The healthcare landscape in India is changing rapidly, especially in terms of mental health coverage in health insurance plans. There is a growing acknowledgement of the significance of mental well-being, leading to insurance providers including mental health services in their plans. This change is largely due to the Mental Healthcare Act of 2017, which requires mental illnesses to be treated equally with physical illnesses in insurance policies. It ensures that individuals with mental health conditions receive the financial support they need for treatment.
Do Indians Need Mental Health Coverage as a Part of Their Health Insurance Plans?
Statistics highlight a concerning reality in India, with approximately 60 to 70 million people suffering from mental illnesses and the World Health Organization (WHO) estimating that 20% of the population experiences some form of mental disorder. The National Mental Health Survey of 2015-16 indicates that 11% of Indians are affected by severe mental disorders and 10% deal with common mental health issues, while 14.3% of deaths in India are attributed to mental disorders, emphasizing the critical need for accessible mental health care solutions.
The rising prevalence of mental health issues has left a significant gap in treatment, with approximately 80% of individuals not receiving adequate care. This emphasizes the need for health insurance plans that cover mental health services, as they can help alleviate the financial strain of long-term treatment, which is often unaffordable for many.
Why Does Mental Health Coverage in India Matter?
Mental health coverage in India is increasingly recognized as a critical component of overall healthcare, reflecting a significant shift in societal attitudes and regulatory frameworks. Here are the key reasons why mental health coverage matters in India:
1. Mental Health Issues are Widespread
Mental health disorders are a significant concern in India, with approximately 20% of the population estimated to be impacted, including 0.8% facing severe conditions. The World Health Organization has emphasized the widespread impact, with around 60 to 70 million people affected, highlighting the potential for significant morbidity and mortality if left untreated.
2. Effects on the Economy
Untreated mental health issues impose a heavy economic burden, placing individuals and families at risk of significant health expenses. The lack of coverage for mental health treatment in existing insurance plans contributes to high out-of-pocket costs, causing financial distress for many. This strain often leads to further mental health challenges and worsened economic hardship. The inclusion of mental health coverage in insurance policies is crucial to addressing these costs and ensuring access to vital care.
3. Laws and Regulations
The Mental Healthcare Act of 2017 ensures that people with mental illnesses get the same care as those with physical illnesses. Insurance providers are required to offer coverage for mental health conditions, promoting equality in healthcare access. However, many insurance policies still lack sufficient mental health coverage, despite the regulations. The Insurance Regulatory and Development Authority of India (IRDAI) has emphasized the importance of mental health coverage, especially during the COVID-19 pandemic, which has exacerbated the country’s mental health crisis.
4. Perceptions and Stigma Change
In the past, mental health problems in India were stigmatized, discouraging people from seeking assistance and resulting in discrimination. However, as mental health becomes better understood and acknowledged as vital for overall well-being, societal attitudes are gradually shifting. The availability of mental health insurance now enables individuals to seek treatment without financial concerns or the fear of social judgment. This facilitates a more inclusive environment for mental health care in the country.
Coverage and Accessibility
Health insurance plans with mental coverage are essential for ensuring individuals can get the necessary treatments, like therapy and medication. Many insurance providers offer plans that cover various mental health disorders, such as depression, anxiety and schizophrenia. However, the effectiveness of these plans can vary, with some policies excluding important services like outpatient care and therapy.
Best Health Insurance Plans in India Offering Mental Health Coverage
Provided below is the list of best health insurance plans in India which offer mental health coverage as well -
Covers mental health treatments including therapy and counseling
2 years
Covers pre/post-hospitalization and outpatient consultations
Max Bupa Health Companion
Schizophrenia, Depression, Anxiety disorders
2-3 years
Hospitalization, consultations and wellness programmes
Bajaj Allianz Health Guard
Mental health treatments including hospitalization
2 years
Cashless treatment, pre and post-hospitalization coverage available
New India Assurance Mediclaim
Covers hospitalization for mental health issues
2 years
Comprehensive coverage including outpatient consultations offered
Oriental Insurance Happy Family Floater
Mental health treatments including hospitalization
2 years
Covers pre-existing diseases after a waiting period along with cashless treatment
Tata AIG MediCare
Schizophrenia, Anxiety, Depression
2 years
Full coverage including outpatient consultations and therapy
SBI Arogya Premier Policy
Covers mental health issues including hospitalization
2-3 years
Cashless treatment and pre-existing conditions covered after a waiting period
Government Schemes (Ayushman Bharat)
Various mental health treatments including counseling
Varies by scheme
Covers low-income families with mental health services
What was IRDAI’s Role in Mandating Mental Health Coverage in All Health Insurance Plans?
The Insurance Regulatory and Development Authority of India (IRDAI) has mandated all health insurance companies to provide coverage for mental illness, acknowledging the rise in mental health challenges due to the complex and stressful nature of contemporary living. This directive, which came into effect on 31 October 2022, seeks to meet the urgent requirement for mental well-being assistance, particularly in the aftermath of the COVID-19 pandemic’s impact on mental health.
The Indian government passed the Mental Health Act in 2017 to ensure mental illness coverage in health insurance was mandated. However, some insurance providers did not adhere to these regulations leading to a delay. The IRDI stepped in to direct insurers to provide coverage for mental illness treatment by October 2020, with the deadline for full implementation set for October 31, 2022.
IRDA’s focus on including mental illness coverage in health insurance policies reflects a growing understanding of the importance of mental health in overall well-being. By providing comprehensive coverage, the regulator is acknowledging the need for holistic healthcare that addresses mental as well as physical health. This initiative aims to ensure that individuals can access the necessary support and treatment for mental health issues without financial barriers.
What is Usually Covered in Health Insurance Policies Offering Mental Health Coverage?
Health insurance generally covers several common types of mental illnesses such as -
As far as treatment is concerned, mental health coverage in health insurance policies covers the following -
Medical Costs for COnsultation and Treatment - A mental health insurance covers hospitalization, consultation and treatment but limits may vary by insurer.
Counselling and Therapy Sessions - Check your mental health insurance policy to see if it covers counselling. Some insurers may not cover outpatient psychologist sessions but you could still have access to a few consultations with specialist psychologists by choosing the right plan.
What is Excluded from Mental Health Coverage?
The exclusions under the mental disease coverage typically include -
All forms of cognitive impairments
Psychological disorders stemming from substance abuse
The majority of insurance plans provide coverage for medical expenses exclusively during hospital stays
Account of a persistent mental disorder’s history
Conclusion
Ultimately, incorporating mental health coverage into health insurance plans in India represents a crucial advancement in combating the pervasive impact of mental health disorders. This move reflects an increasing recognition of the significance of mental wellness and the financial strain linked to unaddressed mental health issues, underscoring the essential need for individuals to prioritize mental health coverage within their insurance arrangements.
Mental health coverage in India is crucial for ensuring access to necessary treatments and reducing financial strain, ultimately promoting overall well-being and fostering a more inclusive healthcare landscape. It plays a vital role in addressing the mental health needs of the population and improving the quality of life for individuals.
Frequently Asked Questions (FAQs)
Q: Is mental health covered by insurance in India?
A: Yes, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated that all insurance companies in India must provide coverage for mental illnesses. This means that health insurance plans in India now include the treatment of various mental health conditions such as depression, anxiety, OCD, PTSD, schizophrenia and more.
Q: Is mental healthcare free in India?
A: No, mental healthcare in India is not entirely free but efforts have been made to improve accessibility and affordability. The government’s National Mental Health Programme offers free medication for mental illnesses in government hospitals. Additionally, some state governments such as Karnataka and Odisha provide free mental healthcare through their health insurance schemes.
Q: Does India have a mental health policy?
A: Yes, India has a Mental Healthcare Act, 2017 that focuses on providing mental healthcare and services to those with mental illness. The act also emphasizes the need to protect and promote the rights of individuals with mental illness. Additionally, the act includes provisions for insurance coverage specifically for mental illnesses.
Q: Does Ayushman Bharat cover mental health?
A: Yes, Ayushman Bharat covers mental illnesses. It includes screening, diagnostics, pre and post-hospitalization charges, counselling and follow-ups for severe psychiatric disorders. The policy offers 5 lakh rupees per family annually.
Q: Is anxiety covered by insurance?
A: Most insurance plans provide comprehensive coverage for anxiety treatment, including assessments, therapy and medication. This act guarantees equal coverage for mental health and physical health services, making sure that individuals with anxiety disorders can receive the necessary care they need.
Q: What is the mental health bill in India?
A: The Mental Healthcare Act of 2017 in India aims to improve mental healthcare accessibility by protecting the rights of individuals with mental health issues and ensuring equal provision of mental health services alongside physical health services. It is a significant step towards addressing the needs of those suffering from mental health problems in the country.
Q: What is the Government scheme for mental health in India?
A: The Indian government has taken significant steps to address mental health issues by launching schemes such as the National Mental Health Programme. This programme aims to enhance mental health services, create awareness and integrate mental health into primary healthcare systems. These efforts are crucial in improving access to care and reducing the stigma surrounding mental health in the country.
Q: How much does mental ill health cost?
A: Global economic costs due to mental ill health are estimated at approximately 1 trillion dollars per year, mainly resulting from lost productivity. This highlights the considerable influence of mental health problems on economies, emphasizing the importance of implementing effective interventions and support systems.
Q: What is India's mental health rates?
A: In India, mental health rates suggest that about 1 in 8 people have a mental disorder, primarily anxiety and depression. The COVID-19 pandemic has worsened these rates, emphasizing the critical requirement for enhanced mental health services and support.
Author: Abhik Das
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