Understanding the Importance of Mental Health and Its Coverage in Health Insurance

Mental health is a crucial part of our overall well-being. Society, including family and friends, has often ignored and stigmatised it. It affects how we think, feel, and act daily. While people frequently discuss physical health problems, conversations about mental health are rare because of the associated stigma.

Mental health has often been overlooked in India, but this is beginning to change. One significant change is the inclusion of health insurance for mental health.

However, the Mental Healthcare Act of 2017, which came into effect in 2018, aims to change this by including mental illnesses in health insurance coverage. This blog will explain importance of mental health and health insurance for mental health. Read on to find out more about mental health insurance in India and what it covers.

Why Mental Health Matters?

Mental health benefits our emotional, psychological, and social well-being. It impacts how we handle stress, relate to others, and make decisions. Good mental health is essential at every stage of life, from childhood through adulthood. In India, many people suffer from mental health issues. A survey found that nearly 15% of adults need help with mental health problems. However, due to stigma and lack of awareness, many people do not seek help. That shows the need for mental health services to be a part of our healthcare system.

Health Insurance for Mental Health

A study by the National Institute of Mental Health and Neurosciences (NMHS) found that around 11% of India's population suffers from mental illnesses like anxiety, depression, severe mental disorders, and substance abuse. Mental health issues have long been stigmatised and avoided in discussions. However, in recent years, this has changed for the better, with people taking mental health more seriously. This shift has also impacted the insurance industry, creating health insurance plans that cover mental health treatment.

One key provision of the Mental Healthcare Act of 2017 requires that mental illnesses be included in health insurance coverage. Following this, the Insurance Regulatory and Development Authority of India (IRDAI) has directed insurance companies to include mental health in their health insurance plans. Since the Mental Healthcare Act was passed, many insurance companies have started to offer coverage for mental health conditions. Here's what to look for in a health insurance plan:

• Inpatient and Outpatient Care: Good insurance should cover both inpatient (hospital) and outpatient (clinic visits) care. Inpatient care covers hospital stays, while outpatient care includes visits to mental health professionals and therapy sessions.
• Pre-Existing Conditions: Check if the plan covers pre-existing mental health conditions. Some plans may have a waiting period before these conditions are covered.
• Therapy and Counseling: Mental health treatment often includes therapy and counselling. A good plan should cover these services to reduce your out-of-pocket expenses.
• Network of Providers: Ensure the insurance plan has a good network of mental health professionals and facilities. That will ensure you can easily access quality care.

What does Medical Insurance for Mental Health Cover?

The Mental Healthcare Act of 2017 defines mental illness as a significant disorder in mood, perception, thinking, memory, or orientation that affects a person's ability to make decisions, judge situations, and perform daily activities. It does not include mental retardation, which is caused by incomplete brain development. Mental illness insurance is meant to cover the treatment of these mental disorders. Having health insurance for mental disorders will help those affected by reducing their financial burden.

Mental Health Insurance Benefits

Here are the benefits of having health insurance for mental illnesses.

Required by Law
One major benefit is that the Mental Health Act of 2017 legally requires health insurance to include mental illness coverage. That means insurers must provide coverage for people diagnosed with mental illnesses, ensuring they get the help they need.

Covers Many Mental Illnesses
Health insurance for mental disorders includes a wide range of conditions like Schizophrenia, Bipolar Disorder, Anxiety Disorder, Dementia, and Alzheimer's disease. These illnesses can greatly affect daily life and brain function. The financial protection from insurance is crucial for those needing medical treatment to improve their health.

Extensive Coverage
Most plans offer both inpatient and outpatient coverage and a substantial insured amount. They cover costs related to pre and post-hospitalisation, treatment, recovery, tests, and diagnoses. Some plans even cover treatment for issues like poor decision-making, mood disorders, memory problems, and perception issues.

Medical Insurance for Mental Health: What's Covered and What's Not?

Here are some of the conditions covered under mental illness insurance:

1. Acute depression
2. Anxiety disorders
3. Attention deficit/hyperactivity disorder (ADHD)
4. Bipolar disorder
5. Mood disorders
6. Obsessive-compulsive disorder (OCD)
7. Post-traumatic stress disorder (PTSD)
8. Psychological disorders
9. Schizophrenia

Here are the exclusions under mental illness insurance coverage:

1. Mental illness resulting from drug or alcohol abuse
2. Mental retardation
3. Recurring mental illness
4. Coverage is generally limited to medical expenses incurred during Hospitalisation

Final Word

Including mental health in health insurance plans is a significant step towards better healthcare in India. The Mental Healthcare Act of 2017 has laid the groundwork for this change. Insurance companies, healthcare providers, and policymakers must work together to ensure mental health services are accessible, affordable, and of high quality.