Stakeholders discuss ways to widen Ayush insurance coverage

Aim is to ensure easy access to Ayush treatments for everyone

 Recently, the stakeholders gathered to discuss the regulatory framework and policy support needed to mainstream Ayush treatments in health insurance schemes at the sensitisation program organised by the Ministry of Ayush for Insurance Companies and  Ayush Hospital Owners at the All India Institute of Ayurveda (AIIA). The objective was to make Ayush treatments available to the last mile patient.

 The meeting was necessitated due to the recent  Insurance Regulatory Development Authority (IRDAI) directions to bring Ayush treatments under health insurance cover effective April 01, 2024 and the need to create a deeper understanding between Ayush Hospitals & healthcare providers and the insurance sector stakeholders and foster affordable Ayush healthcare to citizens.

 Vaidya Rajesh Kotecha, Secretary, Ministry of Ayush, said, “The aim is to ensure easy access to Ayush treatments for everyone. A significant milestone was achieved with the joint publication of standard treatment guidelines by DGHS & Ayush (STG), marking a first-of-its-kind integration in India. The aim is to ensure easy access to Ayush treatments for everyone. This focus on accessibility is coupled with remarkable growth in the sector, with the manufacturing of Ayush products increasing eightfold in the last decade.”

Prof. Tanuja Nesari, Director, All India Institute of Ayurveda (AIIA) said, “ Our collaboration with insurance companies focuses on enabling cashless access to Ayush services through the TPA network.”

 Speaking about the need for separate registry for Ayush hospitals Prof. Bejon Kumar Mishra, Chairman, Core Group of Experts for Insurance, Ministry of Ayush, stated, “ A key recommendation is to promote Ayush HCO empanelment and Adopt MoAyush approved Standard Treatment Guidelines (STGs), ICD-TM2 codes and increase Ayush representation on key committees.”

On the other hand, Rajiv Vasudevan MD & CEO, Apollo AyurVAID Hospitals, discussed the current state of insurance services which are largely focused on surgical and emergency services.  However two-third of the sector belong to people dealing with long-term diseases and effective healthcare is required. 

It’s time to go from symptomatic relief to identifying and working on the root cause of the disease(s).  Ayush treatments will also be highly effective in case of palliative care and end-of-life care” he added.

 “We expect General Insurance Council to provide the leadership on behalf of its 39 general insurance, standalone health insurance, reinsurance and specialised insurance companies to be an integral component in publishing the White Paper,” Mishra further added. 

 Further, Dr Kousthubha Upadhyaya, Adviser, Ministry of Ayush said “Ministry of Ayush has constituted a Core Group of experts for Insurance Sector in October 2023 with the objective to advice and monitor insurance related matters in Ayush Sector and conduct a study of current status of Ayush systems under health insurance and to create a white paper.”

 Ministry of Ayush and NHA are working towards inclusion of Ayush interventions in Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), he added.

Dr A. Raghu, Deputy Director General (Ayush), Ayush vertical in Director General of Health Services emphasised three levels of medical management (Mild/Moderate/Severe) for each disease where treatment duration should be systematically derived by experts. Here package inclusions and exclusions are clearly defined based on Duration x Per Day Rate