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What is Domiciliary Hospitalisation?

Domiciliary hospitalisation cover refers to the medical treatment provided to a patient in their home, which otherwise would have been provided in a hospital.

  • 19 Apr 2023
  • 3 min read
  • 3219 views

In a world where traditional hospital stays can be financially and emotionally draining, many people are opting for alternative solutions to receive quality medical care. One option gaining popularity is the idea of bringing the hospital to the patient, creating a seamless and personalised healthcare experience in the comfort of one’s own home. Patients can recover in familiar surroundings, surrounded by loved ones, with access to top-notch medical equipment and personnel. This concept transforms healthcare and brings hope and comfort to patients worldwide. However, seeking medical care at home can sometimes be costly if insurers refuse to cover the expenses, which is where the concept of domiciliary hospitalisation cover comes into play.

What does Domiciliary Hospitalisation cover mean?

Domiciliary hospitalisation cover refers to the medical treatment provided to a patient in their home, which otherwise would have been provided in a hospital. This type of cover aims to provide financial protection to patients who are unable to get admitted to a hospital or prefer to receive medical care at home.

For instance, let's consider a patient who is bedridden due to a chronic illness and needs constant medical attention. If this patient requires admission to a hospital, the expenses would be astronomical. However, with domiciliary hospitalisation cover, the patient can receive the necessary medical treatment at home without needing hospitalisation. This type of cover is especially beneficial for patients who need long-term medical care and for whom hospitalisation is not convenient.

Domiciliary hospitalisation cover includes medical expenses, such as nursing care, medical equipment, and prescription drugs required for the treatment of the patient at home.

How does Domiciliary Hospitalisation work?

Here are the steps that typically take place in the domiciliary hospitalisation process:

  • Diagnosis: The patient visits a doctor and receives a diagnosis that requires medical treatment. The doctor will determine if the patient is eligible for domiciliary hospitalisation based on the nature and severity of the condition.
  • Treatment plan: Once the patient is deemed eligible for domiciliary hospitalisation, the doctor will prepare a treatment plan that outlines the necessary medical interventions and the required duration of treatment.
  • Insurance coverage: The policyholder or his/her family member will notify the insurer that the insured is planning to undergo domiciliary treatment. The insurance company will then provide the patient with the necessary forms and documents.
  • Medical equipment: If required, the patient will be provided with the necessary medical equipment, such as oxygen cylinders, nebulisers, etc., to facilitate the treatment process.
  • Healthcare provider: The patient will choose a healthcare provider specialising in domiciliary hospitalisation. The healthcare provider will assign a nurse or caregiver who will visit the patient's home and provide the necessary medical care.
  • Treatment at home: The assigned nurse or caregiver will provide medical treatment to the patient at home following the treatment plan, monitoring the patient's progress, and reporting it to the doctor.

  • Follow-up: After treatment completion, the patient visits the doctor for a follow-up to determine the success and need for further treatment.

Benefits and Inclusions of Domiciliary Hospitalisation

Domiciliary hospitalisation offers several benefits and inclusions. It is typically less expensive than traditional hospitalisation. This is due to the fact that it eliminates the need for hospitalisation expenses like room charges and medical equipment rental. Patients can receive medical care in the comfort of their own homes, which is especially beneficial for those with mobility issues or chronic illnesses.

Patients receive one-on-one attention from their assigned nurse or caregiver, allowing for personalised medical care.
The inclusions of domiciliary hospitalisation may vary based on the insurance policy. However, inclusions may include doctor consultation fees, nursing charges, the cost of medical equipment, and medication costs.

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Exclusions of Domiciliary Hospitalisation

The domiciliary hospitalisation coverage may not cover any medical condition that existed before obtaining the insurance policy. Experimental or unproven medical treatment may be subject to exclusions under domiciliary hospitalisation coverage. Several medical procedures or treatments, such as cosmetic surgery, infertility treatments, and weight loss surgery, are usually not covered. The domiciliary hospitalisation cover excludes any medical treatment received outside of the country.

Several medications, such as prescription drugs not approved by regulatory authorities, are excluded from this coverage. A domiciliary hospitalisation policy does not cover injuries caused intentionally by the policyholder.

A domiciliary hospitalisation plan may not provide coverage for substance abuse or addiction treatment. Treatment for mental illness is also not covered under domiciliary hospitalisation coverage. Injuries sustained during hazardous activities, such as extreme sports or actions involving weapons, may not be covered under domiciliary hospitalisation cover. One cannot make a claim for treatment expenses incurred for alternative therapies, such as acupuncture or chiropractic treatments.

Things to note about Domiciliary Hospitalisation benefits

In order to claim the domiciliary hospitalisation expenses, you must keep the following things in mind. 

  • When evaluating the domiciliary hospitalisation benefit, you should consider the medical conditions covered and the specific services provided.
  • It is also crucial to assess the eligibility criteria for the benefit, such as the patient's medical condition, the availability of a suitable home environment, and the requirement for frequent monitoring or specialised equipment.
  • When evaluating the domiciliary hospitalisation benefit, you must consider the duration of the benefit and any limitations or restrictions on the number of visits or treatments it covers.
  • The cost of the domiciliary hospitalisation benefit should also be evaluated, including any co-payments or out-of-pocket expenses that may be necessary.
  • Domiciliary hospitalisation is possible if the policyholder can demonstrate to his/her insurer that the person was unable to obtain a bed in a hospital where the treatment is available.
  • Corona Kavach medical insurance also covers such treatment if it is recommended in writing by a registered medical practitioner.

When claiming such expenses, keep all necessary treatment bills and doctor's prescriptions in one place so that you can easily provide them if your insurer wants documentary evidence.

Conclusion

When a patient cannot get hospitalised because of a medical condition or a doctor suggests that a policyholder receive treatment at home, this is known as "domiciliary hospitalisation." It is a valuable option for patients who require medical treatment but prefer to receive it in the comfort of their own homes. This type of care offers several benefits, including reduced costs, personalised attention, and improved emotional support from family members. Additionally, domiciliary hospitalisation eliminates the risk of acquiring infections commonly found in hospitals, making it a safer option for patients with compromised immune systems. While the inclusions of domiciliary hospitalisation may vary depending on the insurance policy, it typically covers medical treatment, necessary medical equipment, and the services of a trained nurse or caregiver.

There are numerous comprehensive health insurance policies offering domiciliary hospitalisation coverage. If you invest in a policy where domiciliary hospitalisation is covered, you may claim reimbursement for domiciliary care. However, not all health insurance policies cover at-home care, so you must be careful when shopping for a policy that meets your needs. When an insured person has a medical emergency, the option of receiving care in the comfort of his/her home may be a lifesaver. It is a feature that allows access to proper medical assistance when essential medical facilities are absent.


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