Domiciliary Hospitalisation: Coverage and Benefits Explained
Domiciliary hospitalisation in health insurance is a benefit that may cover eligible medical treatment received at home when a patient would normally require hospital admission. Understanding domiciliary hospitalisation meaning in health insurance, domiciliary treatment coverage and home hospitalisation benefits can help policyholders know when home-based medical care may qualify for financial support. This arrangement may be necessary when a patient's condition makes hospital transfer difficult or when hospital beds are unavailable.
Depending on the policy, domiciliary hospitalisation coverage may include prescribed medicines, medical supervision and other eligible treatment expenses at home. However, this benefit is not available in every health insurance plan. Insurers may specify minimum treatment durations, eligible illnesses, expense limits and other conditions that determine whether the treatment qualifies for coverage. Certain medical conditions may also be excluded.
Before purchasing a policy, review the terms and conditions for domiciliary hospitalisation in health insurance, including eligibility requirements, exclusions and applicable limits. Understanding these provisions can help you assess whether the benefit suits your healthcare needs.
This guide explains when domiciliary hospitalisation applies, which conditions may be excluded, the expenses that may be covered and the important factors to consider when choosing a health insurance policy with this benefit.
How Health Insurance Covers Domiciliary Hospitalisation
What is Domiciliary Hospitalisation?
Domiciliary hospitalisation is a further significant benefit that a Health Insurance policy provides. Domiciliary meaning in health insurance refers to medical treatment taken at home when hospitalisation would normally be required, making it an important benefit for patients who cannot be moved or when hospital rooms are unavailable.
Domiciliary hospitalisation is covered under the following circumstances
The condition of the patient is such that he/she is not in a condition to be moved to a hospital, or
The patient takes treatment at home due to the unavailability of a hospital room.
However, remember that your insurance company will cover Domiciliary hospitalisation expenses only if the patient has an active health plan and receives treatment for 3 or more days.
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Domiciliary Hospitalisation Benefit is not available for:
The following is the list of ailments or illnesses which are not covered under Domiciliary Expenses
- Asthma
- Bronchitis
- Chronic Nephritis and Nephritic Syndrome
- Diarrhoea and all types of dysentery, including Gastro-enteritis
- Diabetes Mellitus and Insipidus, Epilepsy
- Hypertension
- Influenza
- Cough and Cold
- All Psychiatric or Psychosomatic Disorders
- Pyrexia of unknown origin for less than 10 days.
- Tonsillitis and Upper Respiratory Tract infection, including Laryngitis and Pharyngitis
- Arthritis
- Gout and Rheumatism
Domiciliary hospitalisation is available under health insurance in India. Let’s see the domiciliary hospitalisation meaning. It denotes the medical treatment given to a patient in their home; otherwise, it would have been given in a hospital.
Let’s see a domiciliary hospitalisation in health insurance example here. If a patient is surviving in a coma, at that time, moving them to their home is usually recommended by the family and the hospital.
How does Domiciliary Hospitalisation in Health Insurance work?
If your Health Insurance plan covers Domiciliary Hospitalisation, your Insurance company will cover the cost of home health care just like they would for an in-patient hospitalisation.
It is recommended to note that Domiciliary Hospitalisation is not included by default in all Health Insurance policies. Therefore, while selecting a Health Insurance plan, you must check and ensure that this feature is covered.
Also Read: Cardiac Care Insurance Policy
What are the benefits of Domiciliary Hospitalisation?
Star Health Insurance provides various Health Insurance Plans with a Domiciliary Hospitalisation feature.
Domiciliary hospitalisation in health insurance costs
Domiciliary hospitalisation in health insurance can cost based on the insurance policy and the expenses incurred.
Some domiciliary treatment lists can include the following expenses: doctor visits, prescribed medications, and nurses or therapists if needed by the treatment plan. Remember, not all health insurance plans cover the cost of these things on the Domiciliary treatment list.
Things to remember while buying domiciliary hospitalisation in health insurance
- Not all health insurance policies cover domiciliary treatment; only some can cover it
- A few expenses or sub-limits on expenses might not be covered in the insurance plan.
- Pre- and post-hospitalisation expenses are not generally covered.
- A few diseases are not covered under domiciliary hospitalisation, in the insurance plans, like diabetes, hypertension, asthma, bronchitis, tonsillitis, etc.
Also Read: What is Health Insurance
Conclusion
Choosing a plan that includes domiciliary hospitalisation in health insurance ensures that you are financially protected even when treatment happens at home instead of a hospital. Select a Health Insurance plan covering hospitalisation expenses, including Domiciliary treatment. And choose a suitable policy that helps you protect your savings.
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The claim for domiciliary hospitalisation means a request to your health insurance provider for reimbursement of medical expenses for a patient who obtained medical treatment at home. Domiciliary medical reimbursement refers to the benefit of health insurance that covers medical expenses incurred at home.
Here are the steps to file a domiciliary medical reimbursement. You could follow the steps below for that, as per your insurance plan:
- Inform the insurance company about the treatment you are getting.
- Offer the health insurance company all the necessary or relevant information, like a doctor's certification and medical records.
- After that, submit a claim form and other necessary documents, like doctor prescriptions, invoices, medication bills, and others.
Now, wait patiently for your health insurance company to verify the application and settle the claim.
Any medical expenses payable must not exceed 50% of the annual sum insured in aggregate. Also note that domiciliary hospitalisation occurs for no more than 14 days.
The domiciliary hospitalisation is not covered under the following situations: pre- and post-hospitalisation expenses; home treatment taken for less than 72 hours.
Home health care is a range of medical services or care provided to patients in the comfort of their homes. Domiciliary hospitalisation is a medical treatment in which a patient gets care at home instead of in a hospital.
This refers to treatment taken at home due to medical reasons, covered under specific conditions. For e.g. If a doctor advises home treatment because hospital beds are not available or the patient cannot be moved, such treatment may be covered under domiciliary hospitalisation, subject to policy conditions.
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The information provided on this page is for general informational purposes only. Availability and terms of health insurance plans may vary based on geographic location and other factors. Consult a licensed insurance agent or professional for specific advice. T&C Apply. For further detailed information or inquiries, feel free to reach out via email at marketing.d2c@starhealth.in
