Domiciliary Hospitalization Related to Health Insurance

Domiciliary hospitalization is recommended in a situation where the policyholder is in such a state that he/she cannot stay in a hospital. The insured undergoes treatment at home in case the hospital room is not available. The insurer will compensate the policyholder for the medical expenses incurred during the policy term as per the advice of the doctor.

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    Paying for domiciliary hospitalization treatment can be expensive therefore having a health insurance policy is essential these days. Various health emergencies are covered under a medical insurance policy.  One of these features is the Domiciliary Hospitalization cover. If you have a medical insurance policy in place the insurer can pay off all the expenses up to the specified limit and all the medical emergencies can be taken care of without any financial worries.

    The insurer will compensate you for the medical expenses incurred during the policy term as per the written advice of the doctor. The insurer compensates a percentage of the sum insured or up to the maximum capping specified in the policy wordings.

    5 Things to Know About Domiciliary Hospitalization Cover

    • Domiciliary hospitalization cover is not provided by every health insurance provider
    • Domiciliary hospitalization is not a default coverage option and the insurer may ask you to pay an additional premium amount as per the coverage opted by you
    • Some health insurance plans cover domiciliary hospitalization expenses up to the sum insured limit and offer a restricted coverage
    • There is a waiting period criteria for domiciliary hospitalization and the illness for which domiciliary hospitalization treatment is taken
    • Some policies only cover the allopathic domiciliary treatment costs. Ayurveda or Homeopathic treatment availed at home for illness may not be covered by them
    • Corona kavach coronavirus health insurance also covers domiciliary treatment costs if the treatment is suggested by a medical practitioner. You can easily buy this health insurance online from our website.

    To avail of domiciliary hospitalization benefit, it is imperative for you to prove to the health insurance company that hospitalization is not possible and there is no other choice except for domiciliary treatment. Remember, that the insurer will only compensate the expenses upon satisfaction with the reason you gave to avail treatment at home. In case you chose yourself to not stay at the hospital and rather opt for treatment at home then you can be denied the claim.  

    4 Things to Remember when Availing Domiciliary Hospitalization Benefit

    There are certain things that you need to consider before availing of domiciliary hospitalization benefit:

    • Make sure that you go through the requirements given to check whether or not you are eligible to avail of domiciliary hospitalization benefit
    • If you think you would need to avail domiciliary hospitalization cover in the future in case of an emergency, and find a plan that covers the benefit
    • If your policy covers home treatment cost, remember to go through the policy inclusions and exclusions well in advance to avoid any last-minute regrets
    • Make sure that you furnish all the necessary information when filing a claim for domiciliary hospitalization expenses

    Here is an illustration to help you understand better:

    Let's understand it better with the help of an example -

    Rajan is a clerk and suffers from dementia. Even though Rajan is undergoing medical treatment, he finds it challenging to do the daily chores. One day while standing in the kitchen he lost his balance, fell, and broke his arm. He bumped his head and sprained his neck and fell unconscious. He was alone at home at the time of the incident and therefore the treatment and first aid got delayed causing swelling and blood clots.

    Since he was in a critical condition, the doctor said that moving him to the hospital would be too difficult, and he should undergo treatment at home. All the medical equipment’s were installed at home, and then the treatment was initiated to normalize his condition. It took around five days for his swelling to reduce, and the plaster was put in place to stabilize his arm bone.  

    Post treatment, Rajan started feeling better, and he decided to claim the expenses from his senior citizen mediclaim policy. Luckily, his medical insurance policy covered domiciliary hospitalization up to 10% of the coverage amount. For instance, Rajan had a plan of Rs 15 Lakh; his domiciliary treatment compensation will come to around Rs 1.5 Lakh. With the money, Rajan was able to avail the treatment without digging a hole into his pocket.

    Bottom-line

    Any illness or an accident does not come with prior notice, and you cannot predict them. All you can do is stay cautious and remain financially prepared. Therefore, it is sensible to invest in a health insurance policy and secure your finances. You can conveniently buy health insurance online in India in an easy manner.​

    Select the best health insurance plan​ that covers hospitalization expenses including domiciliary treatment. And choose a policy that helps you protect your savings. All you need to do is decide the policy and then purchase it online in a hassle-free and convenient manner.

    Written By: PolicyBazaar - Updated: 23 July 2021

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