Looking At A Few FAQs On Mental Health Insurance

Author : Insurance Assistance | Published On : 24 Aug 2021

In recent years, we have seen a steady rise in awareness regarding mental health. This change in the air has positively affected the healthcare sector and consequentially, the health insurance domain. Following the Mental Healthcare Act, 2017, which called for the treatment of mental illness on par with physical illnesses, the Insurance and Regulatory Development Authority of India (IRDAI) also declared that health insurance companies will now be expected to cover several mental illnesses in their medical coverage. This announcement was widely welcomed as it will help in creating a robust healthcare system for people with mental illnesses. 

As the inclusion of mental health in health insurance is a relatively new topic, many may have queries and doubts regarding them. To help clear the air, we are addressing a few FAQs on mental health insurance in this article.  

#1 - What mental illnesses will be covered by health insurance companies?

According to the Mental Healthcare Act, a mental illness can be defined as a “substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behaviour, capacity to recognize reality or ability to meet the ordinary demands of life”. As such, illnesses that arise as a result of these issues can be covered under health insurance policies. Here are a few examples of the illnesses that now can get covered- 

- Bipolar disorders

- Acute depression

- Schizophrenia

- Anxiety disorders

- Attention deficit hyperactive disorders (ADHD)

- Post-traumatic disorders (PTSD)

- Obsessive-compulsive disorder (OCD) 

- Mood and psychiatric disorders

#2 - What is excluded under mental health coverage in health insurance?

Mental health issues emanating from the mental retardation of a patient shall not be covered under health insurance. The 2017 Act also excludes mental retardation from the definition of mental illness. Also, pre-existing mental illnesses shall be excluded during the waiting period as prescribed by the insurer. 


#3 - What kind of expenses for mental health will be covered under health insurance policies? 

As the 2017 Act stated that the treatment for mental illnesses will be on par with physical illness, the mental health expenses applicable for coverage will be the same too. In-hospitalization will be covered by most health insurance plans. We must also heed the fact that the tools and resources required for treatment for mental illnesses differ from that of treatment for physical illnesses. Hence, the insurance needs of potential policyholders could be quite different too. Insurers are still in the process of understanding these needs and are introducing coverage carefully and accordingly. 

#4 - Who should opt for mental health coverage in their health insurance policies? 

Mental illnesses are caused by two broad factors: genetic and environmental. 

People with a family history of mental illnesses are advised to opt for mental health coverage even if they are not showing symptoms of any diseases presently. As for the environmental factor - everyday stresses, work worries, sudden disturbances in our lives, and traumatic events affect many. It would not be an exaggeration to say that many of us are prone to mental health issues. Hence, mental health coverage should be sought by anybody who wishes to secure their future against the costs of mental healthcare. 

#5 - How will including mental illnesses in health insurance benefit us at large?

Essentially, it will increase the awareness and accessibility of mental health treatment to many in India. It is also expected to reduce the stigmatization that one may face while seeking treatment for their mental disorders. Presently, the expenses related to such treatments are quite high; health insurance coverage can ease the worries of mental health patients and their caregivers by providing monetary aid. 

As with any monetary investment, always read the policy documents carefully before making any decisions when buying coverage.

Good luck and take care.