AYUSH Treatment Coverage in Health Insurance

IRDAI mandates that all health insurance policies in India must cover AYUSH treatments — Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy — reflecting the widespread practice of traditional medicine systems in India. This mandatory coverage ensures that policyholders who prefer or supplement their treatment with traditional medicine are not financially disadvantaged. For AYUSH coverage to apply, treatment must typically be received at a government AYUSH hospital, a government-recognised AYUSH college or hospital, or a standalone AYUSH facility with a specific bed count as per IRDAI guidelines.

In-patient treatment requiring overnight hospitalisation is generally required for AYUSH claims, though some policies extend to day care and domiciliary treatment under AYUSH systems. The sum insured available for AYUSH treatment is typically the same as for allopathic treatment — there is no standard sub-limit requirement, though some policies impose one. However, individual plans may impose AYUSH sub-limits, so check the policy terms carefully.

Ayurvedic treatment for conditions like chronic kidney disease, skin disorders, diabetes management, and orthopaedic conditions is commonly availed under this coverage. Yoga and naturopathy in clinical settings for conditions like obesity, lifestyle diseases, and rehabilitation are also gaining traction as covered treatments. When comparing plans, look for whether the policy mandates government AYUSH hospitals only or also covers private recognised facilities, as the latter significantly expands access.

Policyholders who use AYUSH treatments regularly should verify network availability of AYUSH hospitals for cashless claims in their city, as networks are smaller than allopathic hospital networks.