With hospitals overcrowded and burdened with limited resources, it can be difficult to get the healthcare you need at a hospital. Thankfully, there is a workaround. You can find some personal and group health insurance plans that offer support for something called domiciliary hospitalization.
So what is Domiciliary Hospitalization? In simple terms, domiciliary hospitalization refers to treatment or hospitalization at home. If you are receiving medical care at home, your costs can be reimbursed by your insurance provider if you have a domiciliary hospitalization clause in your medical insurance. However, you should know that there are plenty of terms and conditions that apply.
That’s why we are here to help! Here’s a handy guide to everything you need to know about Domiciliary Hospitalization, so you don’t get lost in the paperwork.
The Basics of Domiciliary Hospitalization
If you are undergoing treatment for a medical condition, almost certainly you would be hospitalized. However, in some circumstances, you can receive that treatment at home. Usually, there are two conditions for domiciliary hospitalization:
- When the patient cannot be moved to a hospital due to the severity of his/her condition
- When the hospital does not have the capacity to accommodate the patient, i.e. a lack of rooms or beds.
Just because a patient fulfils one of these two conditions does not mean he/she will be eligible for reimbursement under domiciliary hospitalization. There are still many terms and conditions you need to know about.
Firstly, most health insurance plans only cover charges if the patient is hospitalized for more than a particular number of days. Secondly, some health insurance plans will have a cap or limit on the amount that can be claimed for cases of domiciliary hospitalization.
For example, your policy could have a 10% cap. That means if the hospitalization costs more than 10% of your total Sum Insured, you will have to pay for the difference. Be very careful and ready the full terms and conditions to be sure.
What’s Covered, and What Isn’t?
All allopathic (western/modern medicine) treatments will be covered, except for the following conditions:
- Chronic Nephritis and Chronic Nephritic Syndrome
- Diarrhoea and all types of Dysenteries including Gastro-enteritis
- Diabetes Mellitus and Insipidus
- Influenza, Cough, and Cold
- All Psychiatric or Psychosomatic Disorders
- Pyrexia of unknown origin for less than 10 days
- Tonsillitis and Upper Respiratory Tract Infection including Laryngitis and Pharyngitis
- Arthritis, Gout, and Rheumatism
This list is not exhaustive. Please remember to read your policy documents carefully to know what can and cannot be claimed. You should also know that pre and post hospitalization expenses are not covered as well, so you will have to pay out of your pocket for those.
Please remember that domiciliary hospitalization is not covered for other treatment methods like Ayurveda, homoeopathy, or other alternative medicine systems.
Domiciliary Hospitalization Under Onsurity Plus
Under the group health insurance with the Onsurity Plus Membership, our insurance partner provides coverage for domiciliary hospitalization without a cap. That means you can claim up to the full amount of your Sum Assured for hospitalization if you need to. Our insurance partner will cover cases of domiciliary hospitalization where medical treatment is availed for a period exceeding three days for an illness/disease/injury which in the normal course would require care and treatment at the hospital/nursing home.
You can access the terms and conditions of your group health insurance provided under the Onsurity Plus Membership plan through the Onsurity App. All you need to do is tap the ‘Policy Details’ tab under Insurance. If you need any help or are unclear about the terms and conditions, feel free to get in touch with our friendly Good Doctors Team.
The team of experts can help you understand your employee healthcare benefits plan. With the Good Doctors Team, you are always clear when it comes to hospitalization. The team can also help with the reimbursement process, by telling you what all you need. Please note that Onsurity is only an administrator. We cannot process or verify your claims, that can only be done by our insurance partner.
Domiciliary hospitalization is just one of the many benefits under the Group Health Insurance of Onsurity’s affordable employee healthcare membership plans. If you are a startup or SME, consider getting Onsurity for your employees healthcare today. Our flexible and economical plans aren’t just easy to use and manage. They also offer benefits like doctor teleconsultations, discounted health check-ups and medicine delivery, fitness tracking and group health insurance for members of SMEs and startups.
Onsurity’s business health plans are the best way to put your team’s healthcare first. That way, you unlock their full potential and let them do their best, without worrying about their health.