Health Insurance Coverage for Ayurveda: As alternative forms of healthcare such as Ayurveda, homeopathy, naturopathy, and acupuncture become increasingly popular, many health insurance policyholders are left wondering whether these treatments are covered by their insurance—particularly when availed on an outpatient (OPD) basis. A reader recently wrote in seeking clarity on how insurers treat alternative medicine under existing health insurance plans.
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Does Health Insurance cover alternative treatments under OPD?
Expert view: Coverage for alternative therapies largely depends on whether the policy includes AYUSH benefits and how OPD expenses are defined within the plan.
Under IRDAI regulations, all health insurance policies in India must provide coverage for AYUSH treatments, which include Ayurveda, Yoga, Unani, Siddha, and Homeopathy. However, this coverage is typically restricted to in-patient hospitalisation at government-recognised or accredited AYUSH hospitals or treatment centres. The extent of coverage is also subject to policy-specific terms, conditions, and sub-limits.
Policyholders should be aware that OPD consultations for alternative treatments—such as Ayurveda, homeopathy, naturopathy, or acupuncture—are generally not covered under standard health insurance policies. Most plans continue to focus on hospitalisation-related expenses rather than routine outpatient or wellness care.
Treatments like acupuncture or naturopathy may be eligible for coverage only if they are part of a recognised AYUSH treatment and require hospital admission at an approved facility. OPD-based therapies or wellness sessions are typically excluded. Even where AYUSH hospitalisation coverage is available, insurers often impose caps or sub-limits, and claims depend on factors such as medical necessity and whether the treatment centre meets the eligibility criteria outlined in the policy document.
That said, AYUSH OPD coverage remains limited across the industry. One exception is Aditya Birla Health Insurance, which has introduced Health Meter+, offering OPD coverage for select AYUSH treatments as part of its broader focus on holistic and preventive healthcare.
Key takeaway
While IRDAI mandates AYUSH coverage for hospitalisation, OPD consultations for alternative therapies are usually excluded, unless the insurer explicitly offers such benefits. Policyholders who regularly rely on alternative medicine should carefully review their policy documents to understand the scope of AYUSH coverage beyond the regulatory minimum.
Disclaimer: The views shared by experts are their own and do not reflect the opinions of the platform or its management. Readers are advised to consult certified professionals before making any financial or insurance-related decisions.