Mental Health Insurance Coverage & Benefits

About Health Insurance for Mental Illness

For the longest time, mental illnesses were never considered to be a serious issue in India and people often shrugged off their mental health problems as insignificant. However, over the past few years, the importance of mental health awareness has been recognised by a large number of people across the world and in India.

Various health organisations, celebrities and social media influencers have highlighted the importance of mental health. It has also become important for insurance companies to focus on mental illnesses in the context of health insurance to attract more customers. Let’s take a look at how health insurance for mental illness works in India.

Mental Health Insurance Coverage

Mental illness is defined as a significant disorder of mood, thinking, perception, memory, or orientation. It impairs a person’s judgement, behaviour and ability to conduct the regular activities of daily life.

As per the guidelines issued by the Insurance Regulatory and Development Authority of India (IRDAI), the treatment of stress, mental illness, and psychological disorders are no longer considered exclusions under health insurance coverage. This means that every health insurance policy will include mental illness. Insurance companies can no longer differentiate between individuals suffering from a physical illness and a mental illness. The step was a welcome relief for people suffering from mental illness.

Things to Know About Mental Health Insurance

Here are a few important factors about health insurance for mental illness you need to keep in mind when looking for the right plan to buy:

• Health insurance for mental illness provides coverage for medical expenses during hospitalisation due to any mental health conditions. The coverage includes the cost of treatment, medicine, rent for the room, etc.

• However, the insured or the policyholder must be admitted to the hospital for more than 24 hours, for the health insurance coverage to take effect.

• People who have a family history of mental illness should specifically look for health insurance plans that cover mental conditions. Moreover, anyone who is vulnerable to or suffering from any mental illnesses must also seek out health insurance with cover for mental conditions.

• In case a policyholder has a mental illness as a pre-existing condition, a waiting period on the coverage for mental health treatment may apply. Usually, the waiting period for mental health conditions is 2 years but may differ based on the insurance provider chosen.

• While buying health insurance, make sure that the plan you are purchasing specifically has coverage for mental illness cover. Many health insurance plans still do not have mental illness cover, so you need to be careful while buying the plan.

• The following are some examples of the diseases which are covered under health insurance for mental illness:

1. Depression

2. Anxiety Disorders

3. OCD

4. ADHD

5. PTSD

6. Schizophrenia

7. Mood Disorder

How Does Mental Health Insurance Work?

Following the IRDAI’s guidelines on mental health, most health insurance policies now have to offer a cover for the treatment of mental illness, neurodegenerative disorders, and stress. However, whether the policyholder will be covered specifically for hospitalisation or for outpatient services as well, will be based on the type of policy chosen. Individuals with mental illness can make the most out of health insurance benefits by availing health insurance coverage. When you look for a health insurance policy, you need to choose a plan carefully and consider your mental health coverage requirements. Read the documents thoroughly and go through the terms and conditions of the policy before you file a health insurance claim. Make sure that the plan you are buying includes coverage for mental health.

What is Not Covered Under Health Insurance for Mental Illness

Health insurance for mental illness will not provide coverage for the following conditions:

• Coverage for mental conditions will not be provided if the policyholder or the insured has not been admitted to the hospital for more than 24 hours.

• Coverage for mental conditions will not be provided if they have been caused as a result of alcohol, drugs or substance abuse.

• Coverage for consultations will not be provided in case of mental conditions.

• If a person has a severe history of mental illness, the insurer may choose to not sell the insurance plan to that person.

Final Takeaway

Whether you are suffering from mental illness or not, having health insurance for medical emergencies is very important. Given the rise in work-life imbalance for people in today’s hectic world, a good health insurance plan to deal with the ever-rising healthcare costs has become a necessity. If you are looking for health insurance plans, you can find suitable options as per your needs at Bajaj MARKETS.

With health insurance plans available at Bajaj MARKETS, you can benefit from features like a swift claim settlement process, extensive coverage, and more. You can also claim health insurance tax benefits under Section 80D for the health insurance premiums paid towards the policy.  

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