Do Medical Insurance Companies Offer Mental Health Coverage?

If in the early days of 2022, had you asked whether your health insurance coverage in India is available for mental health, the answer would have been quite different than what it is today. In the latter half of 2022, the Insurance Regulatory and Development Authority of India, i.e., IRDAI, directed all insurance providers to cover mental health issues under their health insurance policies. This is made possible due to the provisions of the Mental Healthcare Act, 2017. ^# So, do health insurance policies cover mental health issues today? The answer to this is – yes, they do. Today, it is possible to find health insurance coverage that looks beyond physical health and well-being. You can find a plan in the Indian market that will cover mental health conditions and allow you to claim benefits for the same. So, what should you know about mental health coverage in your health insurance plan? Before we dive into the mental health coverage aspect of health insurance plans, let’s get to know a bit more about mental health.

Mental Health Conditions

Mental health is a term that encompasses your emotional and psychological well-being. Some of the conditions that upset the precarious balance that keeps you mentally healthy are commonly referred to as psychological disorders. Some of these mental health ailments that you may commonly hear about include:

• Dementia
• Depression
• Anxiety disorders
• Schizophrenia
• Eating disorders
• Bipolar disorder
• Obsessive-compulsive disorder
• Phobias
• Addictions
• Sleep issues
• Stress
• Trauma

Today, there is significant awareness of mental health and the conditions that can upset your mental balance. Being affected by a mental health disorder may upset you in more ways than one, causing your life balance to be disturbed. Mental health disorders often show physical symptoms, too. For example, a person’s general anxiety disorder may show up as palpitations (rapid heartbeat), excessive sweating, trouble breathing or shortness of breath, and muscle aches. Similarly, eating disorders may manifest as dizziness or fainting, fatigue, hair thinning, and extreme weight loss. To ensure an overall healthy life, ensuring mental well-being is almost as important as physical well-being, if not more. Thus, if you were to ever experience any mental health conditions, it is necessary to address them effectively. To do so, you may need to visit specialists and spend money on healthcare. This could be heavy on your pockets, but necessary for your well-being. In such cases, you can rely on your health insurance plans. With the guideline from the IRDAI, you may now be able to claim your mental healthcare costs through your health policy. *

Coverage of Health Insurance Policies for Mental Healthcare

While most health plans for family, i.e., family floater plans, as well as plans for an individual will cover mental health conditions, knowing that is not enough. Every health insurance plan comes with some inclusions and exclusions. These define what gets covered by your policy, and what does not. For example, whether a health insurance policy covers your regular visits to a specialist, or the cost of your medications, will depend on the type of policy you have chosen and the features it offers. One type of policy may cover hospitalisation for a range of physical as well as mental health ailments but may not offer coverage for OPD charges.* Hence, it is not enough to know whether your health insurance plan covers mental health issues or not. It is rather important to understand the nuances of the policy. Will your policy cover hospital room rent, OPD charges, therapy charges, alternative therapy options, rehabilitation, and other such healthcare requirements? Choose a policy that allows you the best balance of these options.*

Waiting Period for Mental Health Conditions

While it is a reassuring development that mental health ailments are now covered by health insurance policies in India, there is still a waiting period before you can claim your benefits. What does this mean? The waiting period is the duration between the time you purchase the policy and the time you may be able to make a claim. The waiting period for each policy may be different. However, most policies will require you to maintain a waiting period of a year or two before the mental health benefits offered by the policy can be claimed. It may suit you to compare policies before buying to ensure that the waiting period is minimal.* With most health insurance policies now covering mental health, it is all the more advisable to get a health insurance policy for yourself as well as your loved ones. A health insurance plan for family can help you cover most bases when it comes to the healthcare needs of your spouse, children, as well as parents. Before you buy a policy, ensure that you understand the full scope of the coverage provided.   * Standard T&C apply. # Visit the official website of IRDAI for further details. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.