Covid-19 treatment at home: Know all about insurance claims

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Domiciliary hospitalisation, also known as home 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. The Covid-19 pandemic has exposed the wobbly health infrastructure and since getting a hospital bed is a nightmare, domiciliary hospitalisation can help you overcome the treatment-related problems.

Under domiciliary hospitalisation, medical expenses are covered by your health insurer provided it is an in-built cover in your policy or if you have opted for it as an add-on cover. Domiciliary hospitalisation, however, does not include any type of treatment that lasts less than 72 hours.

“Domiciliary hospitalisation coverage needs at least 3 days of home treatment provided a continuous line of treatment 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.

Fine print

Another fine print is the coverage under ‘Upper Respiratory Tract Infection’ as many policies have it as an exclusion in their policy.

“A few insurers are covering domiciliary hospitalisation for covid-treatment. But there are certain exclusions such as Upper Respiratory Tract Infection citing which an insurer can deny you coverage for Covid-19 treatment,” said Chhabra.

What is the process?

One can claim under the reimbursement method after the submission of required documents. These documents can be submitted online without any hassle of providing physical copies. It is, however, advisable to always intimate your insurer before taking the treatment at home.

“Not all health insurance policies provide for claims if the treatment is carried at home. However, given the current situation when the availability of hospital beds is a concern, it’s better to get a written communication from the insurer. You may send the doctor’s prescription, your health card or policy number, etc., and get approval after intimating the insurer. It is essential to get in writing on the specific cost-heads that the insurer will cover in case of home treatment of the policyholder,” said Sanjiv Bajaj, Joint Chairman and MD, Bajaj Capital.

If the policy has an in-built or add-on OPD benefit, then teleconsultation and other expenses towards home treatment can also be reimbursed as per policy terms.