Why home treatment cover is pivotal for health insurance?

Rakesh Goyal

In the last over one-and-a-half years Indians have faced numerous challenges on the health front. Ongoing pandemic has demonstrated that we need more and more coverage of health insurance in our country.

In the period between Mach and May this year we saw some stark images of people unable to get beds in the hospitals for the treatment of Covid-19. Now, imagine if someone wanted to get treated for some other health related problems, they might have faced intense trouble to get the admission in the hospitals.

In such situations it is better to have ‘homecare treatment’ in the policy. In the last few years several of the non-life insurance companies have started providing home care reimbursement—some of them provide as an in-built feature while some give as an add-on cover.

Last year, Insurance Regulatory and Development Authority of India (Irdai) has said non-life insurance companies to provide home treatment. According to the insurance regulator, homecare treatment is one taken at home for an ailment that normally needs hospitalisation provided that a medical practitioner advises the insured home treatment; there is a continuous active line of treatment with the health status of the insured monitored daily by a medical practitioner during the duration of home treatment.

And that records of daily monitoring of the insured patient and the treatment given are recorded and signed by a medical practitioner. This also included treatment. for Covid-19.

However, as said some of the policies do cover home treatment, if your policy is not covered it is useful to buy an add-on cover for the same.

The most important benefit is that the patient can now choose to continue the treatment at home and does not need to get admitted to the hospital just to become eligible to make an insurance claim. Policyholder can make the decision by taking into account not just insurance coverage but also the best course of action as per his convenience.

In many cases, cashless home healthcare allows you to avail the best healthcare from the comfort of your home.Another advantage of home care insurance is that policyholders need not worry about arranging cash for home hospitalization as they can seek cashless healthcare.

Cashless homecare is similar to the cashless hospitalization but here the policyholder gets coverage for the treatment he seeks at home instead of getting admitted to the hospital. It is important that the treatment is prescribed by the treating medical practitioner and falls under the scope of the insurance policy.

But there are few points which needs to be looked while having a homecare cover as there are sub-limits of domiciliary reimbursement. Some of the non-life players provide the domiciliary treatment up to a certain percentage of coverage, while for some it might be only add-on cover.

If someone health cover is for Rs 10 lakh and the coverage limit for domiciliary hospitalization is 20% of sum insured, the actual payout will be only Rs 2 lakh. Its also very simple to claim reimbursement for home care treatment.

Looking at the Covid-19 cases in India currently, it seems things are under control. But it is always advisable to have a home care add-one cover to sail through the future crises.

Views expressed in the article are the personal opinion of Rakesh Goyal, Director, Probus Insurance.

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