May 7, 2021

INDAC

Keep Fit & Healthy

Health Insurance Coverage For Home Treatment Of Covid Is Possible

3 min read



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As Covid cases rise exponentially, patients are finding it harder to avail treatment at hospitals that are reportedly overburdened and finding it tough to take on new patients. To address the shortage of hospital beds and to get patients the immediate treatment they require, home treatment is being recommended. This raises the question if home treatment will be covered by your health insurance policy. As you may be aware, health insurance policies are typically used during a hospitalization. Not all health policies cover home treatment. So, what happens when you’re being treated for Covid at home and need to use your coverage? Let us look.

The Rules

In June 2020, the Insurance Regulatory & Development Authority (IRDAI) approved domestic Covid-19 treatment, saying that it needed to be covered under ‘Covid standard health policies’. The IRDAI said that for these policies, “Insurer shall cover the costs of treatment of Covid incurred by the insured person on availing treatment at home maximum up to 14 days per incident” assuming that the home treatment has been advised by a medical practitioner and that a medical practitioner will continue to administer, monitor, and record the treatment. The treatment can be done cashlessly where the healthcare provider is networked with the insurance provider. In other cases, eligible reimbursement claims can be made. In either situation, the claim settlement process of the insurance provider needs to be followed.

Which Policies?

If you buy a new policy today, it’s likely to provide specific instructions on how Covid treatment will be covered. Older policies issued before Covid may or may not carry instructions specific to such a disease or its treatment at home. Domiciliary treatment has become a common feature among health policies issued in recent years. However, this wasn’t the case earlier. All policies should be able to cover the treatment of Covid subject to their terms and conditions, but some older policies may not cover home treatment. For clarity, you can go through the policy booklet or speak to your insurance provider.

What Is Covered & Not Covered?

Standard Covid policies will cover the treatment of Covid, whether at home or in a hospital. Several hospitals are now providing healthcare packages designed for domiciliary treatment wherein the patient will receive nursing, consultation, prescriptions, and treatment through the hospital but at home. Most standard Covid policies will entertain claims after a waiting period of 15 to 30 days. Many health policies do not cover the costs of consumables such as PPEs. However, several Covid policies do so, and some may define the limit to which consumables will be covered. Therefore, while buying such policies do pay attention to sub-limits on coverage.

How To Make Claim

Each policy has its own terms for the claims process and you must follow them. Insurance providers require you to report the treatment in the agreed upon timeframe along with the necessary documents. In the case of home treatment of Covid, you will require a positive RTPCR test report from an approved lab, along with any necessary proof that a hospital bed couldn’t be availed and that home treatment was recommended by the doctor.

If you don’t have a home treatment policy, you can avail one that you’re eligible for. In case you suffered from Covid after the waiting period, your policy will cover your treatment costs, whether they were incurred at home or in a hospital. As such, your best protection is an adequate base coverage along with a large top-up.

The writer is CEO, Bankbazaar.com, an online marketplace for loans, credit cards and more. Image courtesy: Freepik

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