AYUSH Health Insurance
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AYUSH Health Insurance
India is known for its natural treatments and herbal medicines. Natural ways of curing a disease or condition have been an integral part of Indian culture and ancient medical systems. Even today, many people prefer these alternative treatments over conventional allopathic treatments because these treatments are safer and have zero side effects.
To create more awareness about these alternative treatments, IRDAI along with the government has made it mandatory for all health insurance companies to provide these alternative treatments, called AYUSH treatment, as part of their coverage.
What is AYUSH treatment?
AYUSH treatment refers to medical or hospitalisation treatment given under Ayurveda, Yoga, Unani, Siddha, and Homeopathy systems of medicine. These treatments use naturally-made medicines, which do not have any side effects. These treatments can work as supportive therapies with complicated treatments like dialysis and chemotherapy and can give effective results.
Significance of AYUSH treatment coverage in India
The growing popularity of AYUSH treatments has increased its demand in the past few years. Hence, health insurance companies now cover the expenses for AYUSH treatments, in addition to allopathic treatments. These traditional treatments, because of their immense potential, have become a significant part of health insurance coverage in India.
● AYUSH treatments focus on the root cause of an illness to eliminate the factors causing a disease and enable holistic treatment through traditional medicine systems.
● These treatments are useful in preventive care such as detoxification of the body, treating body imbalances, and improving the immune system.
● These treatments are able to fill the gaps in modern medical treatments.
Benefits of AYUSH Health Insurance
There are many benefits of opting for health insurance that offers AYUSH treatment coverage.
● When modern treatments and allopathic medicines fail to cure a disease, the insured can use AYUSH cover to get treatment under alternative medicine.
● These highly effective treatments look after the overall well-being of any patient and not just the illness.
● These treatments are affordable and completely natural.
● These treatments can be easily availed even in the remotest areas where there are no hospitals.
● These treatments are safe with no side effects and can be used to treat young kids, senior citizens, and high-risk patients.
● These treatments have the ability to treat lifestyle diseases and manage chronic illnesses.
How does the AYUSH health plan work?
AYUSH coverage under health insurance varies from insurer to insurer. Some insurers cover specific treatments only and some cover treatments up to a specific amount. Some insurers provide coverage for in-patient hospitalisation expenses but do not cover OPD expenses, while some also cover daycare treatments. To understand the AYUSH coverage offered by your health insurance plan, review policy terms and conditions or talk to your insurance agent.
Key features of AYUSH treatment in health insurance coverage
AYUSH cover offered by health insurance plans has some key features as mentioned below:
1. Coverage for in-patient hospitalisation
AYUSH cover provides coverage for a minimum of 24 hours of hospitalisation for AYUSH treatment. Some policies only cover hospitalisation expenses and do not cover OPD expenses related to AYUSH treatment.
2. Coverage up to a specific amount
Many health insurance plans provide coverage for AYUSH treatments up to only an amount specified in the policy irrespective of the sum insured.
3. Full coverage up to the sum insured
There are also health insurance plans that offer full coverage for AYUSH treatments up to the sum insured opted by you.
4. Coverage according to the hospitals
In some plans, AYUSH treatment coverage is different for different hospitals. For instance, if you avail of treatment in a government hospital it may be covered up to the sum insured. On the other hand, if you avail of treatment in a non-government hospital, coverage up to a specified limit is available.
5. Coverage for specific treatments only
Some health insurance plans provide coverage for only specific AYUSH treatments only. They do not cover all AYUSH treatments. For example, many plans do not cover Yoga or naturopathy treatments.
Note that these features may vary across insurers. Check your policy features for details of the AYUSH cover before buying.
What is covered and not covered in AYUSH coverage?
The coverage for AYUSH treatments in a health insurance policy includes in-patient hospitalisation expenses for treatments taken under Ayurveda Yoga, Unani, Siddha, and Homeopathy medicine systems. Note that only medically required treatments taken at a government-recognized hospital are covered by health insurance policies.
The expenses that are not covered in AYUSH coverage, include expenses for diagnostics, expenses not related to AYUSH treatments and any rejuvenation treatments not required medically.
Eligibility criteria of AYUSH treatment in health insurance coverage
The eligibility criteria for availing of AYUSH coverage are;
● Your health insurance policy should cover AYUSH treatments.
● In-patient hospitalisation of more than 24 hours for AYUSH treatments is required to cover the incurred expenses.
● The treatment should be done only at a government-recognized facility.
Health insurance companies offering AYUSH treatment
As per IRDAI, here is a list of some general insurance and stand-alone health insurance companies, that provide coverage for AYUSH treatments.
● New India Assurance Company
The company offers Arogya Sanjeevani Policy with a sum insured value from ₹ 50,000 to ₹ 10L. This policy provides coverage for AYUSH treatments up to the sum insured.
● Oriental Insurance Company
The company offers a Happy family floater policy with a sum insured starting from ₹ 1L to ₹ 50L. AYUSH cover is available for in-patient hospitalisation expenses up to the full sum insured. The entry age is up to 65 years.
● United India Insurance Company
Family Medicare policy covers Ayurvedic, Homeopathic, and Unani treatments during hospitalisation, up to the sum insured. The policy has a sum insured starting from ₹ 3L to ₹ 25L.
● National Insurance Company
National Mediclaim policy covers Ayurvedic and Homeopathic treatments during hospitalisation at AYUSH hospitals up to the sum insured. The plan has a sum insured from
₹ 1L to ₹ 10L
● Tata AIG General Insurance Company
Medicare policy covers AYUSH treatments up to the sum insured. The policy offers sum insured values from ₹ 3L to ₹20L.
● Bharati AXA General Insurance Company
The health advantage plan offers sum insured options from ₹ 2L to ₹ 3 Cr and provides coverage for AYUSH in-patient treatments up to the sum insured.
● Bajaj Allianz General Insurance Company
Family health insurance plan covers Ayurvedic and Homeopathic treatments for in-patient hospitalisation expenses up to ₹ 20,000.
● Aditya Birla Health Insurance Company
Activ Assures Diamond’s health insurance plan covers AYUSH treatment in-patient expenses at an AYUSH hospital up to a specific limit as per the sum insured opted. The plan offers a sum insured from ₹ 2L to ₹ 2Cr.
● IFFCO Tokio Health Insurance Company
Individual health insurance policy offers a sum insured up to ₹ 20L and provides coverage for in-patient AYUSH treatments up to the sum insured.
● Star Health Insurance Company
Star comprehensive health insurance policy provides AYUSH coverage maximum of up to ₹ 30,000 and offers a sum insured option from ₹ 5L to ₹ 1Cr.
Reasons why you should select a health insurance policy with AYUSH Cover
Following are some reasons why it is a good idea to opt for a health insurance policy with AYUSH cover for your family.
1. Non-invasive treatments
As these treatments are non-invasive or non-surgical, there is no risk involved. Minor health issues that may require surgery or some invasive procedure can be treated using AYUSH treatments.
2. Low-cost treatments
Practitioners of AYUSH treatments do not require any special license, set-up, or advanced equipment to carry out treatments. Hence, these treatments are low-cost and can be easily availed by anyone.
3. Availability
These treatments are available in the remotest or backward areas where there are hardly any medical facilities. Hence, these are easily accessible to the rural population.
4. Mild medicines
These treatments are mild in nature and the medicines involved are also mild. Hence, these are most suitable for high-risk patients such as young kids, senior citizens, or patients with chronic ailments.
5. An effective cure for lifestyle diseases
These treatments are an effective cure for lifestyle diseases without any dependence on medicines. If you follow the regime specified under any AYUSH treatment diligently, it can eliminate the root cause of a disease.
6. A wide range of treatment options
AYUSH treatments involve treatments from different traditional medicine systems. It gives you the flexibility to choose a line of treatment as per your preference.
AYUSH treatment in healthcare services today
AYUSH represents the traditional and non-conventional healthcare systems that provide preventive, promotive, and curative care which are easily accessible and cost-effective. AYUSH treatments focus more on achieving wellness and not just on disease management. It advocates practicing self-care by knowing your health, following a daily routine, and practicing habits according to seasons and conditions.
This approach and the potential of the AYUSH system are being recognized in healthcare services today. The National AYUSH Mission was implemented by the Ministry of AYUSH in 2014, with an aim to strengthen AYUSH healthcare facilities by establishing AYUSH health and wellness centres and AYUSH education institutions all across the nation to reduce the disease burden on the modern healthcare system. The mission is successful in promoting AYUSH treatments through healthcare services and covering these treatments under health insurance policies.
The impact of covering AYUSH treatments in health insurance
There has been a paradigm shift from the allopathic medicine system towards safer and natural AYUSH treatments. This shift is happening because of the high costs of allopathic treatments and their harmful side effects. Initially, health insurance did not cover alternative treatments. But now IRDAI has made it mandatory for health insurers to cover AYUSH treatments. This initiative can help make more people aware of the benefits of traditional medicine systems which not only cure diseases but advocate a healthy and disciplined way of life.
Conditions to be followed by AYUSH Hospitals
AYUSH hospital is a healthcare facility where AYUSH treatments are carried out by AYUSH practitioners. There are certain conditions that need to be followed by a healthcare facility to qualify as AYUSH hospital where you can avail of coverage for AYUSH treatments. The AYUSH treatments will be covered only if;
● The AYUSH Hospital is run by the central or state government
● The hospital is attached to a central government-recognized AYUSH college
● An independent AYUSH hospital with an in-patient facility is registered with the local authority fulfilling the following criteria:
- A qualified AYUSH medical practitioner should be in charge.
- The hospital should have a minimum of 5 in-patient beds.
- It should have dedicated AYUSH therapy sections with an equipped operation theatre for carrying out surgical procedures.
- It should maintain the patient’s record and make it available to the representative of the insurance company.
In addition to AYUSH hospitals, AYUSH treatments can also be availed at different types of daycare centres including Community health centres, Primary health centres, dispensaries, clinics, Polyclinic, etc. registered with local authorities.
Important things to remember when you choose health insurance with AYUSH treatment cover
Here are some important points you should remember when you choose a health insurance plan with AYUSH coverage.
● The coverage for AYUSH treatments under a health insurance plan varies across insurers. So check your policy’s terms and conditions before you buy to avoid any rejection of the claim in the future.
● Check the premium amount of the health insurance policy to find out if there is an additional premium to be paid for AYUSH coverage or if it is available as an in-built cover.
● Before you finalise a plan, check the network of AYUSH hospitals available with the insurers. See if you have any network AYUSH hospitals nearby or not.
● Check the AYUSH cover limitations such as whether there is a limit on the coverage amount, or treatments or treatment at specific hospitals.
To Sum Up!
Considering the many benefits of undergoing AYUSH treatments, many people are now switching to these alternative treatments from conventional treatments. With this growing demand, coverage for AYUSH treatments is included in the health insurance plans. Before you buy a health insurance plan, check for alternative treatment benefits. See if there are any sublimits and to what extent coverage is available. Also, note that the treatment you avail should be medically prescribed and taken at a government-recognized AYUSH hospital or clinic.
Frequently Asked Questions
Yes, health insurance covers Ayurvedic medicine and treatments under AYUSH cover. To understand the scope of coverage read the policy terms and features.
The AYUSH cover does not include
● Coverage for any treatment with less than 24 hours of hospitalisation
● Treatment taken by a non-registered and non-certified AYUSH medical practitioner
● Treatment taken at a non-recognized hospital or clinic
Yes, a cashless facility is available for AYUSH coverage if you get treatment at one of the network hospitals of your insurance company.
No, to get your AYUSH treatment covered, You should get treatment only from a registered AYUSH medical practitioner who is certified by the Quality Council of India or the National Accreditation Board for Hospitals and Healthcare Providers.
The coverage limit for AYUSH treatments depends on the insurance company. Some insurers provide coverage to a specific limit and some provide coverage up to the sum insured by the policy.
Anyone can get coverage for AYUSH treatment under health insurance. However, it is a must-have coverage for individuals above the age of 60 years.
Homeopathy is covered under AYUSH treatments. However, you can get coverage only if there is hospitalisation for a minimum of 24 hours for a homoeopathic treatment. Expenses for homoeopathic medicine are not covered.
An Ayush hospital is a government-recognized hospital where you can get treatment under alternative medicines such as AYUSH.
Yes, AYUSH treatment can be used for critical illnesses along with allopathic treatment as a supportive treatment. It can also be used to cure lifestyle diseases.
AYUSH cover provides coverage for AYUSH treatments that are natural, affordable, and have no side effects. These treatments focus on holistic wellness eliminating the root cause of any disease and improving the overall health of an individual.
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