Insurance for Mental Health – What’s Covered and What’s Not

Mental health is now a trending topic in all media. It’s trending because it is highly relevant. The incidence of mental illnesses is on the rise across all sectors of society. Do you wish to protect your money bag from the medical expenses of potential mental illnesses? You should consider purchasing mental health insurance.

Mental health insurance is a part of all indemnity health insurance policies. That’s because the IRDAI has mandated that all insurers accommodate mental illnesses in their indemnity health insurance. 

However, this coverage may not be enough and may be constrained by waiting periods, terms, conditions, and limits. 

If you are looking to cover specific mental ailments, you can consider specialised mental health insurance. There are very few insurers who provide this cover. Let’s take a look under the hood to examine what’s covered and what’s not. 

What is Covered?

Your insurance plan for mental health may cover costs for common hospitalisation related expenses. These are room rentals, treatment, consultation, procedures, medicine and similar expenses.

Many insurance policies for mental health also cover mental faculties. These may be mental capacity, thinking, memory, cognition, decision-making.

Additionally, some mental health insurance plans cover Outpatient Department or OPD procedures. An OPD procedure is any procedure that requires less than a day’s hospitalisation. OPD procedures may be therapy, counselling and dialysis and similar procedures.

Mental health insurance policies also cover certain common diseases. These may be bipolar disorder, mood disorder, attention deficit disorder, acute depression, schizophrenia, psychotic disorder etc.

What is Not Covered?

Mental illnesses that may be caused due to the abuse of substances like alcohol, drugs and more are not covered. Furthermore, relapsing psychological disorders due to indiscipline and not following the prescribed treatment course are also not covered under health insurance.

Certain factors limit and constrain the coverage of mental illnesses. Let’s inspect them too.

Waiting Periods

Insurance for mental health regards mental illnesses along the lines of pre-existing conditions in regular insurance. Insurers assign waiting periods for coverage of pre-existing ailments up to a few years. They follow similar procedures for mental health insurance.

Let’s say the waiting period for a particular ailment is four years. You will have to buy the policy and renew it for four consecutive years without gaps. Your mental illness will then be covered by your policy.

Distinction by Major Courses of Treatment 

Some mental illnesses can be treated better by treatments that require hospitalisation. While some others can be more effectively treated by therapy, counselling and medication. 

Looking to cover a specific mental illness? You need to find out the major courses of treatment for it.

If the illness requires more hospitalisation, pick a comprehensive indemnity health insurance plan. It would be better suited to cover the illness.

If it requires more therapy and medicine, you need a plan covering OPD or Outpatient Department. An OPD procedure is any procedure that requires less than a day’s hospitalisation. It is also known as a daycare procedure or daycare treatment.

You may purchase medical insurance only for therapy, counselling and medication. This is because specialist therapists and counsellors can be expensive. The cost of medicines and other OPD procedures may also be considerable.

Knowing these facts should lead you to make an informed, educated decision about mental health insurance. 

Read more about Choosing the Best Mental Health Insurance Policy here.


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