Will My Insurance Cover Me If I Don’t Get Hospitalised?

How do you imagine a health insurance claim play out in your head? A serious illness, prolonged treatment requiring consistent medical attention, and hospitalization, right? You’re not alone. Most people think of expensive hospital rooms when they think about insurance. But now, with so many advancements in healthcare, there are many treatments and procedures that can be completed in a few hours. But would your health insurance plan cover these?

Domiciliary Hospitalisation

Domiciliary hospitalisation refers to when you choose to get treated at home either due to being unable to move around or for other personal reasons. But just because you are receiving the treatment at home doesn’t mean it will necessarily be any cheaper; you may still need expensive equipment, attendants and medicines. But with a plan like Tata AIG MediCare, that won’t be a problem because it even covers pre-and post-hospitalisation expenses.

Day Care Treatment

While domiciliary hospitalisation is an option, you are more likely to avail day care treatments, which refer to certain procedures that don’t require extended hospital stays and continuous observation. Surgeries, such as cataracts, kidney biopsy and chemotherapy are some examples of such procedures, where you will be in and out of the hospital within a few hours. Though quick, the cost of these procedures can still be quite high.

So, coming to the most important question - will these treatments be covered under your health insurance plan? The answer is not a clear yes or no. Most health insurance providers cover a part of the day care treatment cost, but certain providers are coming up with an extensive day care insurance plan, which is more comprehensive and provides better coverage. Tata AIG Medicare, for example, covers day care treatment for diseases, illnesses as well as injuries.

Choosing the right health insurance plan

Now, you wouldn’t want to find out at the last hour that your insurance won’t cover your day care treatment, would you? To avoid such nasty shocks, it’s best to #ThinkAhead and research well before you pick your health insurance.

The first thing you must check in a policy is if it covers domiciliary treatment and day care procedures.

Once you’ve ensured that, check the extent of covered procedures. A wide range of coverage ensures that your insurance can take care of most treatments in the future. Tata AIG Medicare Premier covers over 540 procedures including, cardiology, ENT, critical care related to ensure that you can rest assured about your future.

Additionally, also check what the insurance policy’s stand is on the outpatient department (OPD) and dental procedures. Tata AIG Medicare Premier covers OPD expenses related to consultations and pharmacy up to Rs. 5000 annually. The policy also covers dental treatment up to Rs. 10,000 annually, covering root canals, tooth extractions and fillings. Both these benefits kick in once you've completed two continuous years of coverage under the policy.

You should also pay attention to the cashless facility norms the policy offers, as well as what their criteria are pertaining to the age, limit, or sub-limit when it comes to picking the right plan for you and your family.
Check our resources on Family Health Insurance to understand how to pick the right plan for your family. if you are looking for a policy for your self or a loved one, check our resource on individual health insurance to know more

Day care treatment can be a money guzzler given the rising costs of medical care. Your health insurance should be able to support you through tough times, even if it doesn’t need you to stay for days at the hospital. #ThinkAhead and secure yourself with an insurance plan that takes care of you under all circumstances, no matter what the risk.

We couldn’t find much on Medicare’s stance on OPD and dental so please let us know if the policy covers these. Depending on that we’ll rephrase this statement.