What is Mental Illness Cover in Health Insurance – Benefits and Why it is Necessary
Earlier, health insurance companies in India covered only physical illnesses in their health insurance policies. Following a Supreme Court order in June 2020, IRDAI (The Insurance Regulatory and Development Authority of India) made it mandatory for insurers to cover psychological disorders as well. So, following the guidelines, medical insurance providers have started including mental health insurance coverage under the ambit of health insurance.
Go through this article to know all about this!
What is Mental Illness Health Insurance?
This is a benefit that comes with health insurance policies in India. It covers the costs incurred due to in-patient treatment of mental illnesses. The coverage includes ambulance charges, cost of medicines, charges in relation to diagnostic tests, hospital room rent, etc.
Why is Mental Illness Coverage Necessary?
Considering that modern lifestyles can cause an excessive amount of stress, individuals are vulnerable to mental illnesses. Additionally, concerns related to physical health or traumatic experiences, for example, the death of a loved one, can lead to mental disorders.
Medical emergencies resulting from mental disorders can drain the savings of individuals owing to the high cost of treatment at hospitals. To make sure that you’re financially secured at the time of such uncertainties, opting for a health insurance policy with mental illness cover can be a wise move.
Benefits of Mental Health Insurance
The benefits of mental health coverage in India are as follows:
- Cashless treatment: The insured individual can get cashless treatment at any network hospital of the health insurance provider.
- Safeguard savings: Individuals often end up spending a significant amount of savings on the treatment of mental health illnesses. In that regard, a health insurance policy with mental health coverage can serve as an added layer of protection.
- Tax Benefits: Under Section 80D of the Income Tax Act, 1961, individuals can claim tax deductions against the premium paid towards a medical insurance policy.
- Wide scope of coverage: Mental health coverage includes compensation for mental disorders that impact one’s decision-making capabilities, cognitive abilities, and thinking capacity.
- OPD benefit: Some insurance companies provide OPD benefits as a part of their health insurance policy. It covers the expenses incurred for counselling, rehabilitation and consultation.
In accordance with the IRDAI guidelines, health insurance providers like Navi provide mental health coverage as a part of their health insurance plan. This insurer approves cashless claims within 20 minutes only and has over 10,000 network hospitals from where one can avail of cash treatment.
Download the Navi app and buy a comprehensive health insurance policy in 90 seconds through a hassle-free, paperless procedure.
What Does Mental Health Coverage Exclude?
There are some conditions under which one may not get mental health coverage. So, individuals must be careful about the exclusions before buying a health insurance policy with mental illness coverage. The common exclusions are as follows:
- Outpatient consultation
In the case of OPD treatments, one does not get admitted to hospitals, and therefore, most insurers do not cover outpatient consultations. - Mental Disorders resulting from alcohol or drugs
Insurers will not cover expenses if the causes of mental disorders are alcohol or any narcotic substance.
Furthermore, individuals must note that they cannot get coverage until the waiting period is over.
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Things to Consider Before Buying Mental Health Insurance Policies in India
One needs to give attention to the following pointers before buying a health insurance policy in India that covers mental disorders.
1. Premium amount
By choosing an insurance policy that comes with an affordable premium, you can avoid financial stress.
2. The extent of financial coverage
Look for insurance that gives higher coverage for mental disorders at an affordable premium.
3. Waiting period
The policy should not have a waiting period higher than its market competitors.
4. Exclusion criteria
Before purchasing a health insurance policy, be very cautious regarding the exclusions.
5. Claim settlement process
The claim settlement process of the insurance provider must be hassle-free. In this regard, the claim settlement ratio serves as a key indicator.
Final Word
The cost of treatment with regard to mental illnesses can cause financial stress for any individual. However, by purchasing the right health insurance policy with mental health cover, one can protect his/her savings during medical emergencies. That said, now that you are aware of the benefits, inclusions and exclusions of mental illness coverage, you can buy a health insurance policy that is best suited for your requirements.
If you are looking for health insurance policies then you can consider Navi. Navi has a network of 10,000 plus network hospitals spread across 400 plus locations all over India. Download the Navi app from the google playstore today!
FAQs
Ans: This insurance company provides coverage when policyholders suffer from the following diseases:
• Bipolar disorder
• Acute depression
• OCD (Obsessive-compulsive disorder)
• Schizophrenia
• Attention-deficit/hyperactivity disorder (ADHD)
• Anxiety disorder
• Hyperactivity disorder
• Psychotic disorder
• Post-traumatic stress disorder
Ans: Generally speaking, the waiting period in relation to medical insurance policies with mental health cover is two years. This means that if individuals purchase a plan today, they will need to wait for a minimum of 2 years before they can raise a claim.
Ans: Yes, in most cases, individuals need to be admitted to a hospital for more than 24 hours for getting mental disorder treatment. The majority of Insurers give coverage for only in-patient treatments; the cost of OPD treatment is usually not included in the scope of coverage.
Ans: The healthcare facilities that are mentioned in the agreement when purchasing a health insurance policy from health insurance providers are referred to as network hospitals. Insured individuals can avail of cashless treatment at these hospitals. In other words, the insurance companies pay the cost of treatment directly to the network hospital after approving the claim of the insured individuals.
Ans: Co-payment under a health insurance policy is a clause that requires insured individuals to make payments from their own pocket no matter what the claim amount is. As per this arrangement, the insurer has to pay only the remaining portion of the claim amount.
Before you go…
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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