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Home Treatment Coverage under a Health Insurance Policy
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Home Treatment Coverage under a Health Insurance Policy

People are more susceptible to various illnesses and hospitalizations (regardless of their age). Though hospitals are equipped with adequate structure and skilled experts, many still prefer to heal at their homes because they will get a comfortable ambiance. Moreover, the support from their loved ones will make their recovery faster. Apart from offering medical care, a domiciliary treatment provides a spectrum of advantages, including aid for cooking, cleaning, bathing, and more.

Moreover, during this lethal COVID-19 peak time, the stupendous flow of patients has made many people choose homecare treatment facilities for their illnesses, including the COVID-19. Domiciliary treatment means when the insured policyholder avails of the medical treatment at his/her home. After seeing the rising popularity of domiciliary treatment, the Indian insurance regulator (IRDAI) has instructed insurance companies to embrace customers with “homecare/domiciliary treatment” as an add-on cover to their current health insurance plans.

When is Domiciliary Treatment Required?

  • When your doctor recommends home-based treatment instead of hospitalization
  • Due to the unavailability of beds in hospitals
  • When patients can’t be shifted to hospitals due to their pre-existing health conditions or co-morbidity

Before the COVID-19 pandemic, this is not a mandatory health insurance feature. Thus, some companies offer this as an in-built feature while others are offering it as an add-on cover. But after reviewing this pandemic, IRDA has instructed health insurance companies to include domiciliary treatment as an add-on feature into their existing health policy plans.

Domiciliary Cover Means

Domiciliary treatment covers all types of healthcare expenses that you need for your home treatment. This treatment covers the cost of healthcare equipment, medication costs, doctor’s consultation fees, and even the costs of oxygen cylinders. This policy covers the treatment of the COVID-19 for up to 14 days.

Sub-limits of domiciliary treatment reimbursement

Sub-limits mean a certain percentage of the sum insured that a policyholder needs to pay from his/her pockets. Though some insurers offer domiciliary treatment benefits up to a certain percentage of the coverage, still, some companies offer this as add-on coverage.

For example, you purchased a Rs. 10 lakh health insurance policy, and it offers 15% of the sum insured as domiciliary treatment benefits. This means you will get Rs. 1.5 lakh for your domiciliary treatment coverage from your insurer.

Domiciliary treatment doesn’t offer a cashless treatment facility. If your insurer provides homecare treatment benefits, then you need to raise a claim for reimbursement for your treatment expenses. Many experts also believed that this add-on home health care insurance plan was quite beneficial during this COVID-19 pandemic, especially when it was at its peak and hospitals were overflowing. The experts also suggest that the coverage should be priced meticulously after analyzing all the costs, including room rent, healthcare equipment, and so on. Then, this coverage should look affordable to policyholders.

Home Care Treatment Benefits

Safety, Comfort, and Convenience

Several healthcare experts claimed that people with fewer complications or co-morbid conditions could recover quickly at home rather than in a hospital. In addition, home healthcare treatments are beneficial in managing patients’ conditions properly. If older patients opt for homecare treatment, then they can maintain their regular routines and quickly resume their normal activities.

Homecare treatment minimizes falls and hospital readmissions.

If you are admitted to a hospital for an illness or injury, you need to worry about safety concerns, especially the risk of falls. In hospitals, many people experience falls because of their injuries or illness. Though hospital staff offers great care and attention, you still can’t avoid this. Since home offers an acute care setting, hence several experts believe that an elder or ill person may suffer a less serious incident at home. Thus, a domiciliary treatment facility reduces the rate of hospital readmission.

Don’t need to visit hospitals frequently

It is an uphill task to take older patients to hospitals or other healthcare centers for their treatment methods. But now, you don’t need to take these senior people to hospitals frequently because of homecare treatment facilities. They can comfortably manage their conditions at home without visiting a doctor. Domiciliary treatment facility offers daily monitoring, supervision, and education. In addition, patients can talk to their healthcare experts via phone or video call (24X7) if they are not feeling good or experience any discomfort.

Personalized Care

In domiciliary treatment, patients will get individual attention and a customized care plan according to their specific needs and requirements. This means you will get more acute and precise treatment for your diseases. In addition, the domiciliary treatment enhances the trust between the patient, his/her family members, and the home care team.

Team of Professionals

If you choose homecare treatment, you will get the best treatment from a home healthcare team that comprises skilled nurses, deft therapists, and experienced caregivers. An expert doctor will supervise all these people. Each team member is professional and possesses adequate experience in the relevant field. Therefore, patients can comfortably communicate with the professionals and clarify their health conditions without visiting a healthcare center.

This article gave you a sufficient idea about what homecare treatment is, its benefits, and its coverage. IRDA has also allowed insurance companies to include domiciliary treatment as an add-on cover to their present health plans so that more people choose this facility for their treatment.

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