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Health insurance helps people to pay for the high medical bills at hospitals for you and your family members, which in normal cases, would have to be paid by you. Although insurance penetration in India isn’t particularly significant, the recent emergence of the covid19 outbreak has led to a lot of awareness among people to take extra care of their health during the time of crisis. As latest features are being offered by health insurance policies, it is time you know and understand them before choosing to buy a health policy.
Health insurance claims are normally released by the insurer after the policyholder is hospitalized for treatment of ailment or illness. But with the introduction of domiciliary hospitalization claims, insurance companies are now approving claims for those who choose to receive treatment at home instead of a hospital.
Domiciliary Hospitalization is also known as home treatment or hospitalization at home, which means a patient opts to receive treatment for an illness or condition at home instead of getting admitted to a hospital. This kind of scenario occurs whenever the individual is not able to move around or cannot be taken into any nearest hospital when there isn’t the availability of a bed or ward. In these cases, the insured is able to claim for medical expenses to the insurance company even if there was no hospitalization.
One of the greatest advantages offered by health insurance companies through domiciliary treatment is that the policyholder who requires treatment at home is eligible to claim medical costs that are incurred during his period of treatment at home. It assists in reducing the overall treatment cost that may happen in the hospital. Before moving further, it is important to know in detail about the types of domiciliary hospitalization that are offered by Insurance companies:
In both of the scenarios mentioned above, the health insurance company shall be covering the medical expenses incurred through home hospitalization upto a certain amount. This could be an amount that is part of the insurance cover or a portion of it, based on the terms and conditions of the chosen policy.
While talking about Domiciliary Hospitalization, you must understand that not all treatments are covered by this facility. The following are the list of conditions that are not covered:
As every health insurance policy has an individual list of inclusions and exclusions, it’s best to refer them to get a clear understanding of your eligibility prior to deciding whether you should submit any claim for hospitalization that may be taken at home.
There are specific requirements that you must satisfy for you to qualify and utilize the Domiciliary Hospitalization facilities offered by a health insurance policy. While eligibility criteria may vary for each and every insurance policy, the common requirements can be explained as the following:
For a full set of guidelines that you must meet, we strongly recommend you to refer to the policy document which governs the policies on Domiciliary Hospitalization for a much better understanding.
The recent COVID-19 epidemic led to a shortfall of hospital beds, pushing many people to travel long distances to gain admission to hospitals for treatment. There are many advantages for an insurance policyholder to take advantage of domiciliary hospitalization, particularly in unforeseeable situations. A few of them are listed below:
For the successful processing of a claim for domiciliary hospitalization, the insured policyholder needs to submit these documents to the insurance company or TPA for approval. They are:
1.) A copy of the bills, receipts, diagnosis report, prescriptions, scan reports etc., these are given by the laboratory, doctor and pharmacy to treat the illness, sickness, or the onset of a disease at home.
2.) A letter of recommendation or prescription by the doctor recommending home treatment for the insured person.
3) After you have contacted the health insurance provider, forward the above information to their claim processing department or to the appropriate third-party administrator for processing of domiciliary hospitalization.
It’s hard to know the outcome of the severity of any illness or ailment before it is treated, but it is certainly possible for you to be aware and also be financially secure to have an insurance plan that provides comprehensive health coverage.
PayBima helps you in finding the right health insurance plan that includes domiciliary hospitalization from a wide range of insurance providers. You also get to shortlist policies according to your requirements, goals and premium paying capacity. Not only this, but their customer support team is also available to help you get answers to your doubts and questions related to insurance policies.
Also Read: How To Avoid Expensive Hospital Fees With A Medical Insurance Plan? | Health Insurance Glossary – A to Z Health Insurance Terms You Should Know | Health Insurance for Hypertension Patients and It’s Benefits | Also Read: Difference Between Network And Non-Network Hospitals
PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.
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