Why mental health matters: Insights into insurance coverage

Hands holding sad face hiding behind happy face, bipolar and depression, mental health, split personality, mood change,

Just like the physical health of an individual, mental health is an equally important aspect of an individual’s overall health. Unlike open wounds, the suffering of someone with mental health illness cannot be seen on the surface, and hence we tend to neglect them. It’s important to note that these wounds which can take a much longer time to heal often go unnoticed. Mental health is an integral part of an individual’s holistic well-being, and it is high time that society recognizes its significance.

However, there is hope on the horizon. In recent years, there has been a positive shift in society’s perception of mental health. More people, including celebrities, have become vocal about their mental health issues, helping to reduce the stigma associated with these conditions. This change in attitude has had a significant impact on how mental health is perceived and treated in society.

One of the areas, which has been positively impacted by this shift is health insurance. In the past, health insurance policies primarily covered physical ailments, often overlooking mental health conditions. However, with the introduction of the Mental Healthcare Act of 2017 in India, which mandates that health insurance policies must provide coverage for mental health conditions on an equal footing with physical health conditions, there has been a significant change.

So, what is mental illness?

The Mental Healthcare Act of 2017 provides a comprehensive definition of mental illness. It states that if an individual’s mood, thinking, perception, orientation, or memory is significantly disrupted, affecting their behavior, decision-making, judgment, or ability to conduct everyday activities, it qualifies as mental illness. This definition also encompasses mental disorders associated with substance abuse but excludes intellectual disability, as it is typically caused by incomplete or arrested brain development.

Similarly, psychological disorders are mental health conditions that impact an individual’s thoughts, emotions, and behavior. These disorders can cause significant distress, impair an individual’s ability to function normally and interfere with their daily life. These conditions can influence as to how one perceives and copes with stress, how one interacts with others, and how one makes decisions.

Psychological disorders include:

Anxiety disorders: involve excessive worry, fear, and distress that interfere with daily functioning.

Mood disorders: affect a person’s mood and emotions, such as depression and bipolar disorder.

Personality disorders: involve enduring patterns of thought, behavior, and emotions that impair relationships and daily functioning.

Psychotic disorders: involve a detachment from reality.

Eating disorders: characterized by abnormal eating habits and behaviors.

Health insurance to the rescue

The good news is that mental illnesses, including psychological disorders, are now covered under health insurance in India, thanks to the Mental Healthcare Act of 2017. Insurance policies treat mental health conditions on par with physical injuries, offering coverage for their treatment expenses. These benefits comprise cashless treatment and the possibility of a no-claim bonus specifically for mental health issues.

It’s worth noting that while mental health coverage has become more inclusive, there are still some policy-related matters to keep in mind. Insurance providers may impose waiting periods for mental health coverage, similar to waiting periods for certain other pre-existing conditions. Typically, a waiting period of two years applies to mental illness coverage under a health insurance policy. This implies that policyholders can only file a claim for mental health concerns after renewing their health insurance policy for two consecutive years.

However, it’s important to be aware of potential exclusions under mental health coverage. Just like other insurance plans, mental health insurance plans have specific exclusions. Intellectual disability is a clear exclusion when it comes to mental illness. It’s important to keep an eye on potential changes and additions to the exclusions list, as insurance providers continue to adapt to the evolving landscape of mental health coverage.

The inclusion of mental health coverage in health insurance plans is a significant and positive development. Mental health is a vital aspect of an individual’s total well-being, and it is now receiving the recognition and coverage it deserves.

When considering health insurance, it’s crucial to carefully review the terms and conditions of the policy to understand the extent of coverage provided for mental health conditions, including any waiting periods or exclusions that may apply. While mental health insurance is still evolving, recent regulatory changes have made it mandatory for all health insurance plans to offer coverage for mental illnesses, including psychological disorders. This is a step in the right direction to ensure that policyholders have access to the best possible care and treatment for their mental health.


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