Things to know about Mental Health Insurance

Mental Health has remained a stigma and a taboo word for far too long. It has been prevalent for decades but is only being spoken of now since many are coming out with their experiences of depression, paranoia, and other mental health issues. It is only recently that the Government of India included Mental Health as part of the country’s health insurance policies.

On May 29th, the Mental Healthcare Act of 2017 came into being. The Act states that it is mandatory to provide insurance for the treatment of mental illness. The insurance policy should cover ailments such as depression, schizophrenia, and bipolar disorder. But, none of the 33 insurance companies in India has launched a single product covering these. The process is slow and in its very early stages since companies are trying to navigate the grey areas of mental health.

However, there are a few things that one needs to know about Mental Health Insurance before you approach a company to get yourself. Read here to know more…

What is considered as a mental illness: As per the Act, if there is a considerable disorder in the mood, thinking, perception, orientation or memory of an individual that hampers the behavior, decision making, judgment or the capability to meet ordinary day to day activities, it will qualify as mental illness. The Act keeps mental retardation out of the definition since it is mostly due to incomplete or arrested brain development.

What is included within the Act: As per the World Health Organization, ICD’s list of mental health issues (International Classification of Diseases) will be considered as being covered. Norms in these cases will be according to the ICD-10 and ICD-11; for example, WHO considers bipolar disorder and schizophrenia as mental illnesses. In case of hospitalization during mental illness, the coverage will include analysis and diagnosis of a person’s mental condition, treatment as well as care and rehabilitation of such person for his mental illness or suspected mental illness. The 24-hour mandatory hospitalization is to be a part of this healthcare process.

What is excluded from this Act: Like any health insurance plan, the mental health insurance coverage comes with a few exclusions. Here, two explicit exclusions apply in case of which one cannot take mental health insurance coverage. The plan does not cover any sort of mental retardation. Secondly, outcomes due to abuse of drugs or alcohol would also be excluded from the plan. The Act is in its initial periods of being formed, so bear in mind that these can be altered or changed with time.

What are the confusions: Health insurance will cover treatment for mental illness, stress or psychological and neurodegenerative disorders, apart from other physical ailments. But whether a policyholder would be covered only for hospitalization or also for OPD (out-patient department) services would depend on the kind of the policy purchased by the policyholder. The guidelines say an insurer cannot discriminate an illness in being mental or physical. First, it’s advisable to read the fine print and understand the inclusions and exclusions of your policy before filing a claim. It is also uncertain if the insurance covers the therapy charges that insurers may have to undergo as part of their recovery process.

Application to current health plans: The insurer’s existing plans may have to be re-filed with the regulator. There could be a price revision, including the premium for the mental health coverage as well. Mental illness will be covered in the existing plans to the extent specified by the National Mental Healthcare Act, 2017. With more coverage, an increment in premium is expected as companies go for revision in the policies.

Conclusion

The field of mental health has taken a long time to reach this place where people are talking about it openly. It took the support of actors like Deepika Padukone and Ellen DeGeneres to come out and speak of their mental health issues for others to follow suit. Now that the Government is actively supporting, this shows that India and other countries have decided to break this taboo and face the challenge head-on. It is here that one can see the world changing and for the better. Let’s all vow to take a mental health checkup once a year and to opt for mental health illness coverage, smartly, and with thorough knowledge instead of following blindly.

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