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What Are The Exclusions In AYUSH Coverage In Health Insurance?

When searching for a health insurance policy suited to your needs, you might have come across the acronym AYUSH. AYUSH stands for alternative treatments such as Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy.If you buy a health insurance policy that covers AYUSH, you can make a claim for these alternative treatments up to the pre-determined limit of the total sum insured.

The inclusion of AYUSH in health insurance is indeed a boon for the many who truly depend on these forms of treatment for various ailments. It is a known fact that many people rely on non-allopathic or alternative forms of medicine for managing chronic diseases such as diabetes. AYUSH treatments are known for their excellent results as these alternative systems of medicine not only treat the disease in question but also positively impact the patient’s overall health. 

Now, when buying medical insurance that covers you for alternative medicine, it is important to remember that this coverage for AYUSH treatments in your policy is subject to certain exclusions. Let’s take a look at what some of these exclusions for AYUSH in your health insurance policy are.

1. Hospitalisation for less than 24 hours

If the policyholder is not hospitalised for at least 24 hours, they cannot make a valid claim for AYUSH treatment in their health insurance.

• Non-medical procedures

If the policyholder opts to undergo certain AYUSH health treatments that are not medically required, they will not receive coverage. This means that you cannot make a claim for treatments such as spa massages or any kind of general rejuvenation procedures.

• Outpatient costs

It is important to note that the AYUSH coverage only extends to inpatient treatment. This means that any kind of day care treatments or outpatient procedures will not be considered under the scope of AYUSH coverage in your health insurance policy.

• Treatment received at a facility that is not a hospital

If you undergo your treatment at a facility that is not a hospital, your claim will not be held valid. Moreover, the hospital should be a government hospital or one that is accredited by the National Accreditation Board for Hospitals and Healthcare Providers of the Quality Council of India.

Apart from these exclusions, it is important to note that your AYUSH coverage may often be limited to a certain percentage of your total sum insured. This percentage can vary between insurance companies so, it is important that you get clarity on this detail before buying a policy. Furthermore, if you make a claim for a particular illness under the AYUSH coverage in your health insurance policy, you might not be able to get the same illness covered the second time under allopathic treatment within the same policy year. Remember to talk to your health insurance provider about the exact coverage you can expect for AYUSH in your health insurance policy. Asking the right questions when purchasing your policy will prevent any disappointment when raising a claim. We hope this article has helped improve your understanding of AYUSH in health insurance.

Take care.