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Must Know: Get Reimbursed for Yoga, but do not slip on nitty-gritties

Health insurance policies cover Yoga-related treatment under AYUSH coverage, but the benefit comes with limitations
By OLM Desk | June 21, 2017

The International Yoga day fever has gripped the country once again, with thousands lining up to master the perfect poses for a healthier lifestyle.

While awareness of Yoga as the key to good health has increased rapidly in the last couple of years, many individuals remain ignorant of insurance benefits around this ancient form of exercise.

Contrary to the common perception, health insurance coverage is not restricted to the conventional, allopathic treatment alone. Inpatient alternative treatment under the AYUSH - Ayurveda, Yoga, Unani, Siddha, Homepathy and Naturopathy- umbrella are also eligible for claims. This apart, some health insurers have also incorporated Yoga in their outpatient add-ons, value-added service portfolio and wellness programmes for corporate as well as retail policyholders, though the corporate customers have access to wider range of benefits than the latter.

What is the scope of coverage?

As per the Insurance Regulatory and Development Authority of India's (IRDAI) health insurance guidelines, insurers are required to make efforts to cover inpatient hospitalisation under traditional forms of treatment. However, the numerous restrictions have prevented a smooth take-off, despite growing demand for such services. For instance, to avail of the benefit, the insured needs to have undergone the treatment either at government hospitals or institutes recognised by government. Facilities accredited by Quality Council of India or National Accreditation Board on Health are also eligible for the purpose.

Yoga in particular remains largely confined to corporate group health and wellness programmes, though insurers offering individual OPD add-ons that cover Yoga is on the rise, with ICICI Lombard and Cigna TTK Healthcare, among others, offering such policies.

"Under AYUSH we cover the cost of treatment, if the customer opts for hospitalisation under Ayurvedic or Homeopathic lines of treatment for any particular disease. Wellness activities such as Yoga are not a part of our health insurance policies. However, we do organise Yoga sessions and have tied-up with Yoga practitioners who offer their services at discounted rates to our group mediclaim customers," says Sasikumar Adidamu, Chief Technical Officer, Bajaj Allianz General Insurance.

ICICI Lombard reimburses enrollment fees paid by policyholders to Yoga institutes under its wellness and preventive healthcare add-on, in addition to reward points. The sum insured for this optional benefit ranges from Rs 2,500 to Rs 20,000.

"In the retail product segment, we cover out-patient treatment including Yoga and Naturopathy from Rs 500 to Rs 20,000, depending on the plan opted for. The treatment or programme should be delivered by certified yoga professionals and naturopaths," says Sandeep Patel, MD and CEO, Cigna TTK Health Insurance.

What are the restrictions?

Apart from the kind of hospitals, IRDAI regulations also specify certain minimum criteria for these healthcare centres to be eligible for AYUSH claims. For example, they need to have at least five qualified AYUSH doctors, paramedical staff and maintain at least 15 in-patient beds and dedicated AYUSH therapy sessions. Then, there could be restrictions imposed by insurers too. "Coverage is available for Yoga and Naturopathy treatment excluding that for pleasure or rejuvenation purposes or as a preventive aid like purification, detoxification, Panchakarma etc," adds Patel.



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