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When the hospital can’t take you in, your health insurance can still arrange domiciliary hospitalisation, bringing hospital-level care right to your doorstep. Get treated at home with doctor-supervised care without the hospital stress or hefty bills.
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Domiciliary hospitalisation is a base benefit in your insurance policy that offers hospital-like treatment and recovery at home under certain circumstances. A claim under the Care Health Insurance policy refers to medically necessary treatment received while confined at home for an illness, disease, or injury that would typically require hospital care. This is subject to the patient's condition preventing their removal to a hospital or the non-availability of hospital beds.
The health insurance policy will cover hospital-like services and care provided in the comfort and familiar surroundings of your own residence. The purpose of domiciliary treatment is to ensure that patients receive necessary medical attention, surveillance, and specialised services, even without inpatient admission.
Choosing a cost-effective Domiciliary Hospitalisation in Health Insurance simplifies healthcare management protection compared to multiple individual policies. At Care Health Insurance, we meet the diverse healthcare needs of every household with some of our best family health insurance plans in India. Here are some of our top-selling the best medical insurance for family:
For the claim to be accepted, the treatment must meet specific, strict conditions:
Domiciliary hospitalisation is indicated when a patient’s condition can be managed safely at home, thereby avoiding a prolonged hospital stay. Medical professionals typically determine the need for domiciliary hospitalisation, subject to the terms and conditions of the health insurance policy. In health insurance, domiciliary hospitalisation is allowed only under certain conditions specified in the policy.
Any medical expenses incurred for the treatment of the following diseases shall not be payable under the domiciliary hospitalisation:
Eligibility for domiciliary hospitalisation cover in health insurance is determined by both the patient's medical condition and the policy terms. It is eligible when a doctor certifies that the patient needs medical care at home due to critical illness, mobility issues, chronic conditions, or post-surgery recovery. It also applies when hospital beds or resources are unavailable. Eligibility is always subject to policy terms.
The provision of domiciliary hospitalisation cover generally involves a structured process to ensure the treatment is legitimate and medically sound. Understand how it works:
A qualified doctor examines the patient to confirm that home treatment is necessary and safe when hospital admission isn’t possible.
Once approved, the doctor arranges the required support, such as nursing care, monitoring equipment, or periodic check-ups, to provide hospital-level treatment at home.
The patient or family must inform the insurer of the home treatment and submit supporting documents, such as a doctor’s certificate, medical reports, and bills, to initiate the claim.
The insurer reviews the claim, verifies it in accordance with the policy terms, and reimburses the eligible domiciliary hospitalisation expenses.
Filing a claim for domiciliary hospitalisation in health insurance generally involves the reimbursement process. Policyholders must diligently follow the prescribed steps to ensure the swift processing of their domiciliary hospitalisation expenses.
Proper and accurate documentation is a condition precedent to the insurer's liability, ensuring a smooth process for claiming domiciliary hospitalisation expenses. To register a claim for domiciliary hospitalisation cover, policyholders must submit the following documents to the Company:
Pro Tip: For a claim to be registered, all required information and supportive claim-related documents must be furnished within the stipulated timelines, and they must be explicitly made in the insured person's name.
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It refers to medically necessary treatment given at home when hospital admission is not possible or required, providing hospital-level care in a home setting.
Yes, the domiciliary treatment must typically continue for at least 3 consecutive days (72 hours) to qualify for coverage.
Yes, we cover medical expenses incurred 60 days before and 180 days after domiciliary hospitalisation, if related to the same condition.
Yes, professional nursing charges for medication, wound care, and related services are covered under domiciliary hospitalisation.
At Care Health Insurance, we provide coverage for domiciliary hospitalisation up to SI. Refer to your policy schedule for exact details.
A hospitalisation claim covers treatment received in a hospital, while a domiciliary claim covers equivalent medical care provided at home.
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Ultimate Care: UIN - CHIHLIP25044V012425
Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.
~Tax benefit is subject to changes in tax laws. Standard T&C Apply
**Number of Claims Settled as of Dec'24
^10% discount is applicable for a 3-year policy
#Premium calculated for an individual (Age 26) for sum insured 5 Lakhs in Zone 2 cities with Ultimate Care Policy.
^^Number of Cashless Healthcare Providers as of Feb 2025
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