Does Your Health Insurance Policy Cover Home Treatment?

While the problem of not having enough beds is in the spotlight now, it has been a long-standing issue. Even before the current pandemic took the nation by storm, medical facilities were hard to procure & not everybody could manage hospitalization. Lack of hospitals beds, resources, and sometimes medical complications do not allow patients to get treatment through hospitalization. This can lead many to wonder what they can do in this situation. The solution to this is something known as Domiciliary hospitalization.

Home Treatment

What is domiciliary hospitalization?

Domiciliary hospitalization refers to a situation where you receive professional medical treatment at home. Due to whatever reason that you cannot admit yourself into a hospital, you can avail of domiciliary treatment. It has become quite a common practice during this pandemic due to the shortage of beds. But the provision has been available and used by countless patients before.

Most people choose to buy health insurance to protect themselves and their loved ones. This raises another question in a lot of people’s minds. Does their health insurance policy cover home treatment? The simple answer to that question is yes. Almost every insurance provider offers coverage for home treatment. But you can still check with your insurance provider to be safe.

Many patients cannot get hospital treatment due to a wide variety of reasons. But a medical condition needs to be treated in whatever setting possible. Recognizing this, health insurance providers offer this coverage. But different insurance providers have different criteria and different specifics regarding domiciliary treatment. You should know these if you ever need to claim support for home treatment.

When do you need domiciliary hospitalization?

Domiciliary treatment is a provision that is difficult to manage from the insurance provider’s end. While it is more common than you may realize, insurance providers still prefer that you seek hospitalization. This is because it is easier to deal with the hospital in terms of covering medical expenses. Hence, there are only a few situations where health insurance covers home treatment. These include.

  • Your insurance company will offer coverage if your doctor advises domiciliary treatment. Sometimes your doctor may feel you should be at home while receiving treatment. One reason for that could be that you would receive special and round-the-clock care.
  • Your insurance provider will cover the expenses of domiciliary treatment if you cannot find a hospital bed. As the current pandemic has proven, there can be situations where simply finding a bed to admit a patient can be impossible too. In such a situation, you can request your insurance company to cover expenses for home treatment.
  • Your health insurance provider will cover the expenses for home treatment if you have some pre-existing condition that does not allow you to get a hospital admission.

The way that health insurance plans offer coverage for home treatment can be different. Some policies include a feature of reimbursement for the cost of home treatment. Some plans offer the provision as an in-built service. On the other hand, some require you to purchase it as an add-on cover.

How to claim domiciliary hospitalization?

Usually, in a health insurance claim, you would only need to notify the insurance provider and submit the necessary documents at the hospital. However, since there is no hospital to carry out the verification process smoothly during such a time, you would need to manage the process with the insurer yourself. For this, you would have to submit proof that you satisfy the criteria for home treatment coverage.

  • Firstly, you need to show proof for the fact that the doctor recommended your home treatment. Moreover, you need to prove that you actually need treatment at home. For this, you may have to submit documents regarding the reason you are going for domiciliary treatment. For example, if you have a pre-existing illness that does not allow you to get hospitalization, you need to show a record of it.
  • Speaking of medical records, you have to show the necessary documents regarding the disease you seek home treatment for. It is better to know what documents you need to show before making a claim. This includes medical test reports like CT scans, blood reports, prescriptions, and other relevant medical diagnoses.
  • If you go for a reimbursement claim, you should have all the necessary bills and receipts with you. These bills and receipts are proof of the expenses you have made for home treatment.