In recent years, traditional and alternative medicine systems have been gaining significant traction worldwide. This trend is particularly strong in India, where practices like Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy, collectively known as AYUSH have been integral to healthcare for centuries. Since the COVID-19 pandemic, the popularity of Ayurveda has surged, with a four-fold increase in the number of people seeking Ayurvedic treatments over the past four years.
Recognizing this growing interest and the proven benefits of these alternative therapies, the Indian health insurance sector has made a significant move by introducing AYUSH cover as part of health insurance policies. This means that policyholders now have more options for their healthcare needs, combining traditional wisdom with modern convenience.
In this blog, we’ll dive into the details of AYUSH cover, explore its benefits, and explain why it’s an essential addition to your health insurance plan.
Understanding AYUSH
AYUSH treatments are a form of alternative medicine that includes practices like Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy. These traditional methods are trusted by many people worldwide for maintaining health and well-being. They’re popular because they are affordable and have minimal side effects.
To accommodate the growing trend, the IRDAI (Insurance Regulatory and Development Authority of India) has updated its guidelines to allow health insurers to cover AYUSH treatments. Insurers must have a Board-approved policy for providing AYUSH coverage. This policy should ensure that AYUSH treatments are given the same consideration as other medical treatments in health insurance plans, allowing you to choose your preferred treatment method.
The policy must also include quality standards and procedures for enrolling AYUSH hospitals and daycare centres as network providers so they can offer cashless facilities. Insurers must update their existing products to remove limitations on AYUSH treatments and comply with these new guidelines. This circular was made effective from April 1, 2024, making it easier for people to access these beneficial alternative treatments.
What Is AYUSH Cover?
AYUSH cover is a valuable inclusion in health insurance policies that provides coverage for treatments under Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy. With AYUSH cover, policyholders can seek alternative treatments without worrying about the financial burden. This coverage typically includes inpatient treatment costs for these alternative therapies when undertaken at recognized and registered hospitals or AYUSH centres.
Benefits Of AYUSH Cover
Here are some great reasons to consider AYUSH cover as part of your health insurance policy:
- Holistic Treatment Options: AYUSH therapies focus on treating the root cause of diseases rather than just the symptoms, offering a truly holistic approach to health.
- Natural And Less Invasive: These treatments often use natural herbs and therapies, which are less invasive and come with fewer side effects compared to conventional treatments.
- Cost-Effective: Many AYUSH treatments are more affordable than conventional treatments, making healthcare more accessible. It’s a win-win: you get effective care without breaking the bank.
- Coverage For AYUSH In-Patient Hospitalisation: AYUSH coverage includes in-patient hospitalisation expenses incurred for AYUSH treatments.
- Bridging Gaps In Allopathic Treatments: AYUSH coverage fills in the gaps left by allopathic treatments. If you opt for AYUSH therapies, your health insurance will cover the medical expenses, ensuring comprehensive healthcare support.
- Get Treatment At AYUSH Care Facilities: Health insurance policies may grant access to dedicated AYUSH daycare centres or hospitals for in-patient treatments. This means you can get specialised care from facilities that focus on these holistic therapies.
Eligibility Criteria
The best part about AYUSH health insurance is that you don’t need any special qualifications to get it. If you qualify for regular medical insurance, you’re good to go for AYUSH coverage too! This makes it super accessible for everyone.
However, a little heads-up: pre-existing health conditions won’t be covered under this policy. So, it’s important to keep that in mind.
Make sure to carefully read through the policy documents. This will help you understand exactly which AYUSH treatments are covered and how much you can benefit from them.
Who Should Consider AYUSH Cover?
- Individuals Seeking Alternative Therapies: If you prefer or believe in alternative medicine systems for your treatment, AYUSH cover is definitely for you.
- Chronic Disease Patients: If you’re dealing with a chronic illness and want to explore holistic treatment options, AYUSH cover can be a great addition to your health insurance.
- Cost-Conscious Individuals: Are you looking for cost-effective treatment options without compromising on the quality of care? Then AYUSH cover is a smart choice.
AYUSH Health Insurance – Inclusions
Here’s what is included under Ayush cover –
- Medical expenses for treatments at AYUSH care centres registered with local authorities.
- Costs related to AYUSH treatments at government hospitals certified by the National Accreditation Board of Health (NABH) or the Quality Council of India (QCI).
- Expenses for in-patient treatments at NABH and QCI-accredited facilities offering therapies like Ayurveda, Yoga, Unani, Siddha, and Homeopathy.
AYUSH Cover In Health Insurance – Exclusions
Ayush cover does not include the following –
- Treatments in non-government recognized hospitals
- Daycare treatments
- Outpatient department (OPD) treatments.
- Rejuvenation treatments
- Treatments that are not medically necessary
- Domiciliary hospitalisation
- Health check-ups or investigative procedures
Note: These exclusions can vary across insurers.
Conditions Associated With AYUSH Hospitals
Here are some important conditions you should be aware of regarding AYUSH hospitals or daycare centres:
- Government Recognition: The AYUSH hospital must be a State or Central Government institution.
- Affiliation with AYUSH Colleges: It should be a teaching hospital affiliated with AYUSH colleges recognised by governing bodies like the Central Council of Medicine, the Central Government, or the Central Council for Homeopathy.
- Facility Type: The facility must either be a standalone AYUSH hospital or co-located with an in-patient treatment facility of any recognized medicine system. It should be registered with local authorities or supervised by a registered AYUSH medical practitioner.
- Qualified Staff: A qualified and registered AYUSH medical practitioner should be available around the clock.
- Detailed Patient Records: Patient records must be detailed and accessible to representatives from the insurance company.
- In-Patient Capacity: The hospital must have at least five in-patient beds.
- Dedicated Facilities: There should be dedicated AYUSH therapy sections and operation theatres for surgical procedures.
Let’s Wrap Up!
AYUSH cover in health insurance is a great way to integrate traditional and alternative medicine into mainstream healthcare. It offers more treatment options, ensuring a holistic approach to health and wellness. By choosing a plan with AYUSH cover, you can benefit from natural and cost-effective treatments, especially for chronic conditions and preventive care. As awareness of AYUSH therapies grows, having this coverage provides peace of mind and comprehensive protection. Remember to read the policy terms carefully, compare plans, and choose one that fits your healthcare needs and budget.
