Does health insurance cover psychological disorders?

The lockdown and the covid 19 impacts led to a significant rise in the number of reported cases of psychological disorders that required clinical interventions.

IRDA the governing body for all the insurance companies in India has now made it mandatory for all the insurers to include, mental disorder issues, under the coverage scope of all Health insurance policies. While that has moved the premium outlay of such policies higher, but it was a much-needed intervention from the regulator’s end.

The IRDAI has made it clear that insurers cannot deny coverage to policyholders who have used opioids or anti-depressants in the past. Also, insurers can’t deny coverage to people with a proven history of clinical depression, personality or neurodegenerative disorders, sociopathy, and psychopathy. With the latest announcement, IRDAI aims at making mental healthcare available to all.

In line with the directions of IRDAI, some insurers have already started customizing products that cater to the specific needs of people suffering from mental illnesses. Two prominent insurers, Reliance Health Insurance Company and Max Bupa Health Insurance have already introduced health plans which are specifically designed for people suffering from mental illnesses.

Mostly, in-patient hospitalization for mental disorders is covered under regular health plans. However, outpatient counseling or therapy is only covered if the plan offers OPD benefits. In case of a pre-existing mental disorder, the insurer is at liberty to treat it as one and decide on the waiting period, usually 2-3 years.

If you are looking for a mental illness cover, check if the disorder requires hospitalization or can be treated through therapy and medication. In the case of the former, go for a comprehensive indemnity plan that covers hospitalization, while the latter will require a plan that also offers OPD.

Source: Quora
Author: Subhro Fintel Integrated

Founder at Trust Integrated

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