All about Domiciliary Hospitalization in terms of Health Insurance

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  | Published: 08 January 2021 | Last Updated On: 20 January 2021

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While reading about health insurance in UAE, recently you must have come across the term “domiciliary hospitalization”. Is this term making you confused? Don’t worry if that is the case with you.

Just like you, there are various customers of health insurance, which get confused amongst the jargon and terms related to it.

However, in this article, we will help you in understanding what this concept is actually all about. 

What does domiciliary hospitalization mean in health insurance?

In the case of health insurance, it refers to a circumstance where the insured person is considered hospitalized, even when they are at home. This is a treatment, which is home-based, done for an illness, injury, or disease.

The good thing is that any expenses done for the treatment are covered by the insurance provider, however, if only-

  1. The insured patient’s condition does not allow them to get shifted to a hospital or a nursing home.
  2. The treatment is done for an illness, disease, or injury for which it would be important to get hospitalization in normal situations.
  3. The treatment lasts for at least three days.
  4. Due to the unavailability of accommodation at the hospital, the insured patient had to get the treatment at their home. 

What are the inclusions and exclusions of domiciliary hospitalization?

The domiciliary hospitalization gives coverage for the treatment, which justifies the conditions that are mentioned above. However, you must note that there are 3 main conditions where the treatment isn’t covered. Here are these conditions-

  • Expenses for post and pre-hospitalization treatment.
  • Any treatment, which lasts for lesser than 3 days or 72 hours.
  • The treatments including psychiatric disorder, pharyngitis, tonsillitis, infection in the upper respiratory tract, rheumatism, diabetes mellitus & insipidus, gout, nephrotic syndrome, chronic nephritis, arthritis, hypertension, epilepsy, bronchitis, asthma, cough, cold, & influenza. 

What is the importance of domiciliary hospitalization cover under health insurance?

This facility has considerable importance in the lives of various policyholders of health insurance. After all, this benefit gives them the option to enjoy the convenience of getting treated at home, in case they are unable to reach the hospital or find accommodation in the hospital for a certain treatment. The best thing about this facility is that it saves the family and friends of the insured patient from visiting the hospital frequently.

And, another thing to note is that a domiciliary hospitalization facility also helps the insured patients or their family members a huge amount of money, which can be exhausted because of the hospitalization charges and frequent visits to the hospital. 

What all things should you know about the domiciliary hospitalization cover under health insurance?

Here is a list of things you must know about this cover.

  1. It is not offered by each health insurance provider.
  2. It isn’t a default cover. The insurance company may ask you to make payment of an additional amount of premium depending on the condition of your cover.
  3. Some policies may provide coverage for domiciliary hospitalization up to the amount of sum insured, the others provide restricted coverage.
  4. Certain criteria are followed for the type of treatment available at home and the illness or disease for which you are availing the treatment at home.
  5. There are some health insurance companies, which provide coverage for only specific expenses that incur on allopathic treatment. Ayurvedic or Homeopathic treatments that are availed at home for certain diseases might not be covered under this facility.
  6. For making the most of this benefit on your health insurance plan, it is necessary that you prove to the insurance company that it is not possible for you to get admitted to a hospital and do not have any choice except for domiciliary hospitalization. You should remember that the expenses would be paid only when the insurance provider is satisfied with the reason you have given. In case you capable of reaching the hospital but you choose not to, the insurance provider will refuse to make payment of the expenses that have incurred for your treatment. 

What are a few things should you keep in mind about the domiciliary hospitalization cover under Medical Insurance?

The following is the list of things that you must keep in mind while opting for this cover.

  1. In case you think it will be essential for you to have the domiciliary hospitalization benefit included in your health plan for an emergency, you should find a policy, which offers this facility in the first place.
  2. You must remember to read the requirements list carefully, which is given to you for checking if you are eligible for availing of this facility or not.
  3. In case your policy provides this cover, make sure that you check the inclusions and exclusions in advance for avoiding any confusion or disappointments at the last minute.
  4. Also, remember to submit the important information while making a claim for domiciliary hospitalization. 

The Bottom Line!

We hope that this article has helped you in understanding the domiciliary hospitalization cover. It is of huge prominence whenever it is required. Nevertheless, during an emergency, you should visit the hospital instead of opting for this benefit unless absolutely impossible.

While looking forward to availing different benefits of health insurance with this cover, select a plan with this facility at first.

This feature, rest assured, even when it is available at an extra cost, will assist you in getting both financial and physical ease.