Homecare - A patient (employee and dependents if covered under the policy) receiving treatment at home for an illness or injury (Including Covid-19) instead of treatment in a hospital. This is also known as domiciliary hospitalization or Quarantine/Home Isolation treatment in the case of Covid 19
This can be availed via both cashless and as reimbursement.
Cashless - The employee needs to reach out to ICICI Lombard for a cashless which can be arranged by our claims team. Here the Home Care treatment is managed by hospitals or specialist providers under a partnership with ICICI Lombard. Please note, this is basis availability and only available in select locations/cities.
Reimbursement - The employee needs to reach out to ICICI Lombard for mandatory prior approval before treatment without the approval future reimbursement can't be accepted
The process to follow: Employees to reach ICICI Lombard via the below modes,
call @ 040-6627 4205 (8 am to 8 pm from Mon to Sat except for public holidays)
email your request email@example.com (refer below for more details)
In case the employee intends to avail reimbursement, follow the below steps
Take prior approval by providing the following scanned documents via the above-provided email
Positive RT-PCR test report
Doctor prescription suggesting Home Quarantine/Home Isolation/Home treatment
Health Card (refer Plum dashboard) & Govt Issued ID Proof
Approximate treatment cost estimate
Post completion of your treatment submit a claim reimbursement
Reimbursement is to be submitted via Plum dashboard. Login to your profile and choose "Use my insurance" and follow the WhatsApp claims submission process
Documents Required for Home Quarantine claim processing:
Claim form with NEFT details and cancelled cheque copy
Doctor prescription suggesting Home Quarantine/Home Isolation
Plan of treatment/medication details during home isolation period (Prescription/Consultations)
RT-PCR Report / RAT (Rapid Antigen Report) -Investigation report
Bills, Payment receipts, Investigation reports
In case of home quarantine package, break-up is mandatory.
Health Card Copy & ID Proof (issued by Govt. of India)
If the employee doesn’t take prior approval for a reimbursement claim before that of treatment at home, then the claim will not be admissible.
Does my health insurance policy cover COVID -19 infections?
Yes, our policy covers hospitalization expenses arising out of COVID-19 infections.
What tests are required to file a claim?
An RT PCR or Rapid Antigen Test Positive report confirming COVID-19 from a government hospital lab or a lab authorized to conduct COVID 19 test is required.
Is there a waiting period?
There is no specific waiting period for COVID-19. If any new employee joins the organization, the employee and his dependents will get the benefit from day one.
Is a cashless treatment facility available?
Will the policy cover hospitalization in a country other than India?
No, the geographical area covered under the policy is limited to India.
Will my travel history abroad affect the admissibility of a claim under the policy?
No, as long as the hospitalization is in India, the admissibility of the claim will not be affected by the travel history.
What is home care?
Home care is a convenient alternative to hospital care. This service is based on the individual’s needs as prescribed by his or her treating doctor*. The service includes remote monitoring by a medical practitioner and may also include visits from medical professionals (nurses, doctors, and physiotherapists).
*e.g. –if the treating doctor has advised an active line of treatment for which admission in a hospital is required but the same can be managed by qualified personnel at home.
What are the advantages of home care?
Prevents hospital-acquired infection
Convenient and less stressful
What kind of treatment lines are generally covered under home care?
The treatments covered under home care are as below (but not limited to):
Wound management of pressure sores or a surgical wound
Parenteral Administration (Injection admin, IV / IM / SC)
Eligibility for Homecare treatment?
A prescribed continuous active line of treatment from doctor/hospital
Medically manageable at home with the right set of clinical qualified personnel
Subject to policy T & C
What is excluded under home care services?
Medical emergency & OPD treatment
No active line of treatment, as admission required
Subject to policy T & C
What if the treating doctor prescribes COVID-19 home care treatment, will it be covered? If yes, what is the process to initiate a claim with ICICI Lombard?
COVID-19 home care treatment is covered subject to revised guidelines specified by the MoHFW& State Govt. regulations. We will provide assistance with the home care provider based on the prescription of the treating consultant, an active line of treatment for which admission in a hospital is required and the same can be managed by qualified personnel at home.
Which cities will be covered for COVID-19 home care treatment?
Home care service can be provided using remote assistance across cities at a pan-India level. Along with this physical visit at home by a medical professional can be extended at below-mentioned cities as of now, subject to availability:
Tier 1: Delhi NCR, Mumbai, Kolkata, Bangalore, Chennai, Hyderabad, Ahmedabad & Pune
Tier 2: Chandigarh, Indore, Lucknow, Vijayawada, Vishakhapatnam, Jaipur & Coimbatore
Who are the providers ICICI Lombard has tied up to provide home care services?
Apart from leading hospitals, we have tie-up with top home care service providers like Portea, HCAH (Healthcare at Home), Nightingale, Apollo Care, etc.
What are the various home care expenses that will be covered?
Consultations and nursing are covered. Investigations & medicines are covered on a best-effort basis.
Is there any sub-limit applicable for Homecare?
It is as per the terms and conditions applicable in the policy