All about AYUSH Treatment in Health Insurance

August 25, 2022

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Ayush treatment in Health Insurance

Indian culture and its ancient civilization propagated natural remedies and solutions relevant even today through Ayurveda and Yoga. Hence it was inevitable that not everyone in the country opts for allopathic treatment as many people believe in the power of homoeopathy, ayurveda, yoga and natural therapies. In the year 2013, IRDAI directed all the insurance companies to offer coverage for AYUSH i.e. ayurveda, yoga, unani, siddha and homoeopathy treatments under health insurance. Read on to know all about AYUSH treatments in health insurance. 

What is AYUSH treatment? 

AYUSH stands for ayurveda, yoga, unani, siddha and homoeopathy and under health insurance these traditional lines of treatments are covered. Such traditional and wellness treatments are affordable and can be effective in treatment of various medical conditions. This line of treatment is usually opted for by individuals who are not inclined towards allopathy. 

Reasons to choose AYUSH treatment 

Given below are a few reasons as to why people choose AYUSH treatments 

  • Treatments may take time but are usually effective in the long run 
  • In comparison to allopathy, the cost of AYUSH treatment is usually lower 
  • Alternative treatments are available at almost all locations in India 
  • Senior citizens opt for AYUSH cover as the treatment is highly beneficial to them 

 AYUSH treatment coverage in health insurance importance 

 Given below are a few reasons as to why AYUSH treatment coverage in health insurance is essential. 

  • Enables you to explore holistic treatment options through traditional Indian medicines 
  • Provides coverage for treatments such as unani, sidha, etc. apart from allopathy 
  • Helpful towards preventative healthcare and wellness 

 AYUSH treatment features and benefits 

Given below are a few of the benefits and primary features of AYUSH treatments 

  • Provides coverage in case of in-patient hospitalization 
  • Get access to AYUSH daycare centers or hospitals for in-patient treatment 
  • AYUSH treatments are usually low cost in comparison to allopathy, hence chances of exhausting the entire sum insured are lower 

 AYUSH treatment eligibility criteria 

Given below are the eligibility criteria to get treatment under AYUSH cover: 

  • Only in patient hospitalization at state or central government hospitals are covered under the policy 
  • In-patient hospitalization treatment only covered at hospitals accredited by National Accreditation Board or Quality Control of India 
  • In-patient hospitalization must be at least 24 hours 

AYUSH treatment Inclusions 

  • Healthcare expenses incurred from in-patient hospitalization treatment under AYUSH 
  • Expenses incurred from treatment at AYUSH daycare centres  

AYUSH treatment exclusions 

  • Health checkups or evaluation 
  • Preventative or rejuvenation treatments not classified as medical treatments 
  • Pre and post hospitalization expenses 
  • Treatment availed outside government hospitals and centers 

 Things to remember when considering AYUSH cover in health insurance  

Given below are factors to consider when choosing AYUSH cover in health insurance:

  • The terms and conditions of AYUSH cover may vary from insurer to insurer 
  • Check if the coverage offered is in built or is attracting additional premium 
  • Check on the network list of hospitals covered under AYUSH 
  • AYUSH treatment under health insurance comes with a capping. Check on the limit before choosing the plan. 

 AYUSH treatments under group health insurance 

 If you are an employer, ensure you provide AYUSH in health insurance for your team. That way, you are giving your employees more options when it comes to their healthcare. You are also giving them the option to treat themselves with a system that is healthier, and safer.  

 Here are a few other key points to keep in mind when picking employee healthcare plans with an AYUSH medical scheme:  

  • Insurance can only be claimed if an individual is admitted to an AYUSH centre for over 24 hours. He/she needs to be considered an in-patient for the insurer to recognize the treatment.  
  • Expenses can be claimed only for treatments done at government-approved AYUSH hospitals, or those accredited by the Quality Council of India/National Accreditation Board on Health (NABH).  
  • Some group health insurance plans provide AYUSH cover as an add-on, and not a standard part of your insurance policy. That means they will have a separate Sum Assured that can be used only for AYUSH treatments.  
  • You can only claim insurance for Ayurveda, Yoga, Siddha, and Homoeopathy. Naturopathy and Unani are usually not covered, as are other alternative systems.   
  • Not all health insurance plans offer support for cashless claims and treatments for AYUSH treatments. In many cases, you will have to pay for the treatment and file a reimbursement claim.   

 

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