Traditional treatments like Ayurveda, Yoga, Unani, Siddha, and Homeopathy have always played a big role in India’s healthcare.
However, for a long time, these treatments were not covered under health insurance.
In 2013, the insurance regulator IRDAI allowed health insurance policies to include AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy).
This move helped give official insurance coverage to these alternative medical systems.
Now, policyholders can make claims for not just allopathic treatments but also for AYUSH therapies.
However, it is important to know the specific terms, conditions, and limits related to this coverage.
AYUSH Treatment Awareness on the Rise
The National Sample Survey Office (NSSO) conducted a survey in 2024. It found that 95% of rural and 96% of urban people know about AYUSH treatments.
The survey also showed that in the past year, 46% of rural and 53% of urban residents used some form of AYUSH treatment.
The government is also supporting AYUSH. According to the Ministry of AYUSH, 170 AYUSH treatment packages are now part of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The government also plans to open traditional medicine stores in every tehsil.
What Does the Insurance Cover?
Most private insurance companies now offer AYUSH treatment in their plans.
This may be up to the full sum insured or subject to a sub-limit. Some policies offer a fixed amount for AYUSH treatment.
For instance, even if your total coverage is ₹5 lakh, only ₹25,000 may be allowed for AYUSH treatment.
In some cases, the AYUSH limit is a percentage of the total sum insured. For example, with a ₹5 lakh policy and a 10% AYUSH limit, you can only claim up to ₹50,000 for AYUSH care.
So, before making a claim, it’s important for the policyholder to check how much AYUSH coverage is allowed and if any extra conditions apply.
How to Claim AYUSH Treatment Costs
To get reimbursement for AYUSH treatment, you must be hospitalized for at least 24 hours. The hospital must be a government-approved AYUSH center.
If the stay is just for a medical check-up, the claim won’t be accepted.
Also, wellness treatments meant to refresh the body are usually not covered and have to be paid for personally.
Who Can Get AYUSH Health Insurance?
Many private insurers provide AYUSH cover as a regular feature, add-on, or separate plan. Eligibility and the amount of coverage depend on the policy’s terms and conditions.
This insurance is also offered to employees and pensioners covered under the CGHS (Central Government Health Scheme).
Additionally, state schemes like “Arogyasri” in Andhra Pradesh and “Ayushman Bharat” in other states also provide coverage for AYUSH treatments.
