Domiciliary Hospitalization in Care health Insurance

Any care or treatment equivalent to hospitalization provided at home comes under domiciliary hospitalization. But most importantly one must not confuse it with pre/post-hospitalization care at home. You cannot take into consideration that care given after discharge or before hospitalization can be covered under domiciliary hospitalization.

Note that domiciliary hospitalization only comes into effect after establishing the fact that hospitalization for the insured is not possible due to any reasonable cause such as the inability to shift the patient to the hospital or the hospital doesn't have an empty bed or anything, but the cause has to be undeniable. Domiciliary Hospitalization should not be mistaken for Home Care.

Care Health Insurance in Care Supreme's Prospectus point 3.1.1.vi clearly states that

Despite suffering from, an illness/Injury (which normally require care and treatment at a hospital), Hospitalization may not be possible perhaps Your state of health is such that you are not in a condition to be moved to a hospital or a Hospital room may not be available when you need the medical treatment the most. 

Under Our Domiciliary Hospitalization Benefit, We will pay you maximum up to Sum Insured, for the Medical Expenses incurred during your treatment at home, as long as it involves medical treatment for a period exceeding 3 consecutive days. 'Pre Hospitalization Medical Expenses and Post Hospitalization medical Expenses' shall be payable in respect of a claim made under this benefit. 

Any Medical Expenses incurred for the treatment for the treatment in relation to any of the following diseases shall not be payable under this Benefit:

Asthma; Bronchitis; Chronic Nephritis and Chronic Nephritic Syndrome; Diarrhoea and all types of Dysenteries including Gastro-enteritis; Diabetes Mellitus and Diabetes Insipidus; Epilepsy; Hypertension; Influenza, Cough or Cold; All Psychiatric or Psychosomatic Disorder; Pyrexia of Unknow origin; Tonsillitis and Upper Raspatory Tract Infection including Laryngitis and Pharyngitis; Arthritis, Gout and Rheumatism. 

This benefit is optional in certain policies provided by Care Health Insurance, whereas, in other policies, it is included as a foundational benefit. 

As Base Benefit in policies: Care Supreme; 

As Add-on / Optional Benefit in Policies: 

Claim Shield Benefit by Care health Insurance

Claim Shield Benefit is an optional benefit offered by Care Health Insurance. It covers items/consumables that are otherwise excluded in a claim. There are 68 items. 

As per the prospectus of Care Supreme 3.2.17, Claim Shield Benefit states that 

If a claim has been accepted under this benefit, then We shall indemnify for the items which are not payable, as per List - I under Annexure 1. The maximum claim payout under this benefit shall be limited to applicable Sum-Insured under the Policy.  

Note : Coverage for any item as per List-I under Annexure 1, Shall be available only if the same is not covered under any Base Benefit or Optional Benefit.

Various plans from Care Health Insurance allow you to select this optional add-on feature.

Namely: Care Supreme