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Health Insurance that Covers Mental Health

“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.”

Does Health Insurance Cover Mental Illness?

Why Should You Get Health Insurance for Mental Illness?

Mental health is a crucial part of overall well-being, yet many people overlook the financial impact of treating mental illnesses. With rising cases of anxiety, depression, and other disorders, having health insurance that covers mental health treatment is essential.

Investing in health insurance that includes mental illness coverage is crucial for several reasons:

High Prevalence of Mental Disorders

In India, approximately 14% of the population suffers from various mental disorders, including depression, anxiety, mood disorders, Schizophrenia and bipolar disorders. (1)

Financial Protection Against Treatment Costs

Mental health treatments can be expensive, encompassing therapy sessions, medications and hospitalisations. Insurance coverage removes the financial burden, ensuring access to necessary care.

Improved Access to Comprehensive Care

Health insurance policies that include mental health services provide access to a network of qualified professionals and facilities, promoting timely and appropriate treatment.

List of Mental Illnesses Covered in Health Insurance

In India, health insurance policies have evolved to include coverage for various mental illnesses, ensuring equality with physical health treatments. The specific mental health conditions covered can vary between insurers, but commonly included disorders are:

Mental Illness Covered

Description

Mood Disorders

It includes conditions like major depressive disorder and hypomania, affecting emotional state and stability.

Bipolar Disorder

A mental health condition causing extreme mood swings, from depressive lows to manic highs.

Anxiety Disorders

It includes generalised anxiety disorder, panic disorder, and social anxiety disorder.

Obsessive–Compulsive Disorder (OCD)

It is characterised as unwanted repetitive thoughts and behaviours.

Post–Traumatic Stress Disorder (PTSD)

A disorder triggered by traumatic experiences, leading to flashbacks, anxiety and emotional distress.

Schizophrenia

A severe mental disorder affecting thought processes and behaviours.

Psychotic Disorders

Mental illnesses that cause disconnection from reality, including delusions and hallucinations.

Dementia

It includes Alzheimer's disease, which affects memory and cognitive functions.

Attention Deficit Hyperactivity Disorder (ADHD)

A neurodevelopmental disorder causing inattention, impulsivity, and hyperactivity.

Acute Depression

A severe form of depression characterised by intense sadness, hopelessness, and loss of interest in daily activities.

Note: The above conditions are a general representation of Mental Illness. Coverage and exclusion for these conditions may vary depending on your health insurance policy. Please read your policy document thoroughly to understand the coverage.

Exclusions Under Mental Health Insurance Cover

While the Mental Healthcare Act of 2017 mandates that health insurance policies in India cover mental illnesses, certain exclusions may still apply. Understanding the exclusions of mental illness coverage is crucial for preventing claim denials.

The exclusions under the mental illness coverage are shown below:

Suicide Attempts

Many policies exclude coverage for treatments arising from intentional self-harm or suicide attempts.

Substance Abuse-Related Disorders

Mental health issues resulting from alcohol or drug abuse are typically excluded from coverage.

Outpatient Consultations and Therapy

Some insurers may not cover outpatient counselling or therapy unless hospitalisation is required.

Pre-Existing Mental Conditions

Certain policies may permanently exclude coverage for pre-existing mental health conditions.

Waiting Period

The waiting period in health insurance is generally between 1-3 years depending on the policy during which expenses related to mental health are not covered.

Benefits of Buying Health Insurance for Mental Illness

Taking care of your mental health is as important as physical health! Comprehensive coverage, including mental health treatment, should be included in health insurance packages.  The following are some advantages of health insurance for medical conditions:

Necessary as per Law

One of the main advantages of having health insurance for mental illnesses is the requirement to be covered by health insurance under the Mental Health Act of 2017. The policy contains clauses that provide coverage for those with mental health conditions.

Covers a Wide Variety of Mental Illness

 A wide spectrum of mental illnesses, including schizophrenia, bipolar disorder, anxiety disorders, dementia, and Alzheimer's disease, are covered financially by health insurance policies for mental disorders.

Extensive Coverage

The majority of the plans are made to provide both inpatient and outpatient coverage in addition to a respectable sum covered.  The plan covers the cost of tests, diagnosis, treatment and recuperation, and pre and post-hospitalisation.

10 Essential Tips to Maintain Good Mental Health

FAQs About Health Insurance that Covers Mental Health