Use Medical Insurance for Home Care

Medical Insurance

For eligible patients with a doctor's prescription, most medical insurance plans typically cover nursing care expenses. We are familiar with the claims standards and procedures of major medical insurance companies in Hong Kong. With extensive experience in supporting commercial insurance claims, we provide value-added services such as assisting with medical documentation to help shorten claim processing times.

Common Insurance Terms: Private Nursing

We actively discuss and design private nursing clause details with various insurance companies, aiming to popularise private nursing, optimise family expenditures, and provide a non-hospital choice for your family.

Prerequisites for Claims

	Key Requirements
Referral + Pre-authorisation	Must submit a doctor's referral letter. Pre-authorisation with the insurance company is required.
Doctor's Recommendation (Pre-approval Optional)	Written recommendation from the attending physician is required. Pre-approval is suggested but not mandatory.
Disease Specific + Referral Letter	Claims restricted to specified critical illnesses (e.g., Cancer / Heart Attack / Stroke). Must have a doctor's referral letter.
Post-Op / Post-ICU Window	Must be "Post-operative", "Post-ICU", or "Post-discharge / Post-day surgery". Activation within a 60-196 day limit.

Common Coverage Scopes

Common Scenario	Claimable Days/Year	Post-Discharge/Op Window	Max Daily Visits	Pre-approval？	Document Requirements	Disease Restrictions
Dressing Change (Small Surgery)	30 days	≤ 120 days	1 visit / 1 RN	No	Attending Doctor's Written Rec.	None
Twice Daily Care (Morning/Evening)	30 days (max 2 visits/day)	≤ 120 days	2 visits / day	No	Attending Doctor's Written Rec.	None
Joint Replacement / Long-term PT	90 days	90 days	1 visit / 1 RN	Yes	Doctor's Referral Letter	None
Stroke / Major Surgery Rehab	196 days	120-196 days	1 visit / 1 RN	Suggested	Doctor's Written Rec.	None
Early Stage Critical Illness Rehab	30 days (Specified Critical Illness)	60 days	1 visit / 1 RN	No	Doctor's Referral Letter	Specified Critical Illnesses Only

If you are unsure whether your insurance plan supports private nursing, feel free to contact us via WhatsApp.

Medical Insurance Claims: Key Considerations

Common Home Care Coverage:

Key Claims Considerations

Terms vary by policy; please prioritize the following:

In-Patient Private Nursing
Post-Discharge Home/Private Nursing
Post-Discharge Ancillary Services (e.g., Equipment Rental)

Benefit Ratio: Coverage percentage and scope
Limits & Duration: Maximum caps and timeframes
Pre-approval: Requirement for insurer's prior authorization
Condition Restrictions: Limitations on specific diseases/diagnoses
Medical Necessity: Requirement for a formal physician's referral
Staff Qualifications: Requirements for Registered Nurses and headcount limits

Medical Insurance Claims Success Stories

Assess Cost Now

Case 1: Home-based Palliative Care for Advanced Esophageal Cancer

Highlights

Significant Cost Reduction: Saved up to HKD 6,000 per day.
Fulfilled Last Wishes: Provided high-quality end-of-life Cancer Care at home, avoiding hospital stays.
Integrated Insurance Support: Provided professional nursing reports and documentation for private insurance claims.

YDCare Services

12-Hour Daily RN Care: Pain management, repositioning, and oral care
Home Parenteral Nutrition (HPN)
Injections & Oxygen Therapy
Equipment Rental: Oxygen concentrators, suction machines, and infusion pumps
Clinical Records: Daily nursing logs and summary reports to facilitate insurer underwriting

Insurance & Cost Comparison

Claim Amount: HKD 120,000
Coverage Days: 30 Days
Cost Comparison: Home Care (HKD 4,000/day) vs. Est. Hospitalization (HKD 10,000/day)

Total Savings

HKD 6,000 Daily / HKD 180,000 Total

Case 2: Complex Post-Op Wound Care (Horseshoe Abscess & Fistula)