AYUSH treatment cover

What is AYUSH treatment cover?

AYUSH treatment cover is the part of a health insurance policy that pays for medical or hospitalisation treatment under the AYUSH systems: Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy. The IRDAI (Insurance Products) Regulations, 2024 define AYUSH treatment in exactly these terms. Under current rules, insurers must place AYUSH treatment at par with other treatments, so that a policyholder can choose the system of medicine they prefer.

AYUSH cover usually applies to inpatient care in a qualifying AYUSH hospital and, in many products, to day care treatment in a qualifying AYUSH day care centre. Wellness, spa and rejuvenation programmes are not covered.

How AYUSH cover works in India

The regulatory position, as of October 2026.

• The IRDAI (Insurance Products) Regulations, 2024 require every insurer to have a board-approved policy on AYUSH coverage, including how it places AYUSH treatments at par with other treatments.
• IRDAI's Master Circular on Health Insurance Business (May 2024) repeats this. Insurers must make products available for all systems of medicine, including allopathy and AYUSH, and their board-approved underwriting policy must ensure AYUSH treatment at par with other treatments.
• IRDAI first set this out in its Guidelines on providing AYUSH coverage in health insurance policies of 31 January 2024. Those guidelines were folded into the May 2024 master circular, which listed them among the circulars it replaced.

What "at par" means in practice. The regulation sets the principle and leaves the design to each insurer's board policy. Older products often capped AYUSH claims at a percentage of the sum insured or a fixed amount. The 2024 master circular required existing products that did not comply with the new framework to be modified by 30 September 2024, but AYUSH limits still differ across products, so the policy wording and the Customer Information Sheet are what decide a claim. The standard Arogya Sanjeevani policy covers AYUSH hospitalisation up to the sum insured.

Which facilities qualify. Policy wordings use a common definition of an AYUSH hospital. It covers a central or state government AYUSH hospital, a teaching hospital attached to a recognised AYUSH college, or a registered AYUSH hospital (standalone or within another hospital) that has a qualified registered AYUSH practitioner in charge, dedicated AYUSH therapy sections or an equipped operation theatre where surgery is done, and daily patient records open to the insurer. AYUSH day care centres, such as registered clinics and health centres giving day care treatment under an AYUSH practitioner, are defined in a similar way.

Claims. AYUSH claims follow the same process as other claims, cashless at an empanelled AYUSH hospital or by reimbursement. The insurer will check medical necessity, as for any admission.

What AYUSH cover means for distribution

• Ask about the customer's preferences. Some families use Ayurveda or Homeopathy as their first choice for certain conditions. For them, whether AYUSH is covered up to the full sum insured, and which AYUSH hospitals are in the network, can decide the sale.
• Check the facility, not only the treatment. The most common AYUSH claim problem is treatment at a centre that does not meet the policy's definition of an AYUSH hospital or day care centre, such as a wellness resort. Advisers should help customers confirm the facility's registration before admission.
• Explain medical necessity. A stay that looks like a rejuvenation package rather than treatment of a diagnosed condition will be questioned. The treating practitioner's notes should record the diagnosis and the reason for admission.
• Cashless network is thinner. AYUSH hospitals in insurers' cashless networks are fewer than allopathic hospitals in many areas. Customers may need to plan for a reimbursement claim.
• Compare older and newer products. Customers renewing a policy bought before 2024 may still carry an AYUSH cap. Migration to a revised product of the same insurer keeps waiting period credits and may remove the cap; advisers can check this at renewal.