What Does IRDAI’s Order Mean for Mental Health Coverage in India?
The COVID-19 pandemic has brought about one positive change in society. Now, people are giving mental health illnesses much-needed importance. Before the pandemic, people often pushed mental health issues under the carpet due to the stigma associated with them. However, things have changed since the onset of the pandemic. And, this change can be seen in how the Indian health insurance companies are working on their policies to accommodate mental health issues.
In its order dated 16 August 2022, the Insurance Regulatory and Development Authority of India (IRDAI) has directed insurance companies to add provisions to cover mental health illness. This new IRDAI regulation will ensure uniformity and has been welcomed by the insurance industry.
Previously, only some insurers incorporated mental illness in their clauses. However, thanks to this initiative, more policyholders can now enjoy coverage for mental illnesses and avail of the requisite treatment. No denying, authorities breaking taboos by equating physical illnesses with mental health disorders is a welcome step.
The IRDAI has directed insurers to offer coverage for mental health disorders as part of health insurance plans before 31st October 2022. Consequently, more and more insurance companies have started offering mental health illnesses coverage.
In the past, only top insurance companies such as the large PSUs covered hospitalisation due to mental health illnesses by default. Some 30% of the insurance companies had such provisions while the remaining insurers added this coverage on request.
As per the FY16 National Mental Health Survey of India, released by the National Institute of Mental Health and Neuro Sciences, almost 15% of Indian adults have mental health issues requiring treatment. Such patients can now breathe easy as they can purchase individual health insurance plans with provisions for mental health illness coverage.
What does mental health insurance cover?
As part of mental health insurance coverage, expenses arising due to hospitalisation under in-patient care because of mental health problems are covered. Room rent, ambulance fees, treatment costs, medications, and diagnostics are included under such health insurance policies.
Nonetheless, all insurance companies do not provide coverage for counselling sessions and consultations under coverage for mental health problems. Only some insurers have started taking the initiative of offering additional coverage for meditative sessions, consultations, and counselling as part of mental health insurance coverage.
Also, now that people are becoming aware of the importance of addressing mental health issues, they are checking with insurance companies about coverage for mental health disorders.
Who should purchase mental health insurance?
There are raging debates on who should opt for mental health insurance. Well, the general consensus among medical experts is that any person with a family history of mental health illnesses, or who has lived through a traumatic experience, must opt for mental health insurance. They should purchase an individual health insurance plan with mental health coverage.
There is a possibility that people leading a stressful lifestyle could experience mental health issues. Therefore, they could benefit by buying a health insurance plan covering mental health disorders. Moreover, it is best to purchase family health insurance plans having coverage for mental health issues to be on the safer side.
Benefits of having mental health insurance
A person suffering from mental health illnesses should be hospitalised for at least 24 hours to claim expenses under health insurance plans. Mental health disorders covered by insurance companies include anxiety disorder, bipolar disorder, acute depression, psychotic disorder, OCD, PTSD, ADHD, mood fluctuations, and schizophrenia.
Similar to other pre-existing conditions, policyholders can claim insurance for mental health disorders after a given waiting period. Most insurers have a two-year waiting period, which means that you have to wait for two years after purchasing insurance to claim expenses incurred because of mental health illnesses.
By providing coverage for mental health insurance, there will be greater awareness of mental health problems in India. This is the start of the times when you can seek help to fight mental health issues without worrying about the stigma associated with them.