22 May 2016

Health insurance for alternative treatments like Ayurveda, Yoga, Unani, Siddha and Homoeopathy (Ayush) is set to expand with the Centre taking steps to get insurers to develop packages for traditional treatments.

A handful of Government and private health insurance companies have committed to the Government to draw up packages for Ayush treatments, a source familiar with the development told Business Line. The companies said to be involved in the exercise include New India Assurance, National Insurance, Universal Sompo, Star Health Insurance, Max Bupa, Apollo Munich, and Oriental Insurance.

Ayush practitioners have always complained of step motherly treatment from insurers, even at a time Prime Minister Narendra Modi promotes Yoga in India and abroad.

In the renewed push to Ayush, the apex ministry is working with NABH (National Accreditation Board for Hosptials and Healthcare providers) to streamline guidelines for different traditional treatments. Only when companies come out with packages can further interventions be made to expand insurance cover to out patient treatments (that does not involve hospitalization), said the Government source. The reason why health insurance for Ayush has not taken off is because it covers only hospitalization, when traditional treatments are in fact done in outpatient departments.

Sanjay Datta, ICICI Lombard’s Chief ( Underwriting-Claims and Reinsurance) agrees that clearer regulations will see insurers offer cashless services across Ayush hospitals (currently insurers do not have them on their preferred provider network). This will further boost customer demand for Ayush treatments, he adds.

Health covers for Ayush treatments have not become mainstream and even what is offered by most insurers is only on select health insurance products, adds Segar Sampathkumar, General Manager of New India Assurance.

Presently, Ayush coverage is bundled with a comprehensive health insurance plan, and comes at a higher premium. A 30 year old person taking Bajaj Allianz’s Health Care Supreme cover for Rs. 5 lakh will pay Rs. 10,300 as premium for a comprehensive insurance plan and Ayush treatments.

So, a patient hospitalized in a recognized Ayurveda hospital with knee-joint pain will be covered for the regular room rent, nursing, consultation, medicines etc and Ayurvedic treatment procedure charges.

The same customer’s premium would be 5-10 per cent less in a regular health plan without Ayush and other outpatient benefits.

People with cancer are seen taking Ayush treatments, and in some cases, allopathic treatment continues with traditional post-operative procedures, explains an insurance expert. A person paralysed by a brain stroke may be advised follow-up with Ayurvedic procedures, and this is reimbursed, she adds.

There is little historical data on outcomes, but there are clear pathways on treatment and medicines, the expert says. And while treatment at the Kotakal Arya Vaidya Sala are reimbursed, Unani and Siddha are largely limited to outpatient treatments in Government centres.

Stumbling blocks

The Insurance Regulatory and Development Authority of India had in 2013 asked insurers to cover alternative forms of Ayush treatments, without making it mandatory. Health insurance payments were given only to those treated in Government hospitals or institutions accredited by the Quality Council of India or NABH.

With only hospitalization covered and treatment guidelines unclear for traditional treatments, the initiative did not take off. Rajiv Kumar, Universal Sompo General Insurance’s head (Operations and Corporate Planning) said that the number of government-run Ayush hospitals is limited and those providing in-patient facilities are fewer.

But that too is changing as hospitals like Medanta and the new AIIMS (All India Institute of Medical Sciences) have or are slated to have integrated holistic treatments. And the Government takes one more step in the direction by committing to an AIIMS-type Ayurveda hospital.

Source: The Hindu Business Line