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Health Insurance Without Hospitalization

Typically, a health insurance policy is associated with hospitalization. The insurer covers pre and post-hospitalization expenses, in-patient treatment costs, and several other costs incurred by a policyholder while getting treated at a hospital. When most people think about health insurance, they think about reimbursements for expensive hospital rooms and surgeries. However, not all medical treatments need hospitalization. In fact, a few treatments can be done within a day or even at home. But, will your health insurance cover the expenses? 

When you are looking at a comprehensive medical insurance policy, then ensure that treatments that don’t need hospitalization are covered too. The recent pandemic resulted in many people looking for health insurance plans. However, with authorities recommending getting treated at home and not getting hospitalized unless necessary, an important aspect of COVID insurance became health insurance without hospitalization. Some insurers offer health insurance coverage for medical treatment costs even without hospitalization. They are offered under two broad categories:

Domiciliary hospitalization

In simpler words, domiciliary hospitalization means getting treated at home as opposed to getting hospitalized. This can be for various reasons like the inability to move around or other personal reasons. However, getting treated at home usually means higher costs due to costly equipment, medicines, medical professional fees, etc. Some insurers cover these costs as part of the insurance coverage.

Daycare Treatments

Domiciliary hospitalization is not as common as a daycare treatment. Daycare procedures are certain medical procedures that don’t require overnight stays at the hospital. The patient walks into the hospital and walks out the same day. Think about procedures like cataract, chemotherapy (for cancer patients), a biopsy of the kidney, etc. Such procedures are normally completed in no time, and the patient is discharged within a few hours. The list usually includes procedures relating to cardiology, critical care, dental, ENT (Ear, Nose & Throat), Gastroenterology, general surgery, gynaecology, neurology, oncology, salivary glands, skin & subcutaneous tissues, tongue, ophthalmology, orthopaedics, pediatric, thoracic, urology, etc.

There is a huge list of treatments that can be done within the day. Insurance companies usually provide a list of daycare treatments that are covered under the health insurance policy. Therefore, before buying the policy, ensure that you check the list and see if some common treatments are covered. Also, if you have a pre-existing condition or a family history of certain ailments that might require daycare treatments in the future, then ensure that all of them are on the list.

How to choose a policy that offers health insurance without hospitalization?

When you buy a health insurance policy, it is important to remember to include all aspects to ensure that you get a comprehensive 360-degree cover. Imagine scheduling a daycare treatment only to realize that your insurer does not cover non-hospitalization treatment costs. In India, medical inflation is around 18%, and the costs of treatment are high. Hence, you would want your health insurance policy to cover as many treatments as possible. 

Hence, before you buy the policy, go through the policy documents and check if the insurance covers medical treatments without hospitalization. If it does, then check the extent of the cover and the list of procedures permitted. You might also want to check how the insurer deals with the out-patient department or OPD procedures, as well as dental procedures. 

Some insurers like Tata AIG offer these services via attractive and affordable add-ons or riders. Research thoroughly and talk to the insurer before making any decision. Remember, every individual is unique and requires a health insurance plan that is customized to his/her needs. Compromising now would mean a higher financial liability in the future during a medical emergency.

Also, check the insurer’s claim settlement ratio and process. If you are opting for a cashless plan, then check if there are any specific conditions for treatments that do not require hospitalization. This is equally important for reimbursement plans since you will be spending first and claiming a reimbursement later.

Summing up

Technological advancements have made medical surgeries and procedures shorter and costs higher. Hence, many procedures that needed 2-3 days of hospitalization can now be done in less than a day. While many policyholders assume that health insurance policies only reimburse treatment costs pertaining to serious illness and multiple-day hospitalization. However, most insurers provide medical policies that offer a cover for daycare procedures and domiciliary hospitalization.

It is important to remember that many daycare procedures involve the latest technology and hence, can be costly. Therefore, having a policy that covers these costs can save you a lot of money. Research well and look at all aspects before finalizing the policy. Also, if you are including your family in the cover, then ensure that the list of diseases and ailments meets the requirements of all family members.

Atticus Bennett: Atticus, a sports nutritionist, provides dietary advice for athletes, tips for muscle recovery, and nutrition plans to support peak performance.