Mental health has been an area that’s riddled with stereotypes and stigma. It, therefore, comes as no surprise that even if people faced this issue, they were apprehensive to openly talk about it. However, the silver lining from the pandemic era was that this conversation was brought into the limelight after collectively leading a life of seclusion and facing personal losses.
As per the recent Deloitte report, the scale of mental health disorders in India is enormous, accounting for about 15 per cent of the worldwide mental health burden. The main reason cited for this is the treatment gap and the lack of conversation around this crucial topic. In addition, the taboo associated with the disease further adds to the problem.
While the awareness is slowly but gradually setting in, there is still a long way to go. Just like it’s important to seek treatment for mental health issues, it is equally important to ensure mental health coverage through a comprehensive health insurance plan. While the awareness around health insurance has grown after the Covid-19 outbreak, most people are still not aware that mental health coverage is part of a comprehensive health policy.
Thus, on this World Mental Health Day, here is everything you need to know about mental health coverage in your health insurance:
Know about Mental Health
Realizing the gravity of mental health issues after the pandemic, the Insurance Regulatory and Development Authority of India (IRDAI) issued fresh directives to insurance companies to add mental health coverage to all health insurance plans in 2020. The insurers are, therefore, needed to abide by the definition of mental illness as per the Mental Healthcare Act 2017 for underwriting the risk.
Also Read: No-Cost EMI Scheme: Should you opt for it? Here’s what you must know
What falls under mental health coverage?
Most of the comprehensive health insurance policies available nowadays cover the policyholder against the hospitalization costs that could result from a likely mental disorder. Such policies cover the patient’s room rent, medicines and diagnostics, ambulance fees and treatment costs.
A person suffering from mental illness is also likely to spend a significant amount towards OPD (Out-Patient Department) expenses, such as daycare treatments, medicines or doctor consultations. Increasingly, insurance companies are coming up with plans that cover such OPD costs. It is of utmost importance to opt for policies that include OPD expenses.
Some diseases that fall under the mental ailment and are covered under insurance are:
- Anxiety disorders
- Acute Depression
- Post-traumatic stress disorder
- Attention-deficit/hyperactivity condition
- Bipolar disorder
- Mood unrest
- Schizophrenia
- Obsessive-compulsive disorder
- Psychotic turmoil
Who should purchase it?
With a rise in overall stress levels, mental health disorders are not limited to any particular age or set of people. They span from younger to older populations alike, with even students and young adults being prone to it. However, people with a family history or suffering from such a traumatic experience should strongly consider purchasing this insurance as such scenarios increase the likelihood of being affected by it. The others who should buy mental health insurance coverage are those with a record of using antidepressants or opioids. For this, the policyholder needs to declare it as a PED, basis which the underwriter evaluates the risk. Likewise, individuals with an established record of clinical depression, personality or neurodegenerative conditions, sociopathy, or psychopathy are also eligible for this policy. The positive part is that more insurers are now forthcoming about providing coverage for most mental disorders.
Is there a waiting period for mental health insurance?
Like any insurance, a person with a pre-existing disease does not get the immediate benefit of the policy and will have to wait for a defined period of time, as stated by the policy, from the date of the policy issue. Usually, this duration ranges from anywhere between 2 and 3 years. Therefore, if a person is looking to purchase this coverage in the time to come, starting as early as possible is recommended.
What is the premium charged?
Mental health being a part of an insurance plan is a relatively new practice; thus, insurers are finding the best way to assess the risk. At present, there is no extra premium for this coverage; it is innately covered under your health plan.
What are the exclusions?
Like all health insurance coverage, this one, too, comes with some exclusions. The first is mental retardation or intellectual disability, which characterizes and impairs intellectual and adaptive functioning because of neurodevelopmental disorders.
In conclusion, with the high-intensity stress pouting in from all directions, neglecting one’s mental health could be a ticking bomb. So, don’t forget to compare various available policies online, and read the inclusions, exclusions, and clauses before selecting the one that suits you the best.
(By Amit Chhabra, Head – Health Insurance, Policybazaar.com)
