the insurer's Home Care Treatment Add-On covers the cost of treating illnesses and injuries at home — when hospitalisation would normally be required. Covers diagnostic tests, consultation charges, nursing charges, and medicines prescribed by your doctor. Up to 14 days per illness. Sum insured: ₹10,000–₹50,000 (max 10% of base policy sum insured). Floater premium from ₹559 for ₹50,000 cover.
the insurer Health Insurance· Add-On Cover· from· IRDAI Health Product
"Home Care Treatment Add-on provides coverage of expenses for medical treatment in any illness / injury which in normal course would require care and treatment at a hospital." This is a health insurance add-on that bridges the gap between hospitalisation and doing nothing — when you're too ill to be left untreated but don't strictly need a hospital bed.
"Medical treatment in any illness/injury which in normal course would require care and treatment at a hospital." The add-on recognises that many illnesses requiring hospitalisation can be treated safely and effectively at home with proper medical supervision.
the insurerDiagnostic tests at diagnostic centres· Consultation charges· Nursing charges· Medicines — all covered when prescribed by the treating medical practitioner. Complete care ecosystem at home: test, consult, nurse, medicate.
the insurer"Get home care cover for upto 14 days for any one illness." Two weeks of covered home care per illness episode — sufficient for most acute medical conditions that don't require intensive hospitalisation.
14 Days· Per Illness"Coverages from Rs.10,000/- to Rs. 50,000/- Sum Insured not exceeding 10% of base policy sum insured." — the insurer. Maximum home care SI = 10% of your base Mediclaim SI. Base SI ₹5L → max home care SI ₹50,000.
10% of Base SI"Floater premium as low as Rs 559/- for coverage of Rs 50,000/- of a 30 year old adult." An add-on that costs less per year than one doctor visit — providing ₹50,000 of home care coverage across all family members on a floater basis.
₹559 FloaterCan only be purchased alongside 4 specific the insurer base mediclaim policies. The add-on cannot be purchased as a standalone policy — you must hold one of the four eligible base policies. Makes sense as it enhances existing hospital coverage.
4 Base PoliciesFour Eligible Base Policies Only
"You can purchase this add on policy if you are covered by our Mediclaim Policy / Mediclaim Plus Policy, New Parivar Mediclaim Policy, Parivar Mediclaim Plus Policy." The Home Care Treatment Add-On is only available to existing holders of these four the insurer Mediclaim policies.
the insurer's flagship individual indemnity health insurance. Covers hospitalisation, day care, pre/post hospitalisation. Add home care treatment cover to this base policy.
Individual· Base PolicyEnhanced version of Mediclaim with higher sum insured (up to ₹50L) and additional benefits. Add home care treatment for comprehensive at-home coverage.
Individual· High SIthe insurer's floater family mediclaim policy covering entire family under a single sum insured. Add home care as floater — all family members covered at home.
Floater· FamilyEnhanced family floater policy with additional benefits including maternity, ambulance, anti-rabies, infertility. Add home care for the full family at minimum extra premium.
Floater· Family· Plusthe insurer· Four Covered Expense Categories· Doctor Prescription Required
"Expenses such as diagnostic test undergone at diagnostic centre, consultation charges, nursing charges and medicines are covered if prescribed by the treating medical practitioner." All four expense categories require a prescription from a qualified medical practitioner. The treating doctor is central to the entire home care claim.
Blood tests, urine tests, X-rays, ultrasounds, ECG, and other diagnostic investigations ordered by the treating doctor — conducted at an accredited diagnostic centre. Must be prescribed by the treating medical practitioner and directly related to the illness/injury being treated at home.
Doctor-Prescribed· At Diagnostic CentreDoctor's consultation fees for home visits or clinic visits during the home care treatment period. The treating medical practitioner's professional charges for diagnosis, prescription, and monitoring of the illness being treated at home. Includes follow-up consultations during the 14-day home care period.
Treating Doctor FeesProfessional nursing care at home — qualified nurse visits for wound dressing, IV administration, medication supervision, vital sign monitoring, injection administration, and other skilled nursing procedures. Must be prescribed by the treating medical practitioner.
Qualified Nurse· At HomePrescription medicines and drugs for the illness being treated at home. Must be prescribed by the treating medical practitioner. Covers the full course of prescribed medications during the home care treatment period (up to 14 days per illness).
Prescribed Medicines Onlythe insurer· ₹10,000–₹50,000 Range· Maximum 10% of Base Policy SI
"Coverages from Rs.10,000/- to Rs. 50,000/- Sum Insured not exceeding 10% of base policy sum insured." The home care SI is capped at the lower of: (a) ₹50,000, or (b) 10% of your base mediclaim sum insured. Five coverage tiers available.
Minimum cover
Base SI ≥₹1L needed
Base SI ≥₹2L needed
Base SI ≥₹3L needed
Base SI ≥₹4L needed
Maximum
Base SI ≥₹5L needed
the insurer· Policy Conditions· Claim Documentation Requirements
Home Care Treatment claims require specific documentation confirming that the treatment was medically necessary, supervised by a qualified doctor, and conducted according to a prescribed treatment plan. The treating doctor's role is central to both the treatment and the claim process.
the insurer· Specific Exclusions + Standard IRDAI Exclusions
The confirms specific exclusions for this add-on. These are in addition to all standard IRDAI health insurance exclusions that apply to the base mediclaim policy.
"Expenses incurred for alternative treatment." Ayurveda, homeopathy, Unani, naturopathy, acupuncture, and other alternative/complementary medicine treatments at home are excluded. Only allopathic (conventional) medical treatment qualifies under the home care add-on.
"Expenses incurred for maternity or infertility." Home care for pregnancy-related conditions, childbirth, post-natal care, and infertility treatments are excluded. These are covered (if at all) under specific maternity riders in the base policy.
"Cost of Purchase of any External/durable medical/non-medical equipment/instruments of any kind used for diagnosis/treatment." Purchasing wheelchairs, nebulisers, oxygen concentrators, BP monitors, glucometers, or any other medical equipment for home use: excluded. Equipment rental may be discussed with the insurer.
"Any Surgical procedure including day care treatments." Any procedure requiring surgical intervention — even if performed at home — and all day care procedures (as listed under the base policy) are excluded from home care coverage. Surgery always requires a hospital setting.
"Expenses incurred for any of the following diseases: Tonsillitis and upper respiratory tract infection including laryngitis and pharyngitis." These common conditions (sore throat, tonsillitis, laryngitis) are specifically excluded — they are typically mild and do not normally require hospitalisation, so they fail the qualifying test.
"All Standard exclusions as per IRDAI standardisation guidelines." Pre-existing diseases (during waiting period), self-inflicted injuries, substance abuse, cosmetic treatments, war and nuclear events, and all other standard IRDAI health insurance exclusions apply to this add-on as well as the base policy.
the insurer + IRDAI Standard· Home Care Claim Process· Documentation Essential
Home care claims are reimbursement-based — you incur the expenses, maintain proper documentation, and submit for reimbursement. The treating doctor's documentation (daily monitoring charts, discharge certificate) is the most critical requirement. the insurer Toll-Free: 022 4302 0000.
When illness or injury arises that would normally require hospitalisation, consult your treating medical practitioner. The doctor must assess that home treatment is medically appropriate and equivalent to what would be received in hospital. The doctor's judgement is the starting point for every home care claim.
Inform the insurer (022 4302 0000) or your TPA (if assigned) at the start of the home care episode. Early intimation is important. Provide: base policy number, home care add-on details, treating doctor's name, diagnosis, and expected treatment duration.
"Daily monitoring charts including records of treatment administered duly signed by the treating doctor is maintained." Start and maintain daily records from Day 1: temperature readings, BP, medications administered, nurse visits, doctor observations. Each entry must be signed by the treating doctor. This is the most critical claim document.
Collect and preserve all original bills and receipts: diagnostic centre bills (with test reports), pharmacy bills (with prescriptions), nursing agency invoices, consultation receipts. All expenses must have corresponding doctor prescriptions. Do not discard any receipt — even small pharmacy purchases require original bills for reimbursement.
"Discharge Certificate from medical practitioner specifying date of start and completion of home care treatment." When treatment concludes (or at 14 days, whichever is earlier), obtain a signed discharge certificate from the treating doctor specifying the exact start and end dates of the home care treatment.
Submit duly completed claim form with: Discharge certificate, Daily monitoring charts (signed by doctor), All original bills with prescriptions, KYC documents (if claim >₹1 lakh), Base policy and add-on policy documents. Submit within the time limit specified in the policy. the insurer will review and process reimbursement as per the sum insured and covered expenses.
Home Care Treatment Add-On — Frequently Asked Questions
Add Home Care Treatment to Your the insurer Mediclaim
Tell us about your existing the insurer Mediclaim policy. Our health insurance specialist will confirm your eligibility, calculate your maximum home care sum insured, and add this cover to your policy at the next available opportunity (renewal or mid-term if allowed).
By submitting you agree to our Privacy Policy and Terms & Conditions. Home Care Treatment Add-On· the insurer Health Insurance· IRDAI Regulated. Coverage of expenses for home treatment in illness/injury that would normally require hospitalisation. Sum insured ₹10,000–₹50,000, not exceeding 10% of base policy SI. Up to 14 days per illness. Floater from ₹559. Requires eligible base the insurer Mediclaim policy. Probitas Insurance Brokers Pvt. Ltd.· IRDAI Lic. No. 528.