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AYUSH Benefits in Health Insurance Policy: Complete Guide

AYUSH coverage in health insurance provides benefits for alternative treatments including Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy. Key features include in-patient hospitalization coverage at government or accredited facilities, comprehensive coverage across various AYUSH systems, and personalized care approaches. Eligibility typically requires treatments at recognized institutions with minimum 24-hour hospitalization. AYUSH treatments offer natural healing methods aligned with cultural health beliefs.

  • 25 May 2016
  • 6 min read
  • 7671 views

In 2013, the Insurance Regulatory Development Authority of India (IRDAI) asked health insurance companies to provide cover for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) treatments. Similarly, there are several ongoing government initiatives also, to promote alternative medicine, including the promise for an All India Institute of Medical Sciences (AIIMS)-like Ayurveda hospital. In November 2014, the Department of AYUSH was elevated by forming a government body – Ministry of AYUSH – in order to develop education and research in the natural medicine departments and therefore make maximum medical assistance available to patients.

What is AYUSH treatment?

The departments in AYUSH include Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) as well as other alternative medicine systems. The Department of Indian Systems of Medicine and Homeopathy was started in March 1995, whereas the name AYUSH was coined in March 2003.

Despite such government initiatives and interventions to popularize AYUSH, both the rural and urban Indian population are still largely inclined toward allopathic treatments. According to the National Sample Survey Organization (NSSO), 90% of the Indian population – both rural and urban – prefer allopathic treatments over alternative healthcare options.

However, AYUSH offers several benefits over allopathy, especially for recuperation from critical illnesses like cancer. It is believed to cause minimum side effects and considered to focus on treating the cause of the disease rather than just the symptoms. The treatment methods use organic components and are more cost effective.

Importance of AYUSH treatment coverage in health insurance

With the IRDAI move asking insurers to provide cover for AYUSH treatments, the demand for health insurance for alternative treatments has increased to some extent. An AYUSH cover in your health insurance policy covers in-patient hospitalization expenses.

Key features and benefits of AYUSH treatment in health insurance

A health insurance plan offering AYUSH coverage typically includes:

  • In-patient hospitalisation: Coverage for hospitalisation expenses incurred during AYUSH treatments, provided the hospitalisation lasts at least 24 hours.
  • Wide network of hospitals: Access to government and government-recognised hospitals offering AYUSH treatments.
  • Comprehensive coverage: Inclusion of various AYUSH systems, allowing policyholders to choose treatments aligning with their health beliefs and conditions.

Eligibility criteria for AYUSH

To avail of AYUSH coverage in a health insurance plan, policyholders generally need to meet the following criteria:

  • Age requirements: Typically, individuals aged 18 to 65 years are eligible.
  • Hospitalisation duration: A minimum of 24 hours of hospitalisation is required to claim benefits.
  • Recognised institutions: Treatments must be undertaken at government hospitals or institutions accredited by the Quality Council of India or the National Accreditation Board of Health.

Inclusions & exclusions of AYUSH health insurance

Before considering health insurance for AYUSH, it is important to have an idea of its coverages and limitations of the policy.

  • The medical expenses incurred for in-patient treatment taken under Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy will be covered in the policy. We also reimburse enrolment fees paid by the policyholder to Yoga institutes as part of our preventive and wellness healthcare add-on. The sum insured for this benefit ranges from ₹2,500- ₹20,000 depending on the plan.
  • It is important to remember that AYUSH cover covers expenses for alternate treatment, only when the treatment is undergone 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 (NABH).

Reasons to choose AYUSH treatment

Opting for AYUSH treatments offers several benefits:

  • Personalised care: Treatments are often designed for individual needs, promoting personalised healthcare.
  • Natural healing methods: Emphasis on natural remedies and techniques supports the body's intrinsic healing processes. It can be a great addition to family health insurance, where prolonged care for lifestyle and age-related issues is required.
  • Cultural alignment: For many, AYUSH treatments align with cultural and personal health beliefs, enhancing comfort and trust in the healing process.

FAQs

  1. Are AYUSH treatments covered under all health insurance plans?

Not all health insurance plans include AYUSH coverage. It's essential to check with your insurer or review the policy details to confirm inclusion.

  1. Can I claim AYUSH treatment expenses for outpatient procedures?

Generally, AYUSH coverage applies to in-patient treatments requiring hospitalisation for over 24 hours. Outpatient procedures are typically not covered.

  1. Are there any additional premiums for AYUSH coverage?

Some insurers may include AYUSH coverage within standard plans, while others might offer it as an add-on requiring an extra premium. It is always useful to talk to the insurance provider to understand the costs involved before buying the policy.

Conclusion

AYUSH benefits that focus on providing alternative care and healthcare solutions for various issues, added to your health insurance plan, can be a simple but useful choice that allows for holistic and varied healthcare. Understand the scope of the policy you are buying, eligibility criteria, and features of AYUSH coverage before you make your decision to add it to your insurance. Review the policy carefully and remember- you can always get in touch with a good insurance provider to get answers to your queries. It is better to be informed before making any decisions to ensure that it supports your overall well-being.



Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

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