Does Health Insurance cover Psychological disorders?

Does Health Insurance cover Psychological disorders?

The overall well-being of a person is defined not just by his/her physical health but also mental health to a significant extent. Mental health defines a lot of our activities, our thought processes, and our decision making ability. Life becomes incredibly complicated for a person who is mentally ill as it would adversely affect his physical health as well. Previously, the topic of mental health was stigmatized, thanks to awareness campaigns on mental health, now the society is starting to take mental health seriously. 

In the bygone eras, the insurance providers did not provide coverage for mental health. After the implementation of Mental Health Act, of 2017, IRDAI has directed the inclusion of mental health in a health insurance plan and asked them to treat psychological illness similar to other physical ailments.

What are Psychological disorders?

Psychological disorders refer to mental conditions that alter our thinking and functioning. It may cause significant impacts to our daily activities like the way we talk, act, or take decisions. These psychological disorders when untreated become a serious threat to the person suffering from it and their families too. It is why treating mental conditions on time is very important.

Some of the common psychological disorders include,

  • Bipolar Disorder
  • Depression
  • Stress/Anxiety
  • Schizophrenia
  • Sleep Disorders
  • Dissociative Disorders 
  • Dementia
  • Psychosis

Mental Health in India

A Deloitte study found that 80% of India’s workforces have reported mental health issues. Despite these alarming numbers, the report said prevailing social stigmas around mental health, have prevented a major portion of them from getting proper treatment to manage their illness. Not managing mental illness properly, can lead to severe cognitive impairment and may even affect performing our daily activities. 

Covid -19 and the resultant lockdowns which made people confined in their homes saw a lot of spotlight on mental stress and depression that were widely prevalent untreated all the while. According to the IRDA directive based on Mental Health Act of 2017, any standard health insurance must cover the expenses of diagnosis of any psychological ailments and the cost of treating the same.

Psychological illness under Health Insurance

Thanks to the IRDAI directive, now psychological illness is included under the ambit of health insurance. With the implementation of this act, mental ailments must be treated similar to physical ailments and coverage must be provided to treatment and medicines. 

However, the coverage for psychological illness varies from one insurer to the other. While some plans cover hospitalization expenses while some others offers coverage for outpatient visits. To avail that a person must avail a health insurance with OPD Cover. Health Insurance provides coverage for diagnosis, OPD consulting, medications, therapies, room, and rehabilitation.

Waiting Period for psychological illness

Buying a health insurance does not entitle you coverage for mental illness from day 1. Just like many other illnesses that are covered after a waiting period, mental illnesses too are covered after a waiting period of 2 years. The waiting period may vary from one insurer to the other. Buyers are requested to read the policy documents thoroughly to know about the details of the coverage.

What is not covered under psychological illness?

  • Psychological illness caused due to drug or alcohol abuse
  • Self-inflicted injury or abuse

Who should buy Psychological cover?

In this busy world with sedentary lifestyle, everyone is susceptible to mental illness. People who have family history of mental illness should definitely buy a health insurance with mental cover. If you are someone who has suffered the trauma of losing someone close to you, then you must consider buying a health insurance with mental illness cover.

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