AYUSH Cover

AYUSH cover is the part of an Indian health insurance policy that pays for in-patient treatment under recognised non-allopathic systems of medicine — Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy — collectively administered by the Ministry of AYUSH. IRDAI's 2020 health insurance product harmonisation made AYUSH coverage a mandatory inclusion in every indemnity health policy, ending the older practice where AYUSH was either excluded entirely or capped at a token sub-limit. Today every IRDAI-approved indemnity health product must cover AYUSH in-patient treatment up to the full sum insured, subject only to the conditions that the treatment is taken in a hospital recognised by the Central or State Government, the Quality Council of India, the National Accreditation Board for Hospitals (NABH), or another notified authority.

Out-patient AYUSH consultations remain outside the standard indemnity scope unless the policy includes a separate OPD rider. Worked example: Rina, 45, suffers chronic back pain and chooses a 21-day in-patient Panchakarma programme at a NABH-accredited Ayurveda hospital. The total package, including consultation, room, daily therapies, and medications, is ₹95,000.

Under the policy's AYUSH inclusion, the cashless or reimbursement claim is processed against her ₹10 lakh sum insured up to the admissible amount. The same policy would have covered an equivalent allopathic in-patient treatment, and the AYUSH inclusion ensures the buyer is not penalised for choosing a recognised alternate system. A common misconception is that 'AYUSH cover applies even to clinic-based or home-based therapies'.

It does not — the requirement is in-patient treatment in a recognised hospital, with a registered medical practitioner, daily clinical records, and a discharge summary. Out-patient panchakarma at a clinic that does not admit patients overnight typically does not satisfy the in-patient definition and is excluded. Another common misconception is that 'AYUSH is capped at a small percentage of sum insured'.

Pre-2020 policies often capped AYUSH at 10% to 25% of sum insured, but post-2020 IRDAI-compliant policies cover AYUSH up to the full sum insured. If your existing policy still has an AYUSH sub-limit and you renew on the same product, the older cap may apply; consider porting at renewal to a current product to access the full inclusion. Related: sub-limit, sum-insured, network-hospital.