Archive · 19 Jun 2025
Why AYUSH Claims are Still Being Rejected by Insurers
Insurance companies now have to pay for treatments like Ayurveda and Yoga.
But, people are still having trouble getting their claims approved.
Sometimes, insurance companies say the treatment wasn't needed in the hospital or was just for testing.
The problem is that each type of treatment doesn't always have the same rules and some hospitals charge too much.
To get your claim approved, make sure your hospital is approved and you have a good reason for needing treatment.
New insurance rules mandate health policies to cover AYUSH treatments.
Many AYUSH insurance claims are still being rejected despite the new regulations.
Reasons for rejection include insurers claiming treatment was for diagnostic purposes or not requiring hospitalization.
Lack of standardized treatment protocols and CGHS pricing issues are major challenges.
Patients should confirm hospital accreditation, have clear diagnoses, and distinguish between preventive and curative care.
- Who
- Patients seeking AYUSH treatments, insurance companies, and hospitals.
- What
- Many AYUSH health insurance claims are being rejected.
- When
- January 2024 Irdai directive.
- Where
- India
- Why
- Lack of standardized treatment protocols, unclear justifications for hospitalization, and issues with CGHS pricing.
Patients
Insurers
Claim Approvals
Patients
Claims are wrongly rejected.
Insurers
Insurers are following regulations.
Need for Hospitalization
Patients
IPD stays were medically necessary.
Insurers
IPD stays were unnecessary.
- AYUSH
- Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy
- Irdai Directive
- January 2024 - mandates health insurance to cover AYUSH treatments
- Rejection Rate
- At least 70% of AYUSH claims are rejected, according to some hospitals.
- Key Issue
- Lack of standard treatment protocols
- Hospital Accreditation
- NABH-accredited hospitals are often involved
- Preventive Care
- May not be covered by insurance.