Are alternative treatments, Ayurveda, Homeopathy, covered under insurance plans? 

I have always been a proponent of natural healing methods and prefer alternative treatments such as Ayurveda, Homeopathy, and Unani medicine for myself and my family. I am curious to know if these treatments are included in a standard health insurance plan, and if there are any restrictions or stipulations I should consider before choosing such therapies. Are there specific treatments that are covered, or is there a limit on the amount that can be claimed for alternative therapies?

Additionally, do consultations and prescribed herbal medications come under the coverage? I would appreciate clarification on the claims process for alternative treatments and how choosing these therapies might impact my premium or coverage in the future.

Advice by Ashish Yadav, Head Products and operations - ManipalCigna Health Insurance

Health insurance plans in India increasingly cover alternative treatments such as Ayurveda, Homeopathy, Unani, Siddha, and Yoga, collectively known as AYUSH treatments, following IRDAI’s 2024 guidelines endorsing their inclusion. If you prefer natural healing methods, it is possible to get coverage for these treatments under a regular health insurance plan, but there are important conditions and limitations to consider.

Coverage and Limitations

Most health insurance policies that include AYUSH cover inpatient treatments only, meaning you need to be hospitalized for at least 24 hours in a government-recognized AYUSH hospital or institution to claim benefits. Outpatient consultations and therapies are generally excluded unless specifically mentioned in the policy. OPD Treatments aimed at wellness or rejuvenation, which are common in Ayurveda, are typically not covered.

The coverage limit for AYUSH treatments must be at par with allopathic treatment in the policy. This applies to all expenses related to the treatment, including room rent, nursing, and procedural costs. Herbal medicines prescribed during hospitalization are usually covered, but coverage for prescribed herbal or dietary supplements outside hospitalization varies by insurer and policy.

Claim Process

To claim AYUSH treatment expenses, hospitalization must be documented with proper discharge summaries and bills from recognized AYUSH hospitals. Claims can be made either as reimbursement or through cashless facilities if the hospital is within the insurer’s network. Medical evaluation admissions without treatment are not eligible for claims. Pre-existing conditions and chronic illnesses may have waiting periods or exclusions depending on the insurer’s terms and conditions. 

Impact on Premiums and Coverage

Opting for AYUSH coverage generally does not increase your health insurance premium significantly, as insurers consider it an add-on or integrated benefit rather than a separate high-risk coverage. However, premiums may vary depending on the extent of AYUSH coverage chosen and the insurer’s policy design. Including AYUSH treatments does not typically affect coverage for allopathic treatments; both can coexist within a comprehensive health plan.