AYUSH treatment and its benefits in Health Insurance?

Ever heard of people going “off-grid” for a couple of days?

The idea is to set aside all the screens that you surround yourself with and fall back into the cozy greenery around you. This technological detoxing is aimed at your physical and mental well-being.

Now, this “off-grid” perspective is not really a passive criticism of the technology that we are surrounded with. Rather, this is an acknowledgment of the importance that technologies have in our lives and yet taking a moment away from all of that to take a breath. Such retreats do sound alleviating, don’t they?

Well, now just replace “technologies” with modern, mainstream medicine and “off-grid” with alternative treatment methods.

Do you see it now? No wonder people are opting for alternative options like AYUSH treatment as a breather and a way away from the stereotypical healthcare services. And considering its growing popularity, it is no surprise that this method is now worldly accepted and hence included as coverage across the best health insurance plans.

So what exactly is AYUSH treatment? What does AYUSH stand for? What kind of coverage should you be expecting from your AYUSH treatment across your health insurance plan? Take a look -

What is AYUSH Treatment in Health Insurance?

AYUSH Treatment means in-patient hospitalization treatments via traditional methods, such as - Ayurveda, Yoga, and Naturopathy, Unani, Siddha, and Homoeopathy.

The aforementioned channels of medical treatment are mostly plant-based, making it affordable and easily available for those seeking an alternative approach to their ailments.

The mainstream medical world has undergone substantial developments over the years, thanks to a multitude of research and the brilliance of the minds involved in this. However, this goes without saying - each treatment across the prevailing methods brings with it a certain amount of side effects.

When it comes to normal medications, there are 2 kinds of cases where AYUSH treatments seem like a better option -

1. For senior citizens. With age, individuals are either too tired of dealing with the side effects of medicines or are simply looking for alternative treatments to deal with their initial ailment and the side effects of the earlier medications.
2. For critically ill patients. Despite all the advancements made, unfortunately, we are yet to find the cure for some ailments via our streamlined treatment regimens. Or, we have aggressive treatment methods for critically ill patients. In both these cases, the bodies are too fragile to deal with such robust treatment and seek alternatives that would offer the patients some relief without riddling them with side effects.

Apart from this, there are also cases in which a patient prefers to take up AYUSH treatment options when initially diagnosed with a condition. This helps them deal with the minor symptoms and ailments until it gets critical and the patient is forced to take up a more stereotypical way of treatment.

What are the advantages and disadvantages of AYUSH Treatment?

As an alternative to mainstream treatments, AYUSH health care seems like the perfect channel. However, this option isn’t free of its cons too. So, before you respond to the beckoning of this option, weigh the pros and cons of this kind of treatment -

PROS

• Minimal to no side effects - AYUSH treatment is a traditional approach to medical procedures and medicines. Hence, these alternative treatments bank on natural products and plant bases.

This minimizes any chances of side effects in the patients, making it a preferred option for the majority.

• Affordable - In terms of mainstream healthcare charges, we are looking at immense inflation. Such a spike in the cost of medical charges can be attributed to advanced technologies, pricey prescription drugs, and high fees for medical practitioners.

While all of these certainly are catalysts in improving the quality of healthcare across the globe, it certainly minimizes accessibility for a majority of the population who are unable to afford it.

On the other hand, with AYUSH healthcare, you are looking at a far more affordable treatment regime that does not dig a hole into the savings of the patients.

• Holistic approach - Modern medicine believes in the compartmentalization of its treatments. So, you have psychiatrists treating the mind and physicians treating the body. Diverse specialists suggest more time consumption, contradictory medications, and redundant stress.

Hence, with the Ayurvedic approach, you have a single treatment channel addressing the soul, the body, the mind, and the senses all at one go. Such a holistic approach makes the Ayurvedic treatment procedure a preferred method.

• Easy availability of specialists - Unfortunately enough, even today, despite all the medical advancements that we boast of, even the most basic healthcare services are yet to reach the remote areas of the country.

While this percentage of the population stays deprived of basic medical amenities and specialists, ayurvedic benefits are conveniently available. Their specialists are spread to even the most remote corners, thereby providing a kind of medical care at affordable charges.

• Especially beneficial for the elderly - With age, the body of an individual loses its potential to bear the side effects of stereotyped medicines. As a result, Ayurvedic and all other alternate sources of treatment sound just perfect, considering the minimal side effects.

Additionally, with their restricted flow of income, such affordable treatments are preferred over mainstream ones.

Taking a cue from this, AYUSH health insurance coverage is gaining ground. In case you are seeking a Senior Citizen Health Insurance Plan, you will find the best policies actually offer coverage for this alternative treatment up to a certain percentage of the sum insured.

CONS

• Not the answer for immediate relief - The Penicillin way of treatment approach is often preferred because of the speed with which the recovery occurs. More than often, with the mainstream method of treatment, patients are looking at immediate solutions as compared to the Ayurvedic approach, where the speed of recovery is painstakingly slow.
• The herbs bring in some side effects as well - It is true that AYUSH health care ensures minimal side effects in its treatment regime. However, with the herbs that are used, there is a rare chance of side effects (maybe due to high levels of toxic metals present in the herbs) that may cause some side effects in the long run.

With the pros and cons of AYUSH treatment laid out in front of you, you can very well understand the reason why a majority of the plans from the best health insurance providers in India now offer coverage for this kind of treatment.

However, since this treatment regime is relatively new and offbeat, tracking the progress of such methods and subsequently offering to fund it is a cumbersome task. Take a look at how health insurance providers are managing to offer this coverage and what kinds of eligibility criteria you are looking at -

What are the benefits of AYUSH Treatment coverage in Health Insurance Plans?

Yes, AYUSH treatment is inexpensive. However, don’t be fooled.

AYUSH treatment means you are looking at a long-term regime that surmounts a substantial financial burden on your savings in the long run. Hence, a financial security net safeguarding your savings while you pursue the natural remedy procedure is a great idea.

This is where health insurance covering ayurvedic treatment comes to the rescue. However, since this is an unconventional method of healthcare services, expect a slight difference in the coverage offered by health insurance plans.

Features and Benefits of AYUSH Treatment Coverage

• Offers convenient access to premium AYUSH healthcare centers and hospitals for in-hospitalization treatments.
• Since the cost of AYUSH treatment is comparatively less, your sum insured might not be completely exhausted. This leaves you with plenty of coverage to be utilized for other medical emergencies.
• With AYUSH healthcare coverage, you can easily pursue natural remedies to treat your lifestyle diseases.
• With the AYUSH health insurance coverage in place, any gaps in mainstream medicine and treatment regime can be addressed without worries of financial strain on the policyholder. So, you can now opt for allopathy to address your major ailments and AYUSH to cater to the side effects and the minor symptoms - your health insurance will be financially backing you up in both cases.
• The coverage offered may extend from 10% of the sum insured to the entire sum insured.

Eligibility Criteria for AYUSH Treatment in Health Insurance

• A minimum of 24 hours of hospitalization is required. Thus, in this case, the daycare treatment feature is not an option.
• AYUSH treatments are covered under the health insurance policy if the policyholder receives treatment in any of the following centers -

1. AYUSH hospital: Accredited by either the Quality Control of India or the National Accreditation Board.
2. AYUSH Government/ Government-Recognized hospital: AYUSH Government hospital or a medical institution recognized by the Government.
3. AYUSH college treatments: Recognized by the Central Council of Homeopathy (CCH) or the Central Council of Indian Medicine (CCIM).

Inclusions of AYUSH Treatment Coverage in Insurance

• Any and all expenses incurred by the policyholder during hospitalization in an AYUSH medical facility.
• Any and all expenses incurred by the policyholder as treatment charges while in an AYUSH daycare center that have been recognized by the Government.

Exclusions of AYUSH Treatment coverage in Insurance

• None of the best health insurance policies for 2023 offer coverage for AYUSH evaluation and examination charges.
• In case the policyholder undergoes AYUSH treatment in a medical facility that is not recognized by the Government, the charges are not funded by the insurer.
• Pre- and post-hospitalization expenses are not covered under the health insurance policies.
• Charges incurred in rejuvenation or preventive treatments are not covered by the insurance plans since they are not considered technically correct medical treatment.

How to claim health insurance for AYUSH Treatment?

The claim settlement process for AYUSH treatment is much like that in the case of any other health insurance plan. There are two ways in which a policyholder can be funded for the AYUSH treatment -

Each insurance provider offers its policyholders a list of AYUSH treatment and daycare centers that it has a tie-up with.

1. CASHLESS: In case the policyholder approaches and undergoes treatment in a partner facility, cashless claim settlement is the way to go.

Prior to hospitalization, the policyholder will need to inform the insurer about the imminent procedure that he will be undergoing. The insurer reaches out to the partner hospital/facility and requests all the invoices and procedure documents that will help them cross-verify the claim amount. The claim is then paid off by the insurer (up to the capped amount, as specified in the health insurance policy).

2. REIMBURSEMENT: In case the policyholder undergoes AYUSH treatment in a medical facility that is recognized and accredited by the Government but has no tie-up with your insurer, your claim settlement will be a reimbursement.

During the hospitalization process, let your insurer know about the treatment process. Pay off the treatment charges out of your pocket during discharge. Assemble all the invoices, papers of procedures, and hospital documents and raise a claim of reimbursement for the billed amount (up to the capped amount). The insurer will reach out to you and request those papers before cross-verifying and releasing the claimed amount.

What are the best health insurance providers offering Ayush treatment coverage?

Take a look at the best health insurance plans across the market that offer AYUSH treatment coverage. We have also mentioned the age group that the plan caters to. So, choose a plan that best caters to you.

For a customized plan that is tailored to suit your financial and medical requirements, you can either -

1. Try our free health insurance plan comparison tool to compare the best plans and finalize your policy.
2. Contact our insurance experts, who are not inclined to sell you an insurance product but are rather eager to help you with a customized plan (FYI: they also do not spam with follow-up calls). Schedule a call with them and seek out a plan that is tailored as per your requirements.

Conclusion

All said and done, your choice of health insurance policy can’t really be based on a feature like AYUSH coverage. While the coverage can be an added perk, this treatment is not a priority since it is not particularly effective on a swift basis for critically ill patients seeking complete recovery or as an alternative to major surgical procedures.

Thus, while choosing your ideal health insurance plan, factor in the following -

• No copayment
• No room rent restrictions
• No disease-wise sub-limits
• Pre and post-hospitalization expense coverage
• Extensive coverage
• High No-Claim Bonus
• Appreciative Riders
• Low waiting period for pre-existing ailments
• Unlimited restoration benefits
• Daycare and domiciliary treatment coverages
  

Frequently Asked Questions

1. Do all health insurance plans come with AYUSH treatment coverage?

No, not all health insurance plans come with AYUSH coverage. Among the ones that offer coverage, there are some that have caps on the funding available for this kind of treatment. Please ask your insurance provider for the details regarding AYUSH coverage before you avail of the plan. You can also head over to our section on Understand Your Policy, to know the details of your health insurance policy.

2.  Is AYUSH recognized by the Government of India?

AYUSH treatment is recognized by the Government of India under 'The Indian Medicine Central Council Act, 1970' (IMCC Act 1970) and 'The Homoeopathy Central Council Act, 1973' (HCC Act 1973). This alternative method of treatment is supervised by two regulatory bodies set up by the Government of India - the Central Council of Indian Medicine (CCIM) and the Central Council of Homoeopathy (CCH).

3.  Can you avail of cashless claims under an AYUSH health insurance plan?

Yes, you can avail of cashless claims under an AYUSH health insurance plan. The policyholder will need to undergo treatment in an AYUSH treatment facility or hospital that is a partner/network institution with his/her health insurance provider.