AYURVEDIC HOSPITAL CARE: WHY INSURERS PUSH BACK—AND HOW TO WIN CLAIMS

Over the past few years, a friend has undergone Ayurvedic treatment for fluctuating blood pressure at a Kerala hospital. The insurer had routinely covered a week of hospitalization, but this time rejected the claim, arguing the annual treatment appeared more like rest than medical necessity. Ayurvedic claims are becoming harder to get approved.

- KAPIL MEHTA

Ayurveda remains popular, especially for chronic, low-severity conditions such as hypertension, high cholesterol and arthritis. Severity often determines the treatment path—someone with mildly elevated creatinine may opt for Ayurveda alone or as a supplement, but higher levels may require dialysis.

The growing use of Ayurveda, especially for chronic low-severity illnesses, creates a unique challenge for insurers. Allopathic treatment for such conditions usually happens on an outpatient (OPD) basis, so insurers don’t pay for it. But Ayurvedic treatment for the same conditions often requires hospitalization— and insurers do pay for that. Such hospitalization may be repeated annually for long-term benefits. So, from an insurer's perspective, Ayurvedic hospitalization results in additional cost that they would not otherwise have borne.