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Health Insurance that Covers Mental Health

As it is said, “Mental health needs a lot of attention. It’s the final taboo and it needs to be faced and dealt with."

Hence, in today’s fast-paced world, mental health is just as important as physical well-being, yet it often goes unnoticed until it takes a toll. Thankfully, health insurance is evolving to recognise the significance of mental wellness. 😌

Health insurance for mental health ensures that therapy sessions, psychiatric treatments and even hospitalisations don’t become financial burdens. With rising stress levels and increasing awareness, having a policy that supports both mind and body is no longer a luxury, it’s a necessity.

Team Digit

“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?
List of Mental Illnesses Covered in Health Insurance
Exclusions Under Mental Health Insurance Cover
Benefits of Buying Health Insurance for Mental Illness
Essential Tips to Maintain Good Mental Health
Frequently Asked Questions

Does Health Insurance Cover Mental Illness?

Yes, health insurance covers mental illness treatment. On 16th August, the Insurance Regulatory and Development Authority of India (IRDAI) made mandatory for insurance companies to cover mental illness. It was a welcome step as mental health has a large scope, especially in India. So mental health insurance coverage is provided in almost all insurance policies.

The coverage typically includes diagnosis, consultation, hospitalisation, and other costs related to mental health treatment. However, different insurers offer certain limitations in their policies. Hence, it is essential to read the policy terms carefully to understand inclusions and exclusions.

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:

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:

Note: Some policies might provide for OPD cover but it can differ from policy to policy. It's essential to thoroughly review your health insurance policy to understand specific exclusions related to mental health coverage.

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:

10 Essential Tips to Maintain Good Mental Health

Neglecting your mental illness is never a good idea, as it can worsen and may need appropriate medical care. Therefore, it is strongly advised to purchase health insurance with mental illness coverage!

However, here are some tips to maintain and practice good mental health:

Make time for the activities you enjoy.
Relax and enjoy more time in nature.
Eat a diet rich in fruits and vegetables to stay healthy
Practice Yoga & Meditation to reduce stress.
Ensure you get at least 7 to 8 hours of restful sleep each night.
Engage in physical activities like dancing, walking and working out.
Plan exciting events and getaways to help you understand your emotions.
Practice introspection to better understand your thoughts, feelings and emotions.
Start writing or expressing your emotions verbally.
Speak with a trusted person to feel better.

To Sum Up:

Mental health is not a choice, but seeking the right support is. With growing awareness and legal mandates, having health insurance that covers mental illnesses is a crucial step toward overall well-being.

It ensures that financial constraints never come in the way of seeking professional help, whether for therapy, medication, or hospitalisation. Investing in the right mental health insurance plan not only safeguards your peace of mind but also reinforces the idea that mental wellness deserves the same care as physical health. 🤗

FAQs About Health Insurance that Covers Mental Health

All

What does mental health insurance cover?

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

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

The minimum time of hospitalisation 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 mental health insurance coverage?

Yes, very few insurers cover consultations and counselling for mental illness under the OPD benefit. But you should check first if your health insurance policy has the option for both OPD and mental illness benefits. At Digit, you have to opt for OPD benefits to cover the consultation charges.

Is there a waiting period for mental health insurance?

Like all other pre-existing conditions, mental illness benefit also has a waiting period in health insurance that needs to be borne by the insurer. The waiting period for mental illness benefits with most insurers is 2 years. So, if you have bought health insurance today, then you will have to wait for 2 years before you can claim for the expenses incurred due to mental illness.

Does mental health insurance have a co-payment?

Yes, a 20% co-payment on all claims is required for mental health insurance coverage. However, you can avoid this co-payment by paying a higher premium. Always read your policy document to determine whether a co-payment is present.

Does health insurance in India cover schizophrenia?

Yes, in India, there is health insurance for those with schizophrenia. All mental health insurance policies cover schizophrenia because it is a form of mental disorder.

Does health insurance cover anxiety?

Yes, since anxiety is a form of mental disorder, its treatment costs are covered by health insurance for mental illnesses.

Does insurance pay for depression treatment?

The majority of insurance policies cover diseases like depression, although they cannot cover certain services like consultations or prescription drug expenditures. You can opt for health insurance that covers mental illness for getting depression treatment covered.

For whom is mental health insurance appropriate?

Mental health insurance is suggested for:

Anyone who has experienced trauma or has a family history of mental illness is advised to get mental health insurance.
It is also beneficial for people who are traumatised by the death of a loved one or by trauma sustained after an accident.
Anyone who leads a stressful lifestyle may be susceptible to mental health insurance.

How long must a patient with a mental disorder stay in the hospital for mental health insurance to cover them?

You must stay in the hospital for at least 24 hours in order to receive health insurance coverage for the treatment of mental illness. OPD coverage for mental health care is offered by certain insurers. To find out the scope of coverage, consult the insurer when buying the plan.

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CIN: L66010PN2016PLC167410, IRDAI Reg. No. 158.

Go Digit General Insurance Limited | Corporate Office Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru 560095 | Registered Office Address: 1 to 6 floors, Ananta One (AR One), Pride Hotel Lane, Narveer Tanaji Wadi, Shivaji Nagar, Pune-411005, Maharashtra | Trade logo of Go Digit General Insurance Ltd. displayed above belongs to Go Digit lnfoworks Services Private Limited and is provided and used by Go Digit General Insurance Ltd. under license.

Health Insurance that Covers Mental Health

Table of Contents

Does Health Insurance Cover Mental Illness?

Why Should You Get Health Insurance for Mental Illness?

High Prevalence of Mental Disorders

Financial Protection Against Treatment Costs

Improved Access to Comprehensive Care

List of Mental Illnesses Covered in Health Insurance

Exclusions Under Mental Health Insurance Cover

Suicide Attempts

Substance Abuse-Related Disorders

Outpatient Consultations and Therapy

Pre-Existing Mental Conditions

Waiting Period