AYUSH treatment in health insurance covers medical care under traditional Indian systems of medicine, namely Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy. These systems are recognised and supported by the Government of India's Ministry of AYUSH and are widely used for preventive care, chronic conditions, and lifestyle-related ailments. Including AYUSH cover in your health insurance policy gives you financial protection against hospitalisation costs at accredited AYUSH hospitals. This guide explains how AYUSH cover works, what is included and excluded, how to claim, and what tax benefits apply.
What Is AYUSH Treatment in Health Insurance?
AYUSH is an official acronym for six recognised systems of medicine in India. The Ministry of AYUSH was set up by the Government of India in November 2014 to regulate, standardise, and promote these systems.
System | Primary Treatment Focus |
|---|---|
Ayurveda | Balancing the body's doshas through herbs, specialised diets, and Panchakarma (a five-step detoxification therapy). |
Yoga & Naturopathy | Drugless healing through postures, breathwork, diet, and natural elements such as water and sunlight. |
Unani | A Greco-Arabic system that uses herbal medicines and regimens to balance the bodily humours. |
Siddha | An ancient South Indian system that uses minerals, herbs, and detox practices to treat illnesses. |
Sowa-Rigpa | A traditional Himalayan system that focuses on the mind-body connection and natural therapies. |
Homoeopathy | Treatment using highly diluted natural substances to support the body's healing response. |
Key Features of AYUSH Coverage in Health Insurance
Modern health insurance policies treat AYUSH care on par with allopathic care, in line with the IRDAI Master Circular on Health Insurance Business issued in April 2024.
Full Sum Insured: Most insurers have removed sub-limits since April 2024. You can now claim AYUSH treatment up to the full sum insured of your policy.
Inpatient Hospitalisation: Coverage requires a minimum 24-hour hospital stay, with some day-care AYUSH procedures (such as specific Panchakarma steps like Virechana and Basti) also included.
Recognised Institutions: Claims are payable only if treatment is taken at a government hospital or an AYUSH hospital accredited by NABH (National Accreditation Board for Hospitals & Healthcare Providers).
Cashless Facility: Many accredited AYUSH hospitals offer cashless settlement through the National Health Claims Exchange (NHCX), a digital claims platform operated by the National Health Authority.
Curative Focus: The cover applies to medically necessary treatments only. Wellness packages, spa services, and rejuvenation programmes are not covered.
Pre- and Post-Hospitalisation Cover: Medical costs incurred up to 30 days before hospitalisation and up to 60 days after discharge are covered, when linked to the same condition.
Importance of AYUSH Cover in India
India has a long tradition of using indigenous systems of medicine. The Ministry of AYUSH supports and regulates this tradition so that the care is standardised, safer, and more accessible.
AYUSH cover is useful for:
People who prefer natural or preventive therapies for managing health.
Patients with chronic conditions such as arthritis, asthma, skin disorders, and lifestyle-related diabetes, where AYUSH systems offer long-term management.
Senior citizens looking for gentler, non-invasive treatment options with fewer side effects.
Rural and semi-urban communities where AYUSH facilities are often the most accessible source of care.
Benefits of AYUSH Treatment Coverage
Access to all six AYUSH systems on par with allopathic care under your policy.
Coverage of inpatient hospitalisation costs up to the full sum insured.
Lower out-of-pocket cost for chronic-condition management compared with prolonged allopathic regimens.
Treatment at NABH-accredited hospitals, supporting safer and standardised care.
Tax benefits on the premium paid for the policy that includes AYUSH cover.
Lifetime renewability and portability of the policy without losing the AYUSH benefit.
What Is Covered Under AYUSH Health Insurance?
AYUSH cover includes the medical expenses you incur during hospitalisation at a recognised AYUSH facility.
Inpatient hospitalisation expenses such as room rent, nursing, and boarding charges for a stay of 24 hours or more.
Consultation and treatment fees of registered AYUSH practitioners during the hospital stay.
Cost of prescribed medicines, therapeutic oils, and approved consumables used during the treatment.
Diagnostic tests and laboratory work directly linked to the AYUSH inpatient treatment.
Specific day-care procedures, such as Virechana, Basti, or Nasya under Panchakarma, performed in a clinical setting.
Pre-hospitalisation expenses (up to 30 days) and post-hospitalisation expenses (up to 60 days) related to the same condition.
Note: Coverage is limited to treatment at a government AYUSH hospital or an NABH-accredited AYUSH facility, as per the policy wording.
What Is Not Covered Under AYUSH Health Insurance?
While the cover is wide, certain exclusions apply.
Outpatient consultations and treatments that do not need hospitalisation, unless your policy includes an OPD benefit.
Treatment at AYUSH centres that are not government-recognised or NABH-accredited.
Wellness, beauty, or rejuvenation packages, including spa-style massages and detox retreats taken for general health upkeep.
Experimental or unapproved AYUSH therapies that are not recognised by the Ministry of AYUSH.
Non-medical costs such as guest accommodation, special meal preferences, and other personal expenses.
Eligibility and Policy Features for AYUSH Coverage
AYUSH cover is designed to be available to most policy buyers, in line with current IRDAI rules.
Inbuilt Feature: AYUSH cover is an inbuilt feature in most current health insurance plans. A few older or basic plans may still treat it as an optional add-on.
Individual and Family Floater: The cover is available under both individual and family floater policies.
No Upper Age Limit: As per the IRDAI Master Circular on Health Insurance (effective April 2024), there is no upper entry age for buying a new health insurance policy.
Minimum Hospitalisation: Claims usually need at least 24 hours of inpatient care at a government or NABH-accredited AYUSH facility.
Full Sum Insured Access: Sub-limits on AYUSH treatment have been removed, so you can claim up to the full sum insured.
Renewability and Portability: AYUSH cover comes with lifetime renewability, and you can port your policy to another insurer without losing the benefit.
How to Claim AYUSH Treatment Under Health Insurance
The AYUSH claim process is the same as the allopathic claim process at Zurich Kotak General Insurance.
Choose a Recognised Facility: Use a government AYUSH hospital or an NABH-accredited AYUSH hospital. Claims at unaccredited centres or wellness spas are usually rejected.
Notify the Insurer: Inform Zurich Kotak General Insurance or your TPA within 24 hours of an emergency admission, or at least 48 hours before a planned admission.
Cashless Claim: If the hospital is in the Zurich Kotak network, submit your health card and the pre-authorisation form at the hospital's insurance desk.
Reimbursement Claim: If the hospital is outside the network, pay the bills upfront and submit the claim form along with original documents within 30 days of discharge.
Submit the Documents: A duly filled and signed claim form, the discharge summary, the doctor's prescription advising hospitalisation, itemised bills and payment receipts, and relevant diagnostic reports.
For policy support, write to care@zurichkotak.com or call 1800 266 4545.
Government Initiatives Supporting AYUSH Coverage
Ministry of AYUSH: Set up in November 2014 to lead the standardisation and promotion of traditional medical systems.
IRDAI Master Circular on Health Insurance (April 2024): Mandates AYUSH coverage on par with allopathic care, including the removal of sub-limits.
National AYUSH Mission (NAM): A centrally sponsored scheme that supports AYUSH hospitals, dispensaries, and training across states.
Ayushman Arogya Mandir: The renamed network of Health and Wellness Centres under the Ayushman Bharat initiative, which provides outpatient holistic care.
PM-JAY: The hospitalisation arm of Ayushman Bharat that includes AYUSH care at empanelled hospitals for eligible beneficiaries.
Quality Accreditation: Safety is supported through NABH accreditation, the National Accreditation Board for Hospitals & Healthcare Providers, which operates under the Quality Council of India.
Tax Benefits on AYUSH-Inclusive Health Insurance
Premiums paid for a health insurance policy that includes AYUSH cover are eligible for a tax deduction under Section 80D of the Income-Tax Act, 1961 for assessment years up to AY 2025-26. From AY 2026-27 onwards, the equivalent provision under the new Income-Tax Act, 2025 applies.
Category | Maximum Deduction Limit (₹) |
|---|---|
Self, spouse, and dependent children (all below 60 years) | ₹25,000 |
Self and family (any member aged 60 years or above) | ₹50,000 |
Parents (both below 60 years), in addition to the above | ₹25,000 |
Parents (any one aged 60 years or above), in addition to the above | ₹50,000 |
Preventive health check-up (within the overall limit) | ₹5,000 |
Tax benefits are subject to changes in tax laws. Please consult a qualified tax advisor for the section reference applicable to your filing year.
Zurich Kotak Health Insurance Plans With AYUSH Cover
Several Zurich Kotak health plans include AYUSH cover, so you can choose a plan based on your sum insured, age band, and family needs.
Health Premier
Secure Shield
MediShield
Arogya Sanjeevani Policy
Saral Suraksha Bima
Group Health Insurance
Explore the plan details, compare features, and buy or renew online.
Conclusion
AYUSH treatment cover brings traditional Indian medicine into the same financial protection framework as allopathic care. Recognised by the Ministry of AYUSH and supported by IRDAI's Master Circular on Health Insurance, this cover applies to inpatient treatment under Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy at accredited centres. The benefits include access to the full sum insured, lower out-of-pocket cost for chronic conditions, and tax savings on the premium paid. Reading your policy wording, checking the network list, and using the right claim channel are the simple steps to a smooth AYUSH claim experience with Zurich Kotak General Insurance.
Frequently Asked Questions (FAQs)
What Is AYUSH Treatment in Health Insurance?
AYUSH treatment in health insurance refers to inpatient cover for medical care under six recognised systems: Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy. The cover applies at government AYUSH hospitals and NABH-accredited centres, subject to the policy terms.
What Are the Benefits of AYUSH Coverage?
AYUSH cover gives you access to traditional treatment options, supports better management of chronic conditions, provides financial protection up to the full sum insured, and qualifies for tax benefits under the applicable section of the Income-Tax Act.
Are Outpatient AYUSH Treatments Covered?
Most policies cover only inpatient hospitalisation under AYUSH. Outpatient AYUSH consultations are covered only if your plan includes an OPD benefit.
Can AYUSH Claims Be Made Cashless?
Yes. If the AYUSH hospital is in the Zurich Kotak network, you can opt for a cashless claim using your health card and the pre-authorisation form at the hospital's insurance desk.
What Is the Difference Between AYUSH and Ayurveda?
AYUSH is an umbrella term for six recognised systems of medicine in India. Ayurveda is one of these systems and uses herbal medicines, specific diets, and Panchakarma for treatment.
Who Is Eligible for AYUSH Coverage?
Most individuals who are eligible for a Zurich Kotak health insurance policy can choose a plan that includes AYUSH cover. As per current IRDAI rules, there is no upper age limit for buying a new health insurance policy. Premiums depend on age, sum insured, and the chosen plan.
Are There Waiting Periods for AYUSH Treatment?
Yes, the standard waiting periods apply. Most plans have a 30-day initial waiting period, 24 months for specific illnesses, and 36 to 48 months for pre-existing diseases . The exact durations are listed in the policy wording.
Does AYUSH Cover Include Diagnostic Tests?
Yes. Diagnostic tests and laboratory work that are directly linked to the AYUSH inpatient treatment are covered.
Which Hospitals Are Eligible for AYUSH Claims?
Claims are payable at government AYUSH hospitals and at private AYUSH facilities accredited by NABH. You can check the network list of Zurich Kotak AYUSH hospitals on the Hospital Locator page.
How Long Does the Insurer Take to Process an AYUSH Claim?
Cashless approval at the hospital is usually given within a few hours of pre-authorisation. Reimbursement claims with complete documents are typically processed within a few working days, as per Zurich Kotak's Citizen's Charter.
Does the Premium for AYUSH Cover Cost Extra?
On most current Zurich Kotak plans, AYUSH cover is an inbuilt feature with no extra premium. On a few older plans, AYUSH may be available as an optional add-on with a small additional premium.
Can I Switch My Insurer Without Losing the AYUSH Benefit?
Yes. You can port your policy to another insurer using IRDAI's portability rules and keep the AYUSH benefit, subject to the new insurer's underwriting.
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