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Insurance Article

Are Alternative Treatments Covered under Health Insurance?

July 18 2018

Ayurveda, one of the most popular alternate medicine branch, has its roots in India

Simran, a 41-year-old school teacher was suffering from chronic back pain. One of her co-teachers suggested an Ayurvedic treatment from an Ayurveda practitioner she personally knew and highly recommended. Having heard the benefits of Ayurveda over allopathy, Simran consulted the practitioner. He informed her that the treatment would take 12 sittings over 3 months and would cost ₹80,000.

Simran felt optimistic and decided to opt for it. She didn’t worry about the cost as she had health insurance with a sum insured of ₹6,00,000. However, her relief was soon replaced by stress, when she realised halfway through the treatment that her health insurance did not cover alternate treatments like Ayurveda.

To avoid the shock that Simran got, here’s what you need to know about your health insurance and alternative healthcare treatments.

What is Alternative Healthcare Treatments?

Treatments like Ayurveda, Unani, Siddha, homeopathy, naturopathy are alternative healthcare treatments. In our country, such traditional and alternative medicines are preferred by many over conventional, western medicine because it is safer, deals with the disease at its root cause and doesn’t have any harmful side effects.

Scope of Coverage

While there are a few insurance companies that cover alternative healthcare treatments, they usually do so in group health insurance and on request. However, with the growing popularity of alternate medicines, there are quite a few insurance companies out there that are offering cover for alternate healthcare treatments under their standard health care plans.

You should make sure to check that the health insurance plan you’re choosing covers non-allopathic treatments and to what extent. Read all the conditions thoroughly and understand what they imply.

IRDA Regulation

The IRDA issued a regulation in 2012-2013, which suggested that insurance companies should cover alternate healthcare treatments. However, many companies are yet to follow this suggestion while some have implemented it.

Conditions for Coverage

The companies that do cover alternate healthcare treatments do so only when the treatment is undertaken in a government hospital or in any institute recognized by the government and/or accredited by Quality Council of India/National Accreditation Board on Health.

Expenses of hospitalization for evaluation or investigation are not covered. Only the expenses incurred for the actual treatment are covered. If the treatment is taken at a healthcare facility that is not a hospital, the expenses will not be reimbursed.

Allopathy isn’t always the answer and you should have the option of trying alternative healthcare treatments to see what best suits your needs. Choose a health insurance plan that gives you such an option and doesn’t restrict your well-being.

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