Mental Health To Be Covered Under Insurance In India Effective immediately

Mental Health To Be Covered Under Insurance In India Effective immediately


What illnesses are covered by insurance for mental illnesses? Does it also include therapy? Here is what we currently know. 

The pandemic and lockdown shed light on a subject that had previously been kept quiet. When it comes to mental health and wellness, there has always been a strong stigma. Due to higher levels of stress and anxiety, mental health difficulties have become more common, especially after the Covid-19 pandemic. However, because of the stigmas attached to it, it is still frequently ignored. 

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What is the provision under the Mental Healthcare Act, 2017?

The Mental Health Act of 2017 defines "mental illness" as "means a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behavior, capacity to recognize reality, or ability to meet the usual demands of life, mental conditions associated with the abuse of alcohol and drugs," which forms the legal framework for insurance for psychological disorders

All health insurance policies must, starting on October 31, include coverage for mental diseases. "All insurance plans must cover mental illness and adhere strictly to the requirements of the MHC Act, 2017." Before October 31, 2022, insurers are urged to confirm compliance, according to a circular from the Insurance Regulatory and Development Authority IRDAI, which was released on October 18. 

What kind of illnesses are covered under mental health insurance? Will it cover the costs of therapy?

Insurance companies will include coverage for mental health issues under any standard health insurance policy, in addition to the current provisions, even though there isn t enough clarity yet. These conditions include acute depression, bipolar disorder, eating disorders, post-traumatic stress disorder (PTSD), schizophrenia, dementia, etc. 

For a patient with a mental illness to be eligible to file a claim for expenses through their health insurance, their hospitalization must last at least 24 hours. As a result, the cost of the treatment, including medications, diagnostics, ambulance costs, and other expenses, will be covered by the health insurance plan for anyone who needs hospitalization for in-patient treatment of mental illness. 

Which illnesses will not be covered?

The Mental Health Act of 2017 defines mental retardation as "a condition of halted or incomplete development of mind of a person, specially characterized by sub normality of intelligence," although it excludes it from its definition. Therefore, mental retardation-related issues won t be covered by insurance. Similarly, intellectual disability may not currently be covered by health insurance plans as well. Additionally, under the existing rules, insurance plans will not cover drug and alcohol abuse. 

Does suicide or self-harm will be covered?

Treatment for willful self-harm or attempted suicide is not covered by insurance. Complications relating to disorders of intoxication, dependence, abuse, and withdrawal caused by alcohol and other substances will also not be considered under mental health insurance.

Finally, the IRDAI s decision is a significant step towards a more inclusive world that ensures that everyone s mental health is taken care of.

TLDR: In accordance with the requirements of the Mental Healthcare Act of 2017, the Insurance Regulatory and Development Authority of India (IRDAI) has made it essential for all health insurance policies to cover mental illnesses.

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