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Exploring domiciliary hospitalization in health insurance

Published On Dec 19, 2020, Updated On Feb 16, 2021

Within a health insurance plan, this feature of domiciliary hospitalization considers a policy-holder to be in a state of hospitalization even when treatment is ongoing at home. Being in a hospitalization state at home, the expenses related to everyday medical treatment are inevitable.

Inclusions under Domiciliary Hospitalization

Following expenses are completely covered by the health insurance  upon certain conditions such as the following:

  • The policy-holder is suffering from an illness/disease/injury and a certified health professional has prescribed hospitalization for the patient, and also possesses a valid base health policy.
  • The process of treatment continued for at least three days.
  • Due to severe injury, the patient cannot be shifted or relocated from the current state, for instance, major leg fracture or paralysis, and has been advised not to relocate to the hospital or other health centers. 
  • The policy-holder has to undergo treatment at home because of a lack of accommodation at the hospitals. 

Exclusions under Domiciliary Hospitalization

The following expenses are not included in the domiciliary hospitalization:

  • Expenses incurred pre as well as post hospitalized treatment
  • Any treatment that has lasted for less than 72 hours
  • The privilege of domiciliary hospitalization under an employer's insurance plan
  • Treatment for diseases such as bronchitis, asthma, hypertension, chronic nephritis, epilepsy, influenza, diabetes mellitus and insipidus, arthritis, respiratory tract infection, psychiatric illness, tonsillitis, rheumatism, and pharyngitis.

When can the benefits of Domiciliary Hospitalization be availed?

The benefits of domiciliary hospitalization can be easily availed in situations where even the minimum twenty-four-hour hospitalization does not happen. In general, a health insurance claim becomes valid with at least a 24-hour hospitalization duration. That is why most of the health insurance companies do not cover treatments that do not require hospitalization, such as in the case of a knee fracture that requires a minor surgery for which hospitalization is not necessary. This will not be covered by any health policy. 

Importance of Domiciliary Hospitalization in a health insurance

This feature of domiciliary hospitalization is quite significant and useful for health insurance policy-holders. This is because of the benefits that allow policy-holders the provision to undergo treatment at home comfort, and/or in case no accommodation is available in any of the hospitals for a specific treatment. The most attractive part of this feature is that it saves the insured policy-holder and his/her family members from visiting the hospital frequently. Also, the feature has effective benefits in terms of enabling the policy-holder of the family members to save a huge amount of money that could be spent in visiting hospitals frequently. 

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To conclude, the unique feature of domiciliary hospitalization under a health insurance plan is of great significance, especially during emergencies. However, during a medical emergency, it is always recommended to avail of hospitalization rather than domiciliary hospitalization service because of several additional benefits.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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