefits of domiciliary hospitalization:

  • The treatment should last equal to or more than 3 days.
  • The treatment should be related to diseases, injuries, and illnesses that generally require hospitalization.
  • The patient should have an ongoing active health insurance policy.

Benefits of Domiciliary Hospitalization

Domiciliary Hospitalization offers various benefits to the policyholders. Read below to understand the benefits of domiciliary hospitalization in detail.

  • Timely Treatment: Domiciliary hospitalization can be very beneficial when there is a lack of medical amenities for the patient because due to domiciliary hospitalization, patients can take medical treatment at their homes in case of medical emergencies. For example: As we all know, during the second wave of covid-19, India was facing a massive shortage of hospital beds and medical equipment, and patients were not getting timely medical attention. In such situations, home hospitalization can be very beneficial as it allows the policyholders to get timely medical treatment at home and reimburse the total expenses from the health insurance company.
  • Offers Flexibility: Domiciliary hospitalization provides flexibility to receive treatment when the patient is unable to go to the hospital because of his medical condition. In such conditions, domiciliary hospitalization can be life-saving for them. For Instance: Rakesh has suffered severe injuries and his health condition has made it impossible to admit him to the hospital. This is where Domiciliary Hospitalization comes into play, as it will help Rakesh get timely medical treatment at his home so that his health does not deteriorate further.
  • Boon for Senior Citizen or Physical Challenged: Domiciliary treatment can be very beneficial for senior citizens or physically challenged people as they can't visit the hospital frequently. Domiciliary hospitalization is such a boon for them as it allows them to get treated at their home.

What is not Covered under Domiciliary Hospitalization?

Various things like pre and post-hospitalization in domiciliary hospitalization are not covered. Apart from it, the below-mentioned are the following treatment for diseases that are not covered under domiciliary hospitalization:

 

Diseases Not Covered under Home Hospitalization

Epilepsy 

Cough, cold, or influenza

Asthma

Hypertension

Bronchitis

Diabetes Mellitus or Insipidus

Arthritis, Gout, or Rheumatism

Chronic Nephritis

Diarrhea, dysentery & gastro-enteritis

Pyrexia of unknown origin 

Pharyngitis

Psychiatric or Psychosomatic Disorders

Laryngitis

Tonsillitis and Upper Respiratory Tract Infection

Domiciliary Hospitalization Claim Process

You can file a reimbursement claim for domiciliary hospitalization, which means you must first pay your bills before filing a claim for the expenses incurred during treatment.

  • Intimate the Insurer
  1. Intimate the insurer before going for domiciliary hospitalization.
  2. File a reimbursement claim within 2 weeks after the treatment.
  • Duly Signed Documents
  1. Submit all the required documents for claim approval
  2. The insurance company will verify the documents
  3. After the verification is complete, the insurance companies start processing your reimbursement claim.

Required Documents for Reimbursement Claim

Below mentioned are the list of documents that are required to submit to the health insurance companies to file a reimbursement claim:

  • Xerox copy of PAN and Aadhaar Card
  • Original documents of Cash receipts and reports 
  • Discharge Summary in original
  • Other documents related to the treatment

Conclusion

Domiciliary hospitalization is an excellent feature of health insurance as it covers a wide range of treatments, except the ones mentioned above. It is very beneficial for the policyholders, and it provides the right medical aid at home during medical emergencies. So, Always buy a comprehensive health insurance plan that covers all your medical insurance needs in a sudden medical emergency. Choose Well and Stay Healthy.

Disclaimer: The information published in this article is for the reader′s reference only. The content of this information is to provide an overview of your health insurance needs and should not be relied upon for personal, medical, legal, or financial decisions; you should consult an appropriate professional for specific advice. The Company makes no representations about the suitability, reliability, timeliness, and accuracy of the information, services, or any other items mentioned on this subject for any purpose whatsoever.

*Standard Plans Terms and Conditions apply.

 

Frequently Asked Questions (FAQs)

Question 1:- Is the cost of hiring a nurse covered under domiciliary hospitalization?

Answer:- Yes. The total cost of home hospitalization including the cost of hiring nurses is covered under domiciliary hospitalization.

Question 2:- Do I have to wait to take the benefit of domiciliary hospitalization?

Answer:- No. There is no waiting period for domiciliary hospitalization.

Question 3:- Are the AYUSH treatments covered under domiciliary hospitalization?

Answer:- No, alternative treatments such as AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy are not covered under domiciliary hospitalization.

Question 4:- Is the cost of ICU beds covered under domiciliary hospitalization?

Answer:- yes, the cost of ICU beds is covered under domiciliary hospitalization.

Question 5:- Is the cost of medicine covered under domiciliary hospitalization?

Answer:- Yes, the cost of medicines is also covered under domiciliary hospitalization.