Ayush health insurance: Traditional medicine in India- such as Ayurveda, Yoga, Greek, Siddha and Homeopathy have been an important part of the health system. However, these treatment mediums were not included in the insurance cover for a long time. But in 2013, the insurance regulatory body IRDAI allowed Ayush (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) to include in the Health Insurance Policy. After this, the way for alternative medical practices to get formal coverage was cleared.
Now insurance holders can claim insurance not only for allopathy, but also for traditional medical practices. However, some conditions and limitations are set for this, which needs to be known.
Awareness is increasing about AYUSH treatment
The National Sample Survey Office (NSSO) conducted a survey in 2024. According to this, 95% of people in rural India and 96% in urban areas are aware of AYUSH medicine. The survey also revealed that 46% rural and 53% urban population resorted to AYUSH treatment in some form or the other in the last one year.
The government is also taking initiative in this direction. According to the Ministry of AYUSH, 170 AYUSH packages are being included in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Also, the plan to open traditional medicine stores in every tehsil is also going on.
What comes in the insurance cover?
Now most private insurance companies are covering AYUSH treatment in their plans. This cover is either a complete sum insured, or any sub-limit may apply in it. The expenses covered for AYUSH treatment in some health insurance policies may be a fixed amount (lump). For example, you will get the cost of up to ₹ 25,000, even if your entire policy is ₹ 5 lakh.
At the same time, in some cases this limit can be one percent of your total sum insured. For example, if your policy is ₹ 5 lakh, and there is a limit of 10% for AYUSH, then you can claim only ₹ 50,000 on AYUSH treatment.
In such a situation, while claiming the insured, it is necessary to see how much limit is fixed for AYUSH treatment in their policy and whether any additional condition is applicable to it.
How to claim for Ayush treatment?
It is mandatory to be hospitalized for at least 24 hours to claim the cost of Ayush treatment. This hospital should be a government recognized Ayush Hospital or Institute. If the recruitment is only for medical examination, the insurance company will not accept the claim. Also, rejuvenation treatment that gives energy to the body again does not usually come under insurance, so such expenses have to be raised on their own.
Who can take Ayush Health Insurance?
Many private insurance companies offer Ayush coverage as standard policy, ad-on options, or separate plans. For this, the limit of eligibility and cover is given in the terms of insurance scheme. This insurance is also available to the employees working or retired in the service under the Central Government Health Scheme.
Apart from this, the state government schemes- such as “Arogyashree” of Andhra Pradesh and “Ayushman Bharat” applicable in many states also cover Ayush treatment.
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