Maximising AYUSH coverage in health insurance

Avneet Bhatia, CEO and Founder, NatureFit explains how the recent inclusion of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatments in health insurance is a positive step taken by IRDAI towards holistic wellness in India

Health insurance plays a critical role in ensuring comprehensive healthcare coverage for individuals, and as the landscape evolves, there is an increasing emphasis on integrating alternative and traditional healing practices into insurance policies. The recent inclusion of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) treatments in health insurance is a positive step taken by IRDAI towards holistic wellness in India.

Critical to the success of AYUSH coverage is the necessity for heightened awareness among the general public. Despite positive strides, there remains a lack of understanding regarding what AYUSH entails and how individuals can access its benefits under their health insurance policies. Bridging this awareness gap is essential for the effective utilisation of available AYUSH treatments. Public education and awareness campaigns are necessary to dispel misconceptions and myths surrounding AYUSH and to promote its benefits. These programs can educate individuals about the principles and practices of AYUSH, empowering them to make informed decisions about their healthcare options.

Next, supporting the expansion of AYUSH coverage involves enhancing the infrastructure. Registering more AYUSH hospitals and practitioners on government databases not only facilitates better patient care but also contributes significantly to research and development (R&D). The existing shortfall, as indicated by the limited number of established AYUSH hospitals, underscores the necessity for significant expansion in this sector.

Ensuring the success of AYUSH treatments hinges on the ability to identify the right practitioner and reputable treatment centres. Establishing mechanisms to distinguish qualified practitioners is crucial, and creating a robust digital database accessible to the general public and insurers can help bridge this gap. The need for digital availability of a credible ecosystem is paramount to ensure easy accessibility and widespread awareness among consumers. This digital infrastructure not only fosters transparency but also facilitates seamless interaction between insurers, healthcare providers, and policyholders, driving greater adoption of AYUSH coverage and promoting holistic wellness. It streamlines the dissemination of information and promotes a comprehensive understanding of the holistic wellness options available, contributing to a healthier and more conscious society.

To strengthen AYUSH coverage, health insurance policies should incorporate clear quality parameters. Also, Quality control processes must be enhanced to bring clarity to the treatment process and ensure adherence to evidence-based practices. This step is essential for building trust in AYUSH treatments within the insurance framework. These should outline procedures for enrolling AYUSH hospitals and day care centers as network providers, thereby allowing for cashless facilities. Standard Operating Procedures (SOP) are crucial for enrolling hospitals, crafting health service agreements, defining treatment protocols, and addressing potential fraud and misuse.

AYUSH treatments often do not require hospitalisation, potentially creating a coverage void. Addressing this gap requires insurers and the government to explore alternatives, such as outpatient coverage or specialised plans tailored to AYUSH treatments. These alternatives ensure that individuals can access the benefits of AYUSH without the need for hospital admission.

The financial accessibility of AYUSH coverage is crucial in encouraging individuals to opt for such health insurance policies. Maintaining affordable policy rates, without significant alterations, becomes pivotal in making the inclusion of AYUSH financially feasible. This approach encourages a broader audience to avail themselves of holistic healthcare options without the barrier of exorbitant costs.

The journey towards maximising AYUSH coverage in health insurance is a progressive move towards holistic wellness in India. As stakeholders collaborate to address existing gaps, the integration of AYUSH into India’s healthcare narrative promises a future where conventional and traditional healing practices coexist seamlessly, fostering a healthier and more holistic approach to wellness in the country.

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