Can’t find a hospital bed? Get COVID-19 Treatment at Home

Usually, regular health insurance plans do not cover home treatment charges. They cover expenses if the hospitalization is for 24-hours and more and day-care procedures as mentioned.

‘But a special Coronavirus health insurance product i.e. Corona Kavach policy covers the cost of COVID treatment at home for the insured’

So, if you are struggling to find a hospital bed, you can get the set-up done for your loved ones at your home. Let’s discuss how you can file a reimbursement claim for your COVID home-care treatment.

Corona Kavach Policy

 Domiciliary Hospitalization

Corona Kavach pays for COVID Home Treatment Expenses

If you have a health insurance policy that does not cover your home treatment charges then you can buy a Corona Kavach policy with sum insured options from Rs 50,000 to Rs 5 lakh. Corona Kavach policy – is a standard COVID-19 policy by IRDAI that is provided by all the health and general insurance companies in India. The policy tenure can be 3.5 months, 6.5 months, and 9.5 months.

Home care treatment cover allows you to undergo the COVID-19 treatment at your home if it not possible in a hospital. The maximum days for which you get home treatment cover is up to 14 days.

It is provided to those who have tested COVID positive and are suggested an active line of treatment. The cost of oxygen cylinders and pulse oximeters is also covered, which is not covered by most indemnity-based plans.

Also, please note that home quarantine expenses are not covered. What you get paid for is home ICU and COVID-19 treatment to the sum insured amount without any sub-limits. All you need to furnish is a doctor’s prescription advising home treatment. It can also include diagnostic reports, doctor’s original prescriptions, and medicine bills.

Home Care Treatment under Basic Health Plans

Your first resort will be the standard health insurance that you have and the major setback is that not all health plans cover home treatment or domiciliary hospitalization. Only a few insurers offer such facilities.

So, if you have a mild COVID infection that does not require hospitalization and you need to take treatment at home on Doctor’s advice then you can file a health insurance claim.

But whenever such a situation arises be mindful of the policy terms and conditions at the time of claim. If it covers home healthcare, the policyholder i.e. you would need prior authorization from the insurer before you go ahead to ensure smooth claim support. As long as oxygen usage is towards a line of active treatment under medical supervision, it can be claimed.

The cost of cylinders big question-

The cost of oxygen cylinders as medical equipment is usually not reimbursed under basic health plans unless the co-morbidities are given a cover. If a policyholder showcases mild symptoms then also he/she can take COVID-19 treatment at home, while serious cases need to be admitted to the hospitals.

In mild cases, the cost of medical supervision and medication is usually around Rs 15,000 to Rs 20,000.

Post-bed recovery costs won’t be covered. Expenses related to rest and rehabilitation, nursing costs, dietary supplements, vitamins, and minerals are generally not reimbursed.

However, you will have to be mindful of the conditions and exclusions while filing a claim. Remember you can only claim as far as oxygen is used for an active treatment under medical supervision.

You can look for terms like home care or domiciliary hospitalization in your medical insurance policy.

Coverage for Home Hospitalization

However, several regular medical insurance plans include a domiciliary hospitalization cover. So, when you need to get hospitalized and it is difficult to find a hospital bed, you have to take Coronavirus treatment at home. And this is where you can file a claim.

Domiciliary treatment cover is provided when no beds are available or the insured patient cannot be moved in an ambulance to a hospital. Therefore, some hospitals provide them home ICU set-ups that include doctor visits, IV support, nursing charges, etc. a daily chart is maintained based on which compensation is provided.

If you are covered under Corona Kavach policy the coverage and reimbursement might be easier. But if it is a regular policy you would need proper documentation in place. The insurance company can ask for GST bills from the Company providing treatment at home. All the original bills and invoices need to be in place and the approval needs to be taken in advance.

Home care can be challenging because very limited vendors provide full proof bills that can be used for reimbursement. As there are very few organized vendors providing such services with proper bills, therefore it is suggested to have a COVID-9 health plan with fixed benefit payout on testing positive. However, Corona Rakshak, which is a fixed-benefit policy, required a minimum of three days of hospitalization.

Check for sub-limits

If you have a basic health plan or coronavirus health plan check the sub-limits for home COVID treatment.  Like it can be 10% of your sum insured. Like Corona Rakshak only covers it after 3-days, but the treatment for coronavirus lasts longer than 10-14 days so it won’t be a hindrance. On the other hand, there are no sub-limits under the Corona kavach policies. So, you might want to go ahead with that.

Bottom-line

If you need homecare treatment or you think it will be wise to prepare for it in advance then you can buy Corona kavach policy online from Policybazaar. The coverage will start 15-16 days after your policy purchase date. For more details, you can write to us at care@policybazaar.com.