PremiumMUMBAI: Domiciliary hospitalization in health insurance policies is a situation where you are considered to be hospitalised even when you are at home. For instance, it may happen that due to severe illness or injury, you may not be able to get hospitalised, in such a case, the expenses related to the treatment taken at home are covered by your health insurance policy.
Indraneel Chatterjee, co-founder, RenewBuy Insurance said, “A person covered under a health insurance policy should ideally check whether it includes domiciliary hospitalisation, if it includes [this provision] then he/she will receive 100% insurance coverage for the same."
Premium However, you must know that the policy will cover the expenses only if the treatment lasted at least for three days, that is 72 hours. Moreover, it is also observed based on how critical the situation is, i.e., whether one can be shifted to a nursing home or hospital, or accommodation at hospitals is unavailable.
Once the following conditions are satisfied, you are considered to be in a state of hospitalisation. Hence, daily medical treatment expenses are covered by your health insurance policy.
Health insurance policies cover domiciliary hospitalization up to a certain per cent of the sum insured. It will not completely reimburse the treatment cost. For instance, if you have a health policy of ₹10 lakh and your health policy covers domiciliary hospitalisation for up to 10% of the sum insured then in such a case, your domiciliary expense compensation will come to around ₹1 lakh.
Besides, you must also know that any expenses for pre- and post-hospital treatment are not covered under domiciliary hospitalisation. Further, if the treatment lasts for less than 72 hours it will not be covered.
Importance of domiciliary hospitalization amid Covid times
Domiciliary hospitalization is a concept, where patients are treated under hospital-like care and set-up, in their house. “Due to the lack of beds and covid ICUs, critical covid-19 patients can be treated under domiciliary hospitalization. In case of domiciliary hospitalization insurance coverage, the patient receives reimbursement for Outpatient Department (OPD) treatment too; for the treatment received in the last 30-60 days (As per the timeline offered by the insurance company). This includes lab tests, doctor consultation, medication and other OPD consultations," said Chatterjee
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