Know all about mental illness coverage in health insurance

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With our rapidly-changing and super fast lifestyles, it is possible for anyone to succumb to mental illnesses like depression or anxiety. Job stress, personal life tensions, and childhood trauma are just some of the reasons behind the mental ailments we suffer from. In such a case, it is imperative to ensure that our health insurance plans cover the treatment costs of various mental illnesses. 

However, not all existing health insurance plans cover treatment costs for mental illnesses. Therefore, one should opt for a plan that provides comprehensive coverage for their treatments. Keeping this in mind, the insurance regulator IRDAI has now made it mandatory for all health insurance companies to compulsorily include coverage for treatment of mental illness in their policy offerings. The regulator says that mental illness should be treated just like physical illnesses. 

If you are hospitalized due to anxiety, acute depression, bipolar disorder, trauma-induced stress, etc., many insurance plans will cover the treatment costs. This includes the cost of the entire treatment, room charges, ambulance fees, medicine costs, etc. However, most health insurance plans do not offer any coverage for OPD expenses.

In such cases, you should keep two things in mind. First, your plan should cover hospitalization costs due to mental illness. And secondly, OPD services should be covered. 

This is because for the treatment of mental illness, hospitalization may not always be required. Most of the time, just medical consultations are needed. However, the cost of treatment for mental health issues is becoming increasingly expensive. The average cost for one visit to a psychiatrist ranges anywhere from ₹1,500 to ₹5,000.

According to reports, 1 in every 5 individuals in India shows symptoms of mental illness. While 50% of mental health conditions start by the age of 14, and 75% kick off by the age of 24. Globally, 970 million people suffer from various mental illness.

These figures show how rapidly mental illnesses are increasing, and how any one of us can fall victim to them at any stage of our lives. Therefore, we should opt for a comprehensive health insurance plan that covers mental health. Those with a family history of mental health disorders or those who have been taking antidepressants should especially opt for this coverage.

Additionally, there are a few things to keep in mind regarding the coverage of mental illness in health insurance

First, all policyholders will have to complete a waiting period during which certain diseases won’t be covered by your health insurance. It is also necessary to disclose any pre-existing mental conditions before purchasing a health insurance policy. If you do not provide this information beforehand, your claim may be rejected later on. Just like any other pre-existing diseases, there is a waiting period of 2 years for coverage of mental illnesses to kick off. 

Second, an important point to note is that in order to claim hospitalization costs for mental illness treatments, a minimum hospitalization period of 24 hours is required. So, before taking a policy, thoroughly read all rules and conditions related to the waiting period and coverage. Also look for plans that cover OPD expenses.

Third, check for what is not covered in a health insurance plan. Psychological disorders caused by alcohol or other intoxicants are generally not covered under any plan. If you attempt to harm yourself, that will also not be covered.

So, keeping all these points in mind, choose a health insurance plan that meets all your needs.