Covid-19: How to get home care expenses covered under your insurance policy

The covid specific policies, which were launched by all insurers last year under the direction of IRDAI, cover home treatment but your basic mediclaim policy may or may not be covering the homecare

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The lack of hospital beds is posing a concern in the country given the scale of the spread of infection. In such circumstances, many infected patients have no option but to opt for home care treatment. The Covid specific policies, which were launched by all insurers last year under the direction of IRDAI, cover home treatment but your basic mediclaim policy may or may not be covering the homecare.  Here are three things to help you understand whether your basic health insurance policy will cover home treatment:

Domiciliary hospitalisation

Home treatment gets covered by your health insurer provided domiciliary hospitalisation is an in-built cover or as an add-on cover in your policy. Domiciliary hospitalisation is when you take the treatment at home instead of the hospital. It may be required because of two reasons — either the individual cannot be moved to the hospital or when there is no hospital bed available. It is important to know that domiciliary hospitalisation does not include any type of treatment that lasts less than 72 hours.

No hospital beds available

Considering that the number of patients is far higher than the effective number of hospital beds, many people are forced to get treated at home. Having said that, the onus is on the insured that it was not possible to treat in the hospital. The insurance company will reimburse you for home treatment only when there were no hospital beds available in your area. Check with your insurer before going for home treatment so that they are aware and let you know of the required documents to be submitted for the same.

Active Line of Treatment

You need to maintain an active line of treatment with a dedicated doctor and a nurse monitoring the situation on a daily basis. “Domiciliary hospitalisation coverage needs at least 3 days of home treatment provided a continuous line of treatment is along with monitoring of the health status and daily monitoring chart duly signed by the treating doctor is maintained,” said Amit Chhabra, business head-health, PolicyBazaar.

Published: May 24, 2021, 16:53 IST
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