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Mental Illness Cover in Health Insurance - Meaning & Benefits

26 September, 2022

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Mental Illness Cover in Health Insurance - Meaning & Benefits

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Introduction 

People are increasingly concentrating on mental illnesses than they were earlier. According to WHO, over 7.5% or 90 million Indians have a mental illness. A British charity also found that 42.5% of corporate employees have an anxiety disorder or depression. It essentially means that every second employee has a mental disorder. National Mental Health Survey was held in 2016 and found that around 130 million people need mental health services.

 

It was an ignored and taboo topic and was never taken seriously in India. People often thought of mental problems as insignificant. Lately, a large population has recognised the importance of mental health in India, and so do the insurance companies. As a result, most of the insurance plans now include the coverage for mental illness. 

 

Mental Illness Coverage Under Health Insurance and Its Features

The Mental Healthcare Act was implemented in 2017. It ensures that equal importance is given to mental health as physical health. Every insurer that offers health insurance has been directed to do so for the policyholders. The act calls mental illness a substantial disorder affecting mood, memory, orientation, thinking, or perception that grossly impairs behaviour, judgment, or capacity to realise reality or function in other ordinary life demands. It includes mental conditions that are associated with the abuse of drugs or alcohol. However, it does not include the mental retardation that occurs because of the incomplete or arrested development of the human mind, which is essentially characterised as the subnormality of intelligence. 

 

Is Mental Illness Covered by Health Insurance?

Any person who holds a policy can claim health insurance for the mental conditions listed above. (Under Mental Illness Coverage Under Health Insurance). As per IRDAI (Insurance Regulatory and Development Authority of India), the treatment of psychological disorders, mental illness, and stress will no longer be excluded under health insurance coverage. It essentially means that health insurance policyholders will now include mental illness in their range. The insurance companies will no longer differentiate between physical and mental conditions.

 

These diseases are a few examples that are covered under health insurance for mental illnesses :

 

1. Mood disorder

2. Schizophrenia

3. PTSD

4. ADHD

5. OCD

6. Anxiety Disorders

7. Depression

 

Things To Remember for Mental Illness Insurance Plan

It would be best to consider certain factors when choosing the best health insurance for mental illnesses :

 

  • Hospitalisation is included due to mental illnesses. The range of coverage includes room rent, medicine, cost of treatment, etc. 
  • Health insurance will only come into play if the patient has been hospitalised for more than one day or 24 hours. 
  • People having a history of mental illness in their family should always look for the best health insurance that covers mental illness. Anyone vulnerable to getting any mental disorder should also look for insurance that includes mental conditions. 

 

Niva Bupa's GoActive Plan

GoActive plan gives its holders a 360-degree cover. It is designed to provides daily health requirement cover, including access to OPD, inpatient hospitalisation, behavioural counselling, personalised health coaching, 2nd medical opinions, and much more. You can save money from Day 1 by getting a complimentary full body check-up worth up to Rs. 2500 per adult, cashless/reimbursement of OPD coverage, and diagnostics.

 

You also get up to a 20% renewal discount by achieving your health goals. It also has an early age AdvantAGE - a 10% base premium discount when you buy and for future renewals of a person whose maximum age is 35.

 

It is one of the best health insurance for mental illness, and you can buy this health insurance online.

 

In this health insurance policy, the health insurance premium is less, and health insurance benefits are more. You can even get your health insurance claims resolved quickly.

 

How Does It Work?

Due to the new IRDAI guidelines on mental health, health insurance providers now have to offer mental illness cover and treatment of stress, disorders, and neurodegenerative disorders. It will depend on the policy whether the patient/policyholder will be hospitalised or get outpatient services. People who have any mental illness can reap the maximum benefits of their health insurance by availing the coverage in their health insurance.

 

Look carefully for a low health insurance premium plan that suits your needs. Consider your requirements and read the terms and conditions thoroughly. 

 

Things Not Covered Under Mental Illness Health Insurance

Your health insurance for mental illness will not cover the following things :

 

  • If the policyholder or patient has not been admitted to the hospital for mental conditions for more than 24 hours, then the coverage will not be applicable.
  • The policyholder will not get coverage if the cause behind the mental illness is substance, alcohol, or drug abuse. 
  • Mental conditions do not cover consultations. 
  • The insurer is at liberty not to sell the insurance to a person with a severe mental illness history. 

 

Visit Niva Bupa online today and get your mental illness covered.

 

 

 

 

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