Domiciliary Hospitalisation Cover in Group Health Insurance

In this cutthroat competition, companies offer various perks to employees to stand out. One such perk is investing in insurance for SME such as a group mediclaim policy for their employees. This insurance coverage helps ensure that the employee receives timely, high-quality medical care during medical crises.

Not just this; employees can also secure their loved ones' health, such as their spouse, parents and children, under the plan. There are a range of medical treatments covered under the group medical plan, one of which is domiciliary hospitalisation cover. In this guide, we will understand what is domiciliary hospitalisation cover in a group mediclaim policy.

Understanding Domiciliary Hospitalisation Cover in Group Mediclaim Policy

Domiciliary hospitalisation cover in a group health policy is coverage for medical treatment provided at home. There may be a situation where the patient cannot be admitted to the hospital due to specific circumstances but requires medical attention equivalent to hospital care. This treatment comes under domiciliary hospitalisation. The treatment in this category needs to be approved by the medical professional.

Eligibility and Conditions for Domiciliary Hospitalisation Cover

To be qualified for the domiciliary hospitalisation cover in a group mediclaim policy, employees need to meet the eligibility criteria:

●      Employees need to provide the necessary documents, such as a doctor's prescription and health reports, to be eligible for domiciliary treatment.

●      Medical expenses for the domiciliary treatment are usually not covered under the group mediclaim policy if treatment continues for more than 3 days.

Key Features of Domiciliary Hospitalisation Cover

Some of the key features under the domiciliary hospitalisation cover in group mediclaim policy are:

Various Home Based Treatment

Domiciliary hospitalisation covers a wide range of medical illnesses such as cancer treatment, dialysis, etc., specified in the policy conditions. The plan does not offer coverage for the end of life care or enteral feeding.

Pre-hospitalisation Coverage

If the domiciliary hospitalisation claim is admissible, the policy also covers eligible pre-hospitalisation expenses, such as doctor's consultations, diagnostic tests, and prescribed medicines incurred before the treatment, as specified in the policy.

Post-hospitalisation Coverage

The cover also includes eligible post-hospitalisation expenses incurred after the domiciliary treatment. These may include follow-up consultations, prescribed medications, and diagnostic tests for the same illness, subject to the limits and duration specified in the policy.

Claim Process for Domiciliary Hospitalisation Cover Under Group Mediclaim Policy

Filing a claim for domiciliary cover under a group mediclaim policy is straightforward. Here are the steps you need to follow:

●      Verify Eligibility Criteria: Before filing a claim under group mediclaim policy, you need to verify if you meet the eligibility criteria for domiciliary cover.

●      Gather Necessary Documents: If you meet the eligibility criteria, gather necessary documents such as a doctor's letter, prescription, etc., that specify the need for domiciliary hospitalisation.

●      Inform the Insurance Provider: After getting all the documents, inform the insurance provider about the requirement for domiciliary hospitalisation.

●      Submit a Claim: Submit necessary documents such as doctor's prescription, claim form, medical bills and other documents requested by the insurer.

●      Wait for Decision: After receiving the claim, the insurance provider will verify the submitted documents and review them against the policy terms and conditions.

●      Claim Settlement: If the claim is approved, the insurer will settle the admissible amount in accordance with the policy coverage and applicable limits.

Save Your Workforce with TATA AIG Group Mediclaim Policy

A group medical insurance policy with domiciliary hospitalisation cover offers financial security to the workforce. It allows employees to receive necessary medical care during medical crises.

TATA AIG offers a group medical policy with domiciliary hospitalisation cover tailored to meet your workforce needs. Along with comprehensive domiciliary health coverage, employees also benefit from pre and post-hospitalisation coverage. You can get a TATA AIG group medical insurance policy at an affordable rate and ensure enhanced coverage for your employees.

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