Is Home Care Covered by Health Insurance Policy?

Home health care services allow individuals to get treatment for a medical condition in an environment that is comfortable for the patient. Let’s discuss if home care services are covered under health insurance, in this post.

On one hand, India is experiencing a rise in the number of new and emerging health issues, and on the other hand, there has been a steep rise in terms of inflation in the health care sector. To face any sudden medical emergency, you definitely need enough money so that your health can be taken care of. Hence, it is important to purchase a health insurance policy to secure yourself and your dear ones against hospitalization expenses and treatment bills in case of a medical situation. With home care services, it becomes easy for the patient to recover at home amidst all comforts. Thus, many health insurance providers are now-a-days offering coverage against home care services under their health insurance plans.

What are Home Care Services?

Home Care Services in health insurance allow individuals to receive medical treatment at home. This facility especially suits the elderly while recovering from any critical illnesses or during post surgery recovery. With Home care services elderly people as well as other patients can avoid hospitalization and stay within the comforts of their home and receive the best treatment facilities.

What is covered under health insurance? Diseases Covered Under Home Care Services in India

There are several diseases that allow the patient to avail home care services rather than getting him/her admitted in a hospital. COPD or Chronic Obstructive Pulmonary Diseases, Dengue, Gastroenteritis, Hepatitis, Pancreatitis, Bronchopneumonia, Respiratory tract infection and fever are some conditions that do not require the patient to get admitted at a hospital depending on the health condition of the patient. In such cases, the patient can be treated at home under home healthcare services.

Home Health Care Services Offered by Insurance Companies in India: What is covered under health insurance?

Below are some home healthcare services covered by health insurance companies:

1. OPD Treatment – Under OPD or Out Patient Department, minor treatments and procedures are included that normally do not require hospitalization. However, these procedures may be expensive and thus are covered by some health insurance companies. Hence, OPD home healthcare is available for consultation, physiotherapy, regular check-up etc. and are covered under many health insurance policies.
2. Domiciliary treatment – Under domiciliary hospitalization, the policyholder is allowed to get treatment at home in case they are unable to stay in the hospital due to certain critical or other conditions, scare of getting infection etc.  Such patients can get all the required medical facilities at home. In some cases, even the doctor suggests domiciliary hospitalization if there is no hospital rooms available or if the appropriate facilities are not there at the hospital.
3. Pre and Post Hospitalization treatment – Hospitalization before and after a treatment is covered by regular health insurance policies as well as they are covered under home healthcare services. Depending on the insurance company, the period of pre and post hospitalization may vary.
4. Daycare Treatment – Daycare procedures are the ones that do not require the patient to be hospitalized for more than 24 hours. Such conditions are expensive but here hospitalization is not required for the patient and the person can be transferred home on the same day of the medical procedure. Some such conditions are chemotherapy, cataract etc.

Things that are excluded under home health care services

Any medical condition that does not fall under the category of home care services or that is not covered under home healthcare services are excluded. Naturopathy, Acupuncture, Acupressure, are some treatments that are not covered under home healthcare services.

Feature to Consider before buying home health care services

Home health care services are best for elderly patients as well as in case the patient requires a homely environment to stay comfortable while recovering. So, some of the features that are required to be considered before availing home healthcare services are:

• Opt for the home health care services only after discussing the same with your insurer and understanding the terms of the policy and the benefits of the policy that you can avail
• Don’t forget to check the policy exclusions before buying it so that you would not be hassled at the time of making claims for home healthcare services
• Also, check if the treatments that you want to be covered under your plan are there and you get benefits of such treatments in case of any medical emergency