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Category: General

Domiciliary Hospitalisation

Insurers allow treatments at home, subject to certain terms and conditions

Domiciliary Hospitalisation (also known as home care treatment) is a treatment of an illness, where hospitalisation of the patient is normally required, but he/she is treated at home.

There are specific conditions under which health insurers will agree for domiciliary hospitalisation.

  • Due to non-availability of accommodation in nearby hospitals/nursing homes (or )
  • The patient’s condition being such that, he/she cannot be moved to the hospital. The decision for home care treatment needs to be as per doctor’s recommendation and all the required treatment facilities are made available at home.
  • In both the above cases, for the claim to be applicable, the treatment should be for a period of more than 3 days.
  • Domiciliary hospitalisation will not be applicable for certain listed diseases as specified in the policy document of the respective insurers. The list of diseases excluded for domiciliary hospitalisation varies from insurer to insurer.
  • And, last but not the least, you also need to watch out for any sub-limit imposed for domiciliary hospitalisation as a percentage of Sum Insured (SI) in your health insurance policy. For example, if the overall SI is Rs.5,00,000/- and the sub-limit is 50% of the SI, then the claims related to domiciliary hospitalisation will be limited to Rs.2,50,000/-.