Does your health insurance policy cover home care treatment?

Health Insurances 269 views

Most of the people associate health insurance as the cover for expenses incurred on the hospitalization only. But you would be surprised to know that even home care treatment can be covered by your health insurance policy if the insurer has the provision of the same. At a time when critical illnesses have taken a vicious shape, many of the patients are unable to visit the hospital and are forced to get themselves treated at their home. Suppose if you suffer from a chronic back ache and the physician advise you to go for a physiotherapy and you decide to have the treatment at your home. There are growing possibilities that your health insurance policy may not provide you the cover for the same. However, if the physiotherapy is advised post the surgery, then you will get the cover from your health insurer as it comes under the ambit of domiciliary or post-hospitalization treatment.

Treatments Covered

Understanding the inherent needs of the customers to get the treatment done at home because of their inability to visit the hospital for treatment, many health insurers such as ICICI Lombard, Bajaj Allianz and others have stepped up to include the home treatment in their policy. However, the home care services must have been prescribed by the doctors or are an add-on the hospitalization for you get the cover. You can get the cover on below mentioned home care services.

Domiciliary Treatment

This type of treatment does require hospitalization but get carried out at home. According to health insurance companies, the domiciliary treatment gets covered only if the patients suffer from a condition that makes them unable to visit to the hospital or due to the unavailability of rooms in the hospital. You can find insurers offering cover upto 10%-15% of the sum assured. The extent of coverage, however, may differ from insurer to insurer. So, you must ask your insurer of the same while buying the health insurance policy.

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Pre & Post Hospitalization

Health insurers usually cover medical expenses incurred during pre and post hospitalization periods. However, the expenses incurred must be on the illness that led to the hospitalization. You must bear in mind that pre and post hospitalization periods can vary from insurer to insurer. You can find some health insurers offering cover for expenses upto 90 days before and 180 days after the hospitalization and some upto 30 days before and 60 days after the hospitalization.

OPD & Day Care Treatment

These types of treatments can be carried out without hospitalization. The OPD and day care procedures could include radiotherapy, hemodialysis, chemotherapy and others. You can find some insurers offering cover for expenses on diagnostic tests, nursing care, physiotherapy and consultation. Insurers such as ICICI Lombard covers home care treatments that come under the purview of OPD category.


  • With the home environment in place, patients can recuperate from the illness quickly and efficiently.
  • You can save around 10%-40% of your cost by availing the treatment at home. The reason being the elimination of room rent that forms a major part of the hospitalization expenses.

However, don't be too influenced by the covers and overall benefits of home care treatment as you need to follow few points, which are mentioned below, for complete fruition.

Things to keep in mind

  • You must decide to go for home care post-consultation with the insurer.
  • Ask the insurer whether the policy covers home care treatment. If the answer comes Yes, then ask how much, so that you can be assured of the sum you will get and the one you will have to pay from your pocket.
  • Keep an eye on the terms and conditions related to home care coverage.
  • Make sure your treatment is done by certified doctors with high-quality equipment and facilities.
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So get yourself treated at home if you can't go the hospital. But bear in mind the things stated above to get the cover for such expenses.

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