Domiciliary hospitalisation and home care are two different benefits, with different rules and caps. What each pays, and which plans leave it out.
Is treatment at home covered by health insurance?
Sometimes. Policies use two different benefits for treatment at home, and they work very differently.
1. Domiciliary hospitalisation
Domiciliary hospitalisation pays for treatment at home that would normally need a hospital, when:
- the patient's condition does not allow moving them to hospital, or
- no hospital bed is available,
and the treatment lasts more than 3 consecutive days.
The catch: wordings exclude a list of common long-term conditions from this benefit, such as asthma, bronchitis, diabetes, hypertension and epilepsy. Care Supreme lists 12 such conditions.
Caps from real wordings
Plans that do not cover it
Some plans leave it out entirely. SBI Health Edge excludes domiciliary hospitalisation in so many words. HDFC ERGO Energy and Star Cancer Care Platinum have no such benefit.
2. Home care treatment
Home care is a newer benefit: doctor-led treatment at home for a listed set of conditions, as an alternative to admission. It needs a doctor's advice and daily monitoring.
- Star Young Star: up to 10% of the sum insured, maximum ₹5 lakh a year, for conditions such as fever, urinary infection, asthma, gastroenteritis and IV chemotherapy.
- Star Comprehensive: 10% of the sum insured, up to ₹5 lakh.
- Galaxy Marvel Neo: 10% of the sum insured or ₹5 lakh.
What about home isolation for an infection?
Only if your plan's home care list includes that condition, or the domiciliary rules are met. Check the list in your own wording; do not assume.
How to check
Search your wording for "domiciliary" and "home care". Note the cap, the 3-day rule and the excluded conditions. Or upload it to the policy checker.
Frequently asked questions
What is domiciliary hospitalisation?
Treatment at home that would normally need a hospital, when the patient cannot be moved or no bed is available, lasting more than 3 days. Conditions such as asthma, diabetes and hypertension are usually excluded from it.
Is home treatment covered by health insurance?
In many plans, within limits. Caps range from the full sum insured (Care Supreme) to 10% of it (Care Freedom). Some plans, like SBI Health Edge, exclude it.
What is home care treatment?
A doctor-led alternative to admission for a listed set of conditions, such as fever or IV chemotherapy. Star Young Star covers it up to 10% of the sum insured, maximum ₹5 lakh a year.