Mental health is gaining priority in India. Though the Indian government implemented National Mental Health Programmes in the 80s, the progress has been slow due to many roadblocks like social stigma surrounding mental health, lower priority for treatment, shortage of mental health professionals, etc. The COVID-19 pandemic had also significantly impacted the mental health of the citizens. The evolution in terms of legislation on mental healthcare in India has put an unprecedented impact on the importance of mental health improvement.
Implementation of the Mental Healthcare Act, of 2017 has recognized that every individual has the right to mental healthcare and the MHA has given mental health equal importance as that of physical health. With this progressive legislation on mental healthcare in India, the Insurance Regulatory and Development Authority of India (IRDAI) has brought mental health under the ambit of health insurance policies. Prior to September 30th, 2019, all the health insurance policies excluded psychological disorders, neurodevelopmental disorders, behavioural disorders, and other mental illnesses from the coverage.
After the guideline issued by the Insurance Regulatory and Development Authority of India (IRDAI) to include psychological disorders and mental illnesses under all new and existing health insurance policies, patients can now avail of health insurance coverage for the treatment of psychological disorders and mental illnesses. Let’s know more about health insurance coverage for mental illness and what are psychological disorders covered under the health insurance policies.
What is Mental Illness Health Insurance Cover?
Mental illnesses are a wide range of health conditions that affect the mood, behaviour and thinking of a person that has an impact on judgment, cognitive skills, decision-making ability, and even day-to-day activities. Mental illness health insurance cover is designed to provide financial protection against medical emergencies that may arise from a wide range of mental illnesses. As psychological disorders and mental illnesses are rising concerns especially post-pandemic, coverage of mental insurance would help people get the right treatment without a financial burden.
List of Psychological Disorders and Mental Illnesses Covered under the Health Insurance Plan
The following are the psychological disorders and mental illnesses that are covered under the health insurance policies:
- Acute depression
- Obsessive-compulsive disorder
- Bipolar disorder
- Anxiety disorders
- Schizophrenia
- Mood disorders
- Attention Deficit or Hyperactivity Disorder (ADHD)
- Stress-related and post-traumatic stress disorder
- Dementia
- Psychotic or Psychological disorders
It is important to know that most of the standard health insurance policies that cover psychological disorders and mental illnesses now only provide coverage for in-patient hospitalization (more than 24 hours) which includes treatment cost, room rent, diagnostic test charges, etc. However, counselling, therapy, consultation, rehabilitation, and outpatient benefits are not covered under most of the policies.
Waiting Period for Mental Illness Cover in a Health Insurance Plan
Most comprehensive health insurance policies that include psychological disorders and mental illnesses in the scope of coverage come with a waiting period. The coverage kicks in only after the completion of the waiting period mentioned in the terms and conditions of the policy. The waiting period may range from 24 months to 48 months depending on the policy terms and conditions and from one insurance company to another.
Mental Illness Health Insurance Benefits and Features
Comprehensive health insurance policies that include cover for mental illnesses can benefit health insurance policyholders in many ways. Let’s take a look at the features and benefits of mental illness covered in a health insurance policy:
1. Compulsory Coverage by Law
As per the Mental Health Act, 2017, and the guidelines issued by the Insurance Regulatory and Development Authority of India (IRDAI), it is mandatory for health insurance companies to include psychological disorders and mental illnesses in their health insurance policy. Coverage can be availed once the waiting period for psychological disorders and mental illnesses mentioned in the policy terms is completed. Mandatory coverage ensures every individual gets the treatment as per their mental healthcare mentioned in the Mental Health Act, 2017.
2. Wider Coverage
The amount of coverage offered for mental illness remains the same as that for other physical illnesses. The high coverage amount can be availed in a health insurance policy. In-patient hospitalization, post, and pre-hospitalization cover, etc are included in the policy. Only a few health insurance policies may cover outpatient treatment costs for psychological disorders and mental illnesses.
3. Coverage for a Wide Range of Mental Illnesses
Health insurance coverage for psychological disorders and mental illnesses includes various mental health conditions that would require medical care. Especially the disorders that affect the day-to-day functioning of the person and the conditions that require hospitalization need financial protection in the form of a health insurance policy. Mental illness coverage under a health insurance policy works like a financial cushion for the patient and the family to get quality treatment without any financial distress.
However, it is important to know that there are certain exclusions that apply for the mental illness coverage offered under a health insurance policy. This includes mental retardation, outpatient expenses (most of the plans), recurring mental illnesses due to indiscipline in following medication and treatment, mental illness due to drug or alcohol abuse, etc. It is important to understand the inclusions and exclusions in a health insurance policy before you avail of the coverage.
To sum up, the treatment cost of many mental illnesses can be expensive. Inclusion of mental illnesses under the scope of health insurance policy can help people in getting treatment at the right time and also improve their mental well-being.
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