Understanding domiciliary hospitalisation and how it works in healthcare

With life's uncertainty surrounding us, health insurance can often seem like the method in the madness. The right health plan not only offers medical coverage but also allows financial stability. With the increasing popularity of health insurance in India, insurance providers are offering innovative benefits and features to policyholders. One such feature is domiciliary hospitalisation.

Domiciliary hospitalisation, as the name may suggest, refers to hospital-like treatment at home. It comes into play when an insured individual cannot be admitted to a hospital and is provided with the required medical care in their home. These days, most health insurance plans offer the benefit of domiciliary hospitalisation. However, it is recommended that you check with your insurance provider about the coverage. Also, please keep in mind that certain criteria need to be fulfilled to make a claim. Let us take a look.

Generally, domiciliary hospitalisation can happen in the following scenarios:

1. If the insured individual is so unwell that they cannot be taken to the hospital, and if the doctor feels that the insured cannot be taken to the hospital, they will receive the required treatment at home.

2. If the chosen hospital is not equipped to handle the patient. For example, there are no hospital beds available at the hospital.

3. In some cases where continued hospitalisation is not possible, domiciliary hospitalisation can be prescribed.

4. A medical practitioner should certify the injury or illness for which domiciliary hospitalisation is to be taken.

5. The home treatment should last for a minimum of 3 days or 72 hours.
   

Now, let us examine how domiciliary hospitalisation works. If you have a health insurance plan that covers it, you can receive reimbursement for the coverage, just like you would for regular hospitalisation. Here’s how:

Step 1

The insured individual is examined by a doctor. The doctor evaluated that the insured requires hospitalisation. However, due to any of the above-mentioned reasons, the insured would require domiciliary hospitalisation.

Step 2

The doctor/ hospital will certify the process, and a medical treatment plan will be made. The duration of domiciliary hospitalisation will also be determined.

Step 3

The health insurance company will have to be informed about the hospitalisation. The insurer may seek more information about the hospitalisation and ask for the required paperwork.

Step 4

Once the insurance provider verifies the domiciliary hospitalisation, the policyholder will be reimbursed for the expenses borne. Please note that the coverage depends largely on the existing plan.

Conclusion

Domiciliary hospitalisation is indeed a useful feature that can come in very handy in times of a medical emergency. Getting hospital-like treatment from the comfort of your home can offer the best of both worlds for the patient. However, it is suggested that you are well aware of the coverage you are eligible for under domiciliary hospitalisation. The coverage can vary from policy to policy. Whether it is an in-built feature or an add-on option, the coverage will be as per the policy terms and conditions.