Due to a severe shortage of hospital beds and a sharp increase in the number of COVID-19 cases in India, health insurance firms are now providing policyholders with domiciliary hospitalisation coverage. Because of the massive influx of patients during the current epidemic, we decided to highlight the relevance of home treatment facilities in health insurance coverage.
When an insured person receives medical treatment at home, this is referred to as domiciliary hospitalisation. It has undoubtedly proven to be beneficial to many Covid-19 patients, since hospitals were forced to turn them away due to a lack of beds, oxygen, and medications, among other things.
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.
Check out this blog to learn more about what can be covered under a health insurance policy's domiciliary treatment facility, as well as the cost, how to file a claim, limitations, and what to avoid.
When is Domiciliary Hospitalization required?
It's required when:
Instead of hospitalisation, 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 are unable to 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 Treatment Costs will be covered?
You're probably wondering what expenses are covered by the homecare facility.
Technically, it covers all costs associated with domiciliary hospitalisation, 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 a maximum of 14 days.
Sub-limits of Domiciliary Reimbursement
Sub-limits refer 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.
For instance, if your health insurance policy covers Rs20 lakh and the coverage limit for domiciliary hospitalisation is 15% of the sum insured, the insurer's actual reimbursement will be Rs3 lakh.
Remember that cashless services are not accessible during home care treatment, but if your policy covers domiciliary hospitalisation, you can file a claim for reimbursement of your treatment costs.
How to Claim Reimbursement for Homecare Treatment?
To have a stress-free claim experience, be sure to save all of your medical documentation.
What do you need to do?
You must show proof that the treating doctor recommended ‘home treatment' and that hospitalisation was required. In the instance of COVID-19 hospitalisation, for example, many patients sought treatment at home and then made a claim for payment.
You must provide all investigative reports, which may include medical tests, prescriptions, CT scans, and other diagnostic testing. At the time of claim reimbursement, the insurer has the right to request receipts and bills for the expenses incurred.
Whether it's an online video or voice call consultation or a personal visit to the doctor, make sure that the doctor always writes a prescription. It should state whether the patient is being treated in a hospital or at home. Hence, you must ensure that you contact back to obtain a prescription for domiciliary hospitalisation.
It can be difficult to obtain receipts for medical supplies, but you should make it a priority to obtain receipts as far as possible.
However, keep in mind that home care treatment is not a standard provision included in every health insurance coverage. Also, keep in mind that policies with lower domiciliary treatment sub-limits may have cheaper premiums than policies that cover domiciliary treatment up to the total insured amount.
Takeaway
If your current health insurance policy does not cover domiciliary hospitalisation costs, you may always add the add-on benefit or migrate your old policy to a new plan while purchasing a new policy. Also, carefully consider the policy's features and benefits.
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