Provide coverage for AYUSH in health insurance policies: Irdai to insurers
Mumbai, Feb 1, 2024
The board's policy must include the quality parameters and procedure for enrolling AYUSH Hospitals or Day Care Centres as network providers for the purpose of providing cashless facility
The Insurance Regulatory and Development Authority of India (Irdai) has asked the general insurers to treat Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) treatments at par with others in health insurance policies due to increased demand for these treatments.
“In recent times, AYUSH treatments have garnered increased popularity and have become an established branch of medicine. Considering the growing demand for AYUSH treatments, there is a need to consider these treatments at par with other treatments,” IRDAI said in a press release.
The insurance regulator has directed the general insurance companies that offer health insurance products to have a board-approved policy for providing AYUSH coverage which will include their approach towards placing AYUSH treatments at par with other treatments for the purpose of health insurance in order to provide the policyholders an option to choose a treatment of their choice. The guidelines will be effective from April 1, 2024.
The board’s policy must include the quality parameters and procedure for enrolling AYUSH Hospitals or Day Care Centres as network providers for the purpose of providing cashless facility.
Recently, the General Insurance Council (GIC) launched a ‘cashless everywhere’ initiative which is aimed at making cashless treatment available for policyholders even in non-empanelled hospitals that are registered under the Clinical Establishment Act.
The regulator further added that companies must modify their existing products that contain limitations for AYUSH treatments and ensure compliance with these revised guidelines.
The insurance companies also have been asked to put adequate controls in place along with Standard Operating Procedures (SOP) for enrolling hospitals into their network, placing necessary clauses in their health services agreements with AYUSH Hospitals or Day Care Centres, standard treatment protocols, and dealing with possible frauds and abuse of the system.
IRDAI expects general insurers to actively engage with the Core Group of Experts for the Insurance Sector constituted by the Ministry of AYUSH and develop required modalities for providing AYUSH Coverage.
Earlier in December, the Madras High Court had directed IRDAI to treat AYUSH treatments on the same levels as allopathic treatments with regards to the reimbursement of expenses.
[The Business Standard]
