Home Health Care Services Covered Under Health Insurance

If patients are given a choice between staying in a hospital and undergoing medical procedures at home, a fair share of people would opt for the later. Not only is a hospital’s environment depressing, but the costs involved are a major concern too. But, it is important to ensure whether your insurance policy covers the costs of medical procedures carried at home and home care services.

Read More

Get ₹5 Lac Health Insurance starts @ ₹200/month*
Get ₹5 Lac Health Insurance starts @ ₹200/month*
Tax Benefitup to Rs.75,000
Save up to 12.5%* on 2 Year Payment Plans
7 Lakh+ Happy Customers

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Get insured from the comfort of your home No medicals required
I am a

My name is

My number is

By clicking on ‘View Plans’ you, agreed to our Privacy Policy and Terms of use
Close
Back
I am a

My name is

My number is

Select Age

City Living in

    Popular Cities

    Do you have an existing illness or medical history?

    This helps us find plans that cover your condition and avoid claim rejection

    Get updates on WhatsApp

    What is your existing illness?

    Select all that apply

    When did you recover from Covid-19?

    Some plans are available only after a certain time

    Before we delve any further, it is important to know that some diseases or medical conditions not covered by an insurance policy may fall under the post-hospitalization treatment, which is covered by the policy.

    Let’s understand it better with an example. Rajat Sinha was suffering from chronic backache. He was advised for physiotherapy and he opted for treatment at home. His health insurance policy did not cover the expenses of physiotherapy. However, if the physiotherapy had been advised after a surgery the same policy would have covered it, as it would have fallen under post-hospitalization treatment.

     

    Treatments Covered Under Home Health Care Service

    With the rapid developments in the world of medical sciences, follow–up treatment can be easily carried out at home. Several general insurers like Bajaj Allianz and ICICI Lombard are offering riders for home health care insurance, which covers the costs of treatments which can be carried out at home.

    Most of the services offered by home care providers are covered, provided they are prescribed by doctors or are an extension of hospitalization.

    Home Health Care Service in Insurance Can Be Categorized into the Following:

    1. Domiciliary Treatment

    It refers to treatments that need hospitalization but are carried out at home. Insurers say that they cover domiciliary treatment, if the patient is suffering from a health condition owing to which he cannot go to the hospital or rooms aren’t available in hospital to accommodate the patient.According to Religare health insurance, home health care insurance coverage can extend up to 10% of the sum insured. This indicates that if you are insured with a sum of Rs. 5 lakhs, the insurer will pay Rs. 50,000 on domiciliary treatment.

    2. Pre and Post Hospitalization

    Usually medical expenses both before and after hospitalization are covered by the insurer. However, the expenses incurred must be related to the illness which led to hospitalization. It is important to note that the period of pre and post hospitalization varies from one insurer to other. Some policies may cover home care service expenses up to 90 days before and 180 days after hospitalization, whereas some just cover 30 days before and 60 days after hospitalization.

    3. OPD and Day Care Treatments

    There are some medical procedures that can be done without hospitalization. Some common day care procedures that are covered include chemotherapy, radiotherapy and hemodialysis. Some insurers like Cigna TTK provide maintenance benefits for nursing care, diagnostic tests, consultation and physiotherapy. Additionally, ICICI Lombard also covers home care treatments that fall under the OPD category. Here, the treatments covered include consultation, physiotherapy and routine diagnostics.

    You May Like to Read: What Day Car Procedure is covered in Health Insurance?

    Home Health Care Services Covered by Insurers

    Category

    What is covered?

    Out-patient cover

    Physiotherapy, nursing, lab tests, doctor’s consultation

    Day care

    Procedures which do not require 24 hours hospitalization

    Domiciliary care (home care service)

    Disease, illness, injury which requires care at hospital, but is treated at home

    Value-added services

    Some insurers offer discount on home care services

    Benefits of Home Health Care Insurance Cover

    Both policyholders and insurers stand to gain from home care. Patients can recover better in a homely environment. The outgo is reduced for insurers which in turn results in better claims control. Additionally, if a policyholder avails treatment at home, he/she can save 10% to 30% of the total cost.

    Room rent which accounts for a chunk of the hospitalization cost is completely eliminated in such cases. But here it is important to understand that the savings depends, to a large extent, on the hospital and the medical treatment procedure.

    Points to Consider Before Opting Home Health Care Service

    Before opting for home care, there are several factors that one must carefully consider. Here are just five of the most prominent ones that you must remain vigilant about:

    • It is best to opt for home care services after consulting with the insurer.
    • Find out if the intended treatment is covered by your policy.
    • Be informed about the conditions that are excluded from your policy.
    • Take your health conditions into consideration.
    • It is crucial to find quality professionals, facilities and equipment when opting for home care.

    Disclaimer : *Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.  

    Written By: PolicyBazaar - Updated: 23 July 2021
    Search
    Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

    Health insurance articles

    Recent Articles
    Popular Articles
    Most-Important Lessons from the Covid-19 Pandemic

    23 Sep 2021

    Not very long back, the entire world was thrown aback by a...
    Does Health Insurance Cover Preventive Health Check-ups?

    22 Sep 2021

    Every object needs to be checked regularly to identify a...
    Bid Goodbye to Seasonal Diseases during the Pandemic with 7 Basic Practices

    21 Sep 2021

    Adding to the insurmountable loss of life the ongoing COVID-19...
    What is the Survival Period in Health Insurance?

    21 Sep 2021

    The prevalence of critical diseases in India has increased...
    Health Insurance for Autoimmune Diseases in India

    16 Sep 2021

    Every human body comes with an immune system to fight against...
    Best Health Insurance Plans in India 2021
    Finding the best health insurance plan from so many different health insurance companies can get confusing for many...
    Top Maternity Insurance Plans
    Maternity or pregnancy is an important phase of life, and one needs to prepare in advance to embrace parenthood...
    Top Family Health Insurance Policies in India 2021
    From the air we breathe to the food we eat; everything is intentionally or unintentionally subjected to...
    Health Insurance Claims Ratio- Things You Should Look Before Buying Health Insurance
    There has always been a doubt in customers mind about whether the private company will keep its side of the bargain...
    Best Health Insurance Plans for Senior Citizens in 2021
    Considering the increasing percentage of medical inflation in India, it has become an absolute necessity to buy...
    Close
    Download the Policybazaar app
    to manage all your insurance needs.
    INSTALL