Insurance Latest Update: In recent years, there has been a significant shift in people’s approach to healthcare. While previously people would immediately turn to allopathic doctors when they fell ill, now they are increasingly opting for alternatives like Ayurveda, Homeopathy, Yoga, and Naturopathy. People are especially considering natural and traditional medicine as safer options for long-term health problems. However, when the costs of treatment and medication arise, the question arises whether health insurance will cover these treatments.
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What do IRDAI regulations say?
The Insurance Regulatory and Development Authority of India (IRDAI) has mandated that health insurance companies include AYUSH treatments in their policies. AYUSH includes Ayurveda, Yoga, Unani, Siddha, and Homeopathy. However, this coverage is entirely subject to certain conditions. Generally, insurance companies only cover expenses when the patient is admitted to a government-recognized or accredited AYUSH hospital.
Why is OPD treatment not covered?
Most health insurance policies are still hospitalization-based. This means that only treatments requiring hospitalization are covered. OPD consultations for Ayurveda or Homeopathy, regular medications, and follow-up visits are usually outside the scope of insurance. Therapies like acupuncture or naturopathy are also only covered if they are part of a recognized AYUSH treatment and the patient is hospitalized.
Limitations in AYUSH hospitalization coverage
Even where AYUSH treatment is covered, certain conditions apply. Insurance companies set a specific limit on the treatment expenses they will cover. Additionally, it is also considered whether the treatment is medically necessary and whether the hospital meets the insurance company’s standards. Not every expense is automatically claimable.
Is there hope for OPD coverage in the future?
Although AYUSH OPD coverage is currently very limited, changes are beginning to emerge in the insurance industry. Some companies are offering OPD coverage for select alternative treatments, keeping preventive and holistic health in mind. Such plans can be beneficial for those who regularly use Ayurveda or other alternative therapies.
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What to consider before buying a policy
If you prefer alternative treatments over allopathic medicine, it is crucial to carefully read the AYUSH section of the policy when buying or renewing health insurance. It’s important to understand whether only inpatient treatment is covered or if OPD facilities are also included.
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