Does your health insurance cover mental illnesses?

August 16, 2020 12:40 PM

With the aim of making mental healthcare available to all, IRDAI has asked mental illnesses to be included in all regular health insurance coverage.

 health insurance, mental illnesses, mental illness cover, covid-19, IRDAI, Max Bupa GoActive plan, Manipal Cigna ProHealth Insurance , HDFC Ergo Critical Illness PlanIn line with the directions of IRDAI, some insurers have already started customizing products that cater to the specific needs of people suffering from mental illnesses.

Given the significant emotional and financial consequences of COVID-19 in India, it is important to devote adequate resources and attention to the mental health needs of the people throughout the remaining course of the COVID-19 pandemic and most importantly, to prepare for any such pandemics in the near future. As per various researches and studies conducted in the last three months, a majority of people have shown signs of frustration on some level with the primary reason being not able to do what they normally enjoy doing.

An equal number of people seem to be worried about their own health apart from the health of their loved ones. A survey even revealed that adults younger than 50 were much more likely to report emotional impact of the pandemic compared to older adults. Most people are showing signs of panic and anxiety with a substantial number also reporting sleep disorders.

COVID-19 Bringing Along a ‘Mental Health Pandemic’

One of the most worrying aspects of the pandemic is the rise in poverty and unemployment, both of which are linked with a higher incidence of mental health problems. If not addressed at the right time, mental health problems can even culminate in suicide in many cases. According to a World Health Organisation (WHO) report, close to 0.8 million (8 lakh) people commit suicide every year across the globe, which roughly amounts to approximately one death every 40 seconds.

Considering the severity of the pandemic, even if there is a 10 per cent uptick in the number of suicides each year, the world could witness 80,000 additional suicide-related deaths in a year. It won’t be incorrect to state that coronavirus pandemic has severely affected the psychology of people as health experts report a sharp rise in the number of people seeking mental health care since the COVID-19 outbreak. With online mental health consultations experiencing a surge of 180 per cent in last 4 months, it’s time to work on the mental health of people or else India might face another pandemic amidst a pandemic – ‘mental health pandemic’ – a war within a war.

Time to Cater to Mental Health Needs

It is very important that all attempts must be made to reduce the number of incidences of nervousness, fear of contamination, panic attacks, constant reassurance seeking behaviour, sleep disturbance, excessive worry and feelings of helplessness – which are also the major factors leading to depression and anxiety amongst the people. An approach to contain COVID-19 is needed which is based on precautions but which avoids causing panic. It is also important to increase the access of troubled people to counselling and mental health centres and doctors. This may seem difficult, but demands strong efforts nevertheless.

Health insurance – A Reliable Solution

With the aim of making mental healthcare available to all, the Insurance Regulatory and Development Authority of India (IRDAI) has asked mental illnesses to be included in all regular health insurance coverage. The IRDAI has made it clear that insurers cannot deny coverage to policyholders who have used opioids or anti-depressants in the past. Also, insurers can’t deny coverage to people with a proven history of clinical depression, personality or neurodegenerative disorders, sociopathy and psychopathy. With the latest announcement, IRDAI aims at making mental healthcare available to all.

In line with the directions of IRDAI, some insurers have already started customizing products that cater to the specific needs of people suffering from mental illnesses. Two prominent insurers, Reliance Health Insurance Company and Max Bupa Health Insurance, have already introduced health plans which are specifically designed for people suffering from mental illnesses.

Mostly, in-patient hospitalisation for mental disorders is covered under regular health plans. However, outpatient counselling or therapy is only covered if the plan offers OPD benefit. In case of a pre-existing mental disorder, the insurer is at liberty to treat it as one and decide on the waiting period, usually 2-3 years. If you are looking for a mental illness cover, check if the disorder requires hospitalisation or can be treated through therapy and medication. In case of the former, go for a comprehensive indemnity plan that covers hospitalisation, while the latter will require a plan that also offers OPD.

One of the most recent plans that provide comprehensive OPD cover for Psychiatric Illness and other ailments within the base plan is Digit’s OPD Policy (Non-Network). The policy offers OPD cover up to Rs. 10,000 and is available in two variants – PB OPD Family and PB OPD 1 Adult. For now, the plan is available in two sum insured options – Min 5 Lakh and Max 10 lakh, you may choose any sum insured from R. 5 lakh to Rs. 10 lakh.

Max Bupa’s GoActive plan and Manipal Cigna’s ProHealth Insurance also cover conditions related to mental illnesses, though these products are relatively less popular. Similarly, HDFC Ergo’s Critical Illness Plan – Platinum covers a popular mental disorder – Alzheimer among 15 other critical illnesses. Star Health and Allied Insurance’s Star Special Care plan covers autism in people from 3 to 25 years of age.

(By Amit Chhabra, Head-Health Insurance,

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