What is treatment for home care?
In health care, home care treatment refers to the medical care that is provided at home to a patient instead of in a hospital. This is for patients who are unable to go to a hospital, or need continuous care following discharge from a hospital.
Almost all mediclaim plans will cover home care services, if they are ordered by a doctor or an extension of hospitalisation. The extent of coverage depends on the insurance policy and company.
It is also important to know that certain diseases or conditions, not covered by insurance companies, may be covered under the post-hospitalisation treatments, which are covered by the policy. We’ll explain it with an example.
Rajat, for example, suffered from chronic backache. He was recommended to undergo physiotherapy and chose home treatment. The costs of physiotherapy were not covered by his health insurance. If physiotherapy was recommended to help with recovery after surgery, then the same insurance policy would have covered this under post-hospitalisation treatments.
Health Insurance for Home Care Covers Treatments
With the rapid advancement of medical science, it is now possible to carry out follow-up treatments at home. Many health insurance companies offer riders that cover the cost of home-based treatments.
The following are some of the most common home care treatments covered by health insurance:
- Fever and Infectious Diseases Management
- Uncomplicated urinary infections
- Mild exacerbations of COPD and Asthma requiring home nebulisation
- Gastroenteritis
- Acute Vertigo
- After hospitalisation, care for patients with spinal and brain injuries
- Dengue
Different categories of home health care services in insurance
mediclaim Insurance offers a wide range of services for home health care.
1. Domiciliary Treatment
Domiciliary treatment is a term used to describe treatments that require hospitalisation, but are performed at home. Insurance companies will cover domiciliary treatments if they are recommended by a MBBS physician, if a patient has ill health and cannot travel to the hospital or if there are no rooms available at the hospital.
2. Pre- and post-hospitalisation
In most cases, the insurer will cover medical expenses before and after hospitalisation. The expenses must, however, be directly related to the hospitalisation. The period between pre- and post-hospitalisation can vary from insurer to insurer. Some policies cover expenses for home care services up to 180 days following hospitalisation and 90 days prior. Others only cover 30 days and 60 days.
3. Daycare Treatments
Day Care Treatments are medical treatments that do not require 24 hours in hospitalisation. Day care procedures covered by mediclaim include chemotherapy, haemodialysis and radiotherapy.
4. OPD Treatments
Some health insurance companies cover home care services that fall under OPD, like consultation, physiotherapy, and routine diagnostics. Be sure to read the policy document carefully to understand the coverage.
Exclusions under Home Care Treatment for Health Insurance
Insurers may exclude home care treatments from coverage if they are not directly related to the main illness or condition that led the patient to be hospitalised. If the treatment is not recommended by a physician and is initiated by the patient, it will also be excluded from health insurance.
Home Health Care Insurance Benefits
Home care insurance benefits both policyholders as well as insurers. In a familiar environment, patients can heal better. The room rental, which is a major part of the cost of hospitalisation, can be completely eliminated. If a policyholder receives home treatment, they can save between 10% and 30% on the total cost. It is important to note that the amount of savings will depend largely on the hospital chosen and the treatment provided.
