Is mental health covered by insurance?

Team Digit, 01 Dec 2018

Mental Illness is a topic that has always been pushed behind closed doors. There has been a huge stigma around mental health and wellness. Thank god, now that times are changing people have been more open to talk about mental health and take it as seriously as a physical illness. This same change has been brought about in the insurance space too.

On 16th August, Insurance Regulatory and Development Authority of India (IRDAI) asked insurance companies to make provisions to cover mental illness.  It was a welcome step as mental health has a large scope especially in India.

As per the National Mental Health Survey of India for FY16 conducted by the National Institute of Mental Health and Neuro Sciences, nearly 15% of Indian adults need treatment for one or more mental health issues.

So mental health insurance is for real now and will not be excluded from your health insurance anymore.

Here are the things that you should know about mental health insurance and why it is useful

What does mental health insurance cover?

Mental health insurance covers any expenses incurred if anyone has to be hospitalized under in-patient care due to any mental illness. It includes diagnostics, medications, treatment costs, room rent road ambulance charges etc.

Who should take mental health insurance?

Mental health insurance coverage is relevant for anyone with a family history or any traumatic experience, where it is likely for the person to acquire such a disease. It is also useful for anyone suffering from a post-accident trauma or trauma due to losing a loved one. With the current scenario of stressful lifestyle and living conditions, actually everyone is vulnerable to mental illness.

What is the minimum time a mental illness patient must be hospitalised to claim?

The minimum time of hospitalization for a mental illness patient has to be 24 hours for a person to claim the expenses in their health insurance.

Are consultations and counselling covered under the mental health insurance coverage?

Very few insurers cover consultations and counselling for mental illness under the OPD benefit. But what needs to be kept in mind is, you should check first if you are plan has the option for both OPD benefit and mental illness benefit, in your health insurance policy.

Is there a waiting period for mental health insurance?

Like all other pre existing condition <link>, mental illness benefit also has a waiting period that needs to be borne by the insurer. The waiting period for mental illness benefit with most insurers is 2 years. So, if you have bought a health insurance today, then you will have to wait for 2 years before you can claim for the expenses incurred due to mental illness. Hence, it is advisable to start early and take this benefit with your first policy. So, all your waiting periods are over right when you need it.

So, what are the diseases that fall under the Mental Illness list?

These are some of the known diseases that fall in the list of mental illness

  • Acute Depression
  • Bipolar disorder
  • Schizophrenia
  • Anxiety disorders
  • Obsessive-compulsive disorders
  • Attention-deficit/hyperactivity disorder
  • Post-traumatic stress disorder
  • Mood disorder
  • Psychotic disorder

What is not covered under mental health insurance?

Mental health insurance covers expenses only when the patient has to be hospitalized. Very few insurers cover expenses for out-patient care like consultations. Any mental illness induced due to drug or alcohol abuse will not be covered. Also, if there’s history of recurring mental condition, the claim might not be accepted, as usually a recurring mental condition occurs due to indiscipline in taking treatments and medication.

Mental health insurance is a fresh take at how mental illness has been looked at since time immemorial. It’s time to dig in deep if you feel your loved ones are suffering from any mental illness. It’s time we talk about it to ensure they get help at the right time!

Want to read more about health insurance? Read this blog!

 

 

Team Digit

Digit is a General Insurance company on a mission to Make Insurance Simple for people. We are backed by Fairfax, one of the largest insurance companies in the world.

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