Bangalore · Insurance guide
An honest guide to how major Indian health insurers handle home nursing — what qualifies, what doesn’t, and how to claim without surprises.
Reviewed by Sister Mary George, B.Sc Nursing, Care DirectorLast updated May 2026
In one paragraph
Indian health insurance typically covers skilled home nursing — IV, wound care, post-surgical monitoring — under "domiciliary hospitalisation" clauses, with doctor certification and pre-authorisation. It almost never covers caretaker or companion services. The amount varies by plan, often 5–10% of sum insured per year.
Major insurers
Plan-level details vary. Read your specific policy wordings or call your TPA — but this is roughly where each company stands.
Home nursing under Domiciliary Hospitalisation in select plans (ReAssure, Health Companion). Typically 5–10% of sum insured per year.
Pre-authorisation required. Doctor must certify hospitalisation would otherwise be needed.
Home Care benefit in Senior Citizens Red Carpet, Family Health Optima, and Star Health Comprehensive — daily limits apply.
Often capped at ₹3,000–₹5,000/day. Pre-authorisation mandatory.
Activ Assure, Activ Health Platinum include domiciliary hospitalisation and limited home nursing.
Conditions: continuous treatment for at least 3 days, doctor certification.
Optima Restore, my:health Suraksha plans cover home healthcare with conditions.
Network providers preferred for cashless. Reimbursement otherwise.
Complete Health Insurance includes domiciliary hospitalisation under specific clauses.
Daily caps; requires hospitalisation alternative justification.
Health Guard plan covers domiciliary in some variants.
Most plans require hospitalisation; home nursing only in upgraded variants.
What qualifies
Typically covered
Typically not covered
How to claim
Skip any of these and the claim is likely to be rejected. The order matters too.
Get a written prescription from the treating doctor stating that home nursing is medically necessary as an alternative to continued hospitalisation.
Submit the prescription, hospital discharge summary, and treatment plan to the insurer. Approval typically takes 24–48 hours.
Cashless claims work only with empanelled providers. For non-network arrangements, you pay first and claim reimbursement later.
Daily nursing log, medication records, treatment notes — all needed at claim submission. Without these, claims are routinely rejected.
Frequently asked
Tell us your insurer and the situation. We’ll let you know what’s likely to be covered, what isn’t, and provide the documentation you need to claim cleanly.
