Mental Health Insurance: Your Mental Health Is Worth the Premium

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Mental Health Insurance: Your Mental Health Is Worth the Premium

According to a WHO report, every 1 in 8 people worldwide live with some kind of mental disorder. With so many people battling with problems every day, it is no news that mental health must be included in mainstream public healthcare services. In India, the government has recognized the gravity of the mental health crisis and is making a crucial development in this arena, in the form of Mental Health Insurance.

In 2017, the Government of India launched the Mental Healthcare Act (MHCA), which aims to improve mental healthcare services and protect the rights of individuals with mental ensure that affordable and accessible mental healthcare is available. The MHCA mandated mental illnesses to be included in insurance coverage. As a result, the Insurance Regulatory and Development Authority of India (IRDAI) directed insurance companies to include mental illnesses in their plans by October 2022. This has led to many insurance plans that now cover mental illnesses.

Problems Covered by Mental Health Insurance in India 

  • Disorders- Following disorders are covered under mental health insurance:
    Bipolar disorder
    Acute depression
    Obsessive-compulsive disorder
    Anxiety disorders
    Hyperactivity/attention deficit disorder
    Mood disorders
    Post-traumatic stress disorder
    Psychological disorders
  • Cognitive Issues- This is defined as a considerable disorder in moods, perception, thinking, memory, or orientation that impacts their decision-making, judgment, and behavior capabilities to meet ordinary day-to-day activities.
  • Hospitalization- 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.
  • OPD Benefit- This covers the expenses for doctor consultations, diagnosis, and prescribed medical treatments. However, very few insurers cover consultations and counseling for mental illness under the OPD benefit.

Some exclusions 

Some conditions under which mental health insurance doesn’t provide coverage are:

  • Any type of mental retardation
  • Mental illness arising from drug or alcohol abuse
  • History of recurring mental illness

How to avail insurance coverage?

To avail of health insurance coverage for mental illness treatment, you must be hospitalized for at least a minimum of 24 hours. Some insurers provide OPD coverage for the treatment of mental illness. 

Available Mental Health Insurance Plans 

There are both public and private insurance plans available in India:

Government plans 

  • Ayushman Bharat- Covers all treatment costs, including pre and post-hospitalization costs under the Pradhan Mantri Jan Arogya Yojana (PM-JAY)
  • National Insurance Company Limited- Only provides coverage after hospitalization. Doesn’t include any kind of counseling, cognitive behavioral therapy, or psychotherapy, which does not require hospitalization.
  • Oriental Insurance Company Limited- Also provides coverage only after hospitalization. It also excludes counseling and any therapy which doesn’t require hospitalization.

Private plans

  • HDFC ERGO- Offers counseling and consultation costs apart from hospital expenses.
  • Aditya Birla Health Insurance- Offers counseling and consultation costs apart from hospital expenses.
  • ManipalCigna Health Insurance-  Covers mental illnesses under a comprehensive indemnity plan, which offers insurance only in case of hospitalization.

Limitations of Mental Health Insurance Plans

India's traditional health insurance model primarily focuses on episodic illness and hospitalization. However, many mental health conditions require outpatient treatment or long periods of hospitalization, leading to financial burdens for individuals and families. The need for long-term medication and ongoing rehabilitation, psychotherapy, and counseling also add to the financial strain. The chronic nature of illnesses such as recurrent depression, bipolar disorder, and schizophrenia calls for sustained financial support, which existing insurance policies may not adequately address.

Another challenge is the potential discrimination between physical and mental illnesses in insurance coverage. Instances of claims being rejected or limited coverage being offered for mental illness have raised concerns among individuals and advocacy groups. Such discrepancies must be addressed through better implementation of MHCA and spreading awareness.

We at Solh Wellness understand that mental health is as important as physical health. Understanding the lack of tools and resources for people when it comes to mental health, we have provided a holistic solution with our dedicated platform, in an attempt to make mental health accepted, affordable, 24/7 available, accessible and personalized. We give you unlimited support where you can get free professional support through the Talk Now feature of the app. You also get a thriving community with people who might be going through similar problems as you, so you are able to share feelings, gain mutual bonds, and help each other through tough times. We also provide paid expert services and packages through our network of 250+ certified professionals.

Solh Wellness is committed to assisting you in every step toward better mental health.