Ayurvedic and Homeopathic Treatment Coverage in Health Insurance

India has a rich culture and history of traditional medicine, with Ayurveda, Homeopathy, Yoga and other alternative therapies playing a significant role in healthcare. These treatments, known for their natural and holistic approach, have gained widespread acceptance due to their ease, effectiveness and minimal side effects. Until recently, getting insurance coverage for these treatments was cumbersome. Today, as more people embrace AYUSH which stands for Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy, health insurers are recognizing its value and offering coverage. This shift is bridging the gap between conventional and traditional medicine, providing policyholders with comprehensive healthcare options.

According to a recent survey by the National Sample Survey Office (NSSO) on AYUSH, nearly 95% of rural and 96% of urban respondents were aware of AYUSH practices. About 46% of rural and 53% of urban individuals have turned to AYUSH for preventative or curing purposes in the past year. According to a special report by Lancet journal in 2007, notably, over 100 million people in India rely solely on homeopathy for their healthcare. Additionally, our country is home to nearly 2,50,000 registered homeopathic doctors—more than anywhere else in the world. This raises an important question: Do insurance companies cover these treatments? The answer is yes. In 2013, the Insurance Regulatory and Development Authority of India (IRDAI) initiated coverage for AYUSH treatments, making alternative healthcare more accessible.

What is covered under AYUSH treatment?

AYUSH treatments encompasses a variety of effective therapies from different traditional systems. These therapies can address diseases in their early stages, helping to prevent further deterioration. They also support recovery after hospitalization.

One of Ayurveda’s notable treatments is 'Panchakarma' which addresses long-term ailments such as paralysis, migraine, and other nerve-related conditions. Additionally, select AYUSH hospitals offer specialized treatments for piles and fistula using 'Ksharasutra', an Ayurvedic procedure. The Unani system effectively treats various ailments, especially joint pain, skin disorders, and gynaecological issues. Therapies such as 'Hijama therapy (cupping)’, 'Dalak' are effective in treating a wide range of conditions. Additionally, Yoga and Naturopathy focusses on techniques like yoga, pranayama (breathing exercises), mud therapy, and water therapy to address various health issues like stress and lifestyle disorders. Homoeopathic medicines, on the other hand, are effective for many illnesses, particularly in treating skin conditions, asthma, thyroid issues, and numerous other ailments. Each of these treatments offers unique benefits and can play a significant role in holistic health care. Patients can select the approach that best suits their condition with a range of choices available.

AYUSH cover in a health insurance policy

Many health insurance companies today provide coverage for AYUSH treatments up to the sum insured opted for by the policyholder. Some insurers may impose an upper limit on the coverage amount, or the limit could be specified as a lump sum or a percentage of the sum insured. In the best-case scenario, the coverage may extend to the entire sum insured. Therefore, if a policyholder files a claim for Ayurvedic or Homeopathic treatments, it will be settled according to the limits specified in their health insurance policy. Hence, policyholders should check their policy details to understand the sum insured and any sub-limits on AYUSH treatments.

How to claim for AYUSH treatment?

To claim coverage for AYUSH treatments, hospitalisation for at least 24 hours in any government recognised AYUSH hospital or institute is mandatory. If the purpose of hospitalisation is only medical evaluation, then the claim will not be covered by the insurer. Also, treatments that focus on the rejuvenation of the body, which is an integral part of Ayurveda, are generally excluded from the cover, meaning that therapeutic or wellness related treatments must be borne out of pocket.

Who is eligible for AYUSH health insurance?

Many private health insurance providers offer AYUSH treatment coverage through standard policies, add-on options, or separate plans. The coverage limits and eligibility criteria for these plans are typically outlined in the specific insurance plan's terms and conditions. AYUSH health insurance is available to various groups, including central government employees and pensioners, who are covered under the Central Government Health Scheme (CGHS) for AYUSH treatments. Additionally, several state government insurance schemes, such as Arogyasri in Andhra Pradesh and Ayushman Bharat in certain states, provide coverage for AYUSH therapies.

With origins dating back over 3,000 years, Ayurveda remains one of the world’s most structured traditional medical systems. Similarly, Homeopathy, founded in the 18th century, has gained global recognition for its effectiveness in managing chronic diseases. As India continues to adopt integrative healthcare, the inclusion of AYUSH treatments in health insurance reflects a shift in how healthcare is perceived. This shift empowers policyholders to make informed healthcare decisions and also strengthens the foundation of a more inclusive and sustainable healthcare ecosystem.