Will your insurance cover home care?

Almost certainly not. Indian health insurance covers medical/nursing care, not personal care. A "home caretaker" providing hygiene, meals, mobility, and companionship is considered non-medical and isn’t reimbursable. A home nurse providing IV, wound care, or post-surgical monitoring under doctor’s prescription often is.

It’s a clause that lets you receive hospital-grade care at home if your condition would otherwise require admission. Most plans have it but with conditions: doctor certification, minimum continuous treatment period (often 3 days), and pre-authorisation. The benefit is usually a fraction of the sum insured.

Only if EzyHelpers (or your nursing provider) is empanelled with your insurer’s network. We can check. Otherwise, you pay first and claim reimbursement, claim approval typically takes 30–45 days.

Highly plan-dependent. Most plans cap home nursing at 5–10% of the total sum insured per year, or apply daily limits (₹2,000–₹5,000/day). For long-term placements (3+ months), expect that insurance covers a meaningful portion but not all.

Often yes, these are clear medical needs. The placement must include skilled nursing tasks (vitals, wound care, medication administration), be prescribed by a doctor, and be documented daily. Companionship-only post-stroke placements typically aren’t covered.

Yes. We provide daily nursing logs, treatment summaries, and prescription copies on request, the documentation insurers ask for. We don’t directly handle claim filing but can guide you to a TPA or insurance advisor who does.

Almost none in standard Indian health insurance. Some senior-specific top-up plans (e.g. specific Star Senior variants, certain corporate group plans) include limited home care benefits, read the wordings carefully or have us review with your TPA.

Not on its own. Health insurance is built around medical treatment, and a general caretaker helping with bathing, meals, mobility or company is a personal-care service, not a medical one. Some policies cover skilled nursing tasks under a domiciliary-hospitalisation clause when a doctor certifies the need, but that is a different arrangement to ongoing caretaker support. Check your specific policy wording rather than assuming either way.

Typically a doctor’s certification that hospital admission would otherwise be necessary but is not possible or practical for a specific reason, plus a minimum period of continuous treatment and pre-authorisation from the insurer. The exact conditions and the amount payable vary by policy, so confirm them with your insurer before assuming a claim will go through.

Many policies define a fixed number of days after discharge during which certain follow-up expenses are covered, but the length of this window and what it includes differ between insurers and even between plans from the same insurer. Your policy schedule will state the exact number of days and what is included, worth checking before you plan care around it.

No. Coverage depends on the specific plan, the policy year, and sometimes the individual clauses added at purchase, so one family’s experience is not a reliable guide for another policy. Always verify with your own insurer or TPA using your policy document rather than a general assumption.