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Understanding Domiciliary Hospitalization in Health Insurance

By Juhi Walia
12 September 2022, 10:12 AM

Did the word "domiciliary hospitalisation" mystify you while searching for the best health insurance in India? If that is the case, relax! Like you, many people who purchase health insurance are perplexed by the jargon or words used in the industry. 

However, we're here to explain the idea's true meaning. So, let's get going!

Domiciliary hospitalization describes a circumstance in which the insured person is treated as hospitalized even though they are at home. It is recommended if the policyholder is unable to stay in a hospital or when a hospital room is not available. In such cases, the insured receives treatment at home. However, a qualified doctor must prescribe home treatment to get domiciliary hospitalisation coverage. According to the doctor's recommendations, the insurer will reimburse the policyholder for medical expenses incurred throughout the term.

How Does Health Insurance Define Domiciliary Hospitalisation?

It is a form of at-home treatment for an ailment, disease, or accident. The health insurance company will pay for any expenses incurred for the therapy, but in specific circumstances, when-

  • Hospitalization is needed to treat an injury, illness, or disease.
  • The insured patient's health hinders him/her from being transferred to a nursing home or hospital.
  • Due to a lack of available accommodations during hospitalisation, the insured patient is forced to receive treatment at home.
  • The therapy needs at least three days to treat the patient.

The Significance of Domiciliary Hospitalisation Coverage in Health Insurance

Many people who have health insurance place a lot of value on the domiciliary hospitalisation option. After all, if they can't travel to the hospital or find lodging at a hospital for a particular treatment, the benefit gives them the convenience of getting treated at home. More importantly, relatives won’t have to visit the hospital frequently to meet the insured patient.

Not to mention, the benefit of domiciliary hospitalisation allows the insured or their family members to avoid spending much money that would otherwise be wasted on repeated hospital visits.

The Significance of In-home Care in Health Insurance

Note a few reasons why it's important to confirm that your health insurance covers domiciliary hospitalisation.

  • A solace health insurance cover that goes beyond hospitalisation.
  • It covers medical costs if hospitals cannot accommodate patients, as was the case at the height of the COVID-19 pandemic.
  • Coverage if the covered patient's current medical condition prevents them from being transferred to a facility.
  • Offers peace of mind.

Understand These Points About Domiciliary Hospitalisation

  • Most, but maybe not all health insurance companies, offer domiciliary hospitalisation coverage.
  • Hospitalization at home is not a standard option for coverage, and the insurer may require you to pay an extra premium depending on the level of coverage you choose.
  • Some health insurance policies cover in-home hospitalization expenses up to a certain percentage of the policy sum insured.
  • Domiciliary hospitalisation must span for a minimum of three days for you to get reimbursed by the insurer.
  • Any medical procedure lasting less than 3 days or 72 hours is excluded. 
  • Some insurance plans only pay for allopathic in-home care. They might not cover homoeopathic or ayurvedic medicine used for disease.
  • Domiciliary treatment can be advised in case of COVID if approved by the doctor.
  • Costs for both pre-and post-hospitalization care are not covered under domiciliary hospitalisation.
  • Treatment for conditions like asthma, bronchitis, epilepsy, hypertension, chronic nephritis, coughing, colds, and the flu, as well as chronic nephritis and nephrotic syndrome, arthritis, gout, diabetes mellitus and insipidus, rheumatism, upper respiratory tract infection, tonsillitis, pharyngitis, and psychiatric disorders, shall not be covered. 
  • Above everything else, you must demonstrate to the insurance company that you cannot be admitted to a hospital and do not have any other option except to undergo domiciliary hospitalisation. Keep in mind that the insurer will only cover your costs if your justification convinces them. The insurer will not cover the cost of the treatment if you could have easily gotten to the hospital but chose not to.

Things To Keep in Mind

Before utilising the benefit of home hospitalisation, there are a few factors to keep in mind:

  • If you believe it would be crucial for you to have domiciliary hospitalisation coverage by your side in the event of an emergency, find a plan that includes the benefit in the first place.
  • Don't forget to review the requirements to see if you qualify for the domiciliary hospitalisation benefit.
  • If your policy offers this protection, ensure that you read the terms and limitations thoroughly in advance to prevent last-minute disappointments.
  • When filing a health insurance claim for a hospitalisation at home, don't forget to include all pertinent details.
  • It is critical to consider the specific coverage provided by the domiciliary hospitalisation feature that may vary depending on the health insurance provider. In other words, whilst one health insurance company's plan may provide coverage for domestic expenses up to the sum insured amount, a different health insurance company's plan may cover domestic expenses up to a particular percentage of the sum insured amount.

So, while purchasing a health insurance plan with a domiciliary hospitalisation benefit, you must be attentive to confirm your needs. Do examine the policy wording and other policy documents carefully before purchasing.


Accidents and illnesses can hit you anytime and cannot be predicted. All you can do is proceed with caution and maintain your financial readiness. So it makes sense to purchase health insurance and protect your funds. In India, purchasing health insurance online is simple and convenient. ​

Choose the most acceptable health insurance option that includes coverage for domiciliary care and hospitalisation costs. And pick a health insurance policy that enables you to safeguard your savings. All you have to do is choose the insurance, and then quickly and conveniently buy it online.

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1. Do all health insurance plans include domiciliary hospitalisation?

Most health insurance plans may include domiciliary hospitalisation as a standard benefit. Some may keep it as an add-on at an extra premium. Before acquiring the coverage, it is advised to review its inclusions and exclusions carefully.

2. Can I get AYUSH treatment coverage while receiving care at home?

Domiciliary hospitalisation generally does not cover AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homoeopathy) treatments. It is advised to confirm the same with the insurer before purchasing the coverage.

3. Is the cost of medications covered under in-home hospitalisation?

Yes, the domiciliary hospitalization program covers the cost of medications.

4. Does the domiciliary hospital insurance cover the cost of hiring a nurse?

Yes, domiciliary hospitalization covers the entire course of care, including the cost of hiring a nurse.

5. Does it also cover the cost of the ICU?

Yes, as long as the cost falls within the policy's total coverage amount.

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