Getting home treatment for COVID-19? Here is all you should know
One of the biggest problems that most states in India face regarding COVID treatment is the shortage of beds. There are plenty of instances all around the country where people are being forced to go for treatment at home. This is till the time that they can gain access to COVID-19 treatment facilities at hospitals and the like. As seen during the first wave of the pandemic, several hospitals, healthcare companies, and doctors are offering medical consultations over the phone for mild cases. So come, let us see how you can file a claim if you are getting treatment for COVID-19 at home.
Home care treatment under regular policies
The first option that you have in these cases is your health insurance policy. The biggest problem is that most of these policies would not provide coverage for treatment for COVID-19 availed of at home. However, these days, you get insurers such as ICICI Lombard that are offering such coverage. This is available in their regular policies as well. Experts say that you can file a claim if your doctor has advised you to follow the COVID-19 treatment protocol and get treated.
This is applicable even in cases where you only have a mild case of infection and do not need hospitalization as such. However, you need to know the terms and conditions in these cases – especially the exclusions. For example, maybe you got a new treatment for COVID-19, but that is not covered in your policy. Experts believe that even if your policy covers home healthcare, you should get permission from your insurer before you start the treatment. Obviously, you have to follow all the necessary COVID-19 treatment guidelines in these cases. You should do all this before you prepare the treatment setup.
Doing this would make sure that there are no issues with the payment of your claims. As long as you are using oxygen for actively treating yourself and are doing so under medical supervision, you can always file a claim for it. It is also important to look at the claim settlement ratio of health insurance companies before you choose them as such. You must remember that you would not be reimbursed for the money you spent in buying the oxygen cylinder, the medical equipment in this case.
Coverage for home hospitalization
A lot of conventional health insurance policies have a clause named domiciliary hospitalization. This is not the same as simple home care. This is a situation where the doctor has recommended hospitalization, but you are unable to find a bed in any hospital. So, you are getting treated at home. You need to know how to file a health insurance claim in these cases. The main aim of domiciliary treatment is to offer you the best possible medical management while you are at home. Remember this while filling up the health insurance claim form. Apart from the fact that you can avail such treatment in case of a shortage of beds, this treatment is also provided when the patient is not in a condition to be moved to a hospital for treatment.
However, you need to keep in mind a few things, such as having proper documents in these cases. Your insurer could also insist that you get such treatment from properly organized companies and have registered themselves for GST (goods and services tax). This would help them get the detailed invoices that they are looking for in these cases. Second, you must never ignore the Mediclaim claim settlement ratio of a company while you select it.
Corona Kavach covers for home treatment
Corona Kavach is the final option that you have in these cases. Here you would get maximum coverage of Rs 5 lakh. For those who do not know, this is a standard COVID policy mandated by IRDAI (Insurance Regulatory Development Authority), and insurers have been offering it since 2020. Under this policy, you would get reimbursements even in the case when you have been treated for Corona at home. Experts say that the term home care treatment in the context of this policy means COVID-19 treatment at home based on the suggestion of a medical practitioner.
Usually, the policy provides coverage for treatment expenses for up to 14 days. However, if you have tested positive for the disease and your doctor has prescribed that you be treated actively, the coverage could be extended. In this case, the policy would also cover the costs incurred in buying necessary medical equipment such as oxygen cylinders and pulse oximeters. You can be sure that the settlement ratio of health insurance companies would not be an issue in this context.
As experts have pointed out, such coverage is not provided in the majority of the indemnity or hospital reimbursement policies. However, you need to know that the policy would not cover minor treatment that you may have sought during home quarantine. Instead, it would cover the money you have spent on setting up an ICU at your home and getting treatment for the disease. You would have to furnish your doctor’s prescription where they have suggested home treatment for you when you file a claim under the policy. That way, you would not have to bother about the Mediclaim settlement ratio of the insurer.
