“I feel sad and hopeless.” 

“I feel tired and exhausted.” 

I find it so difficult to focus.” 

We all might have experienced these feelings. 

But how many of us have sought professional help? Probably not many. Either we are held back by the stigma attached to mental health or we fear we cannot afford therapy. 

However, it’s imperative that we take our mental health as seriously as our physical health. 

The World Health Organisation (WHO) reported a 25% increase in the prevalence of mental illnesses like anxiety and depression post-COVID due to factors such as social isolation, which led to feelings of loneliness and financial worries, and the death of loved ones leading to grief. 

According to research conducted by the National Institute of Mental Health and Neuro Sciences (NIMHANS), at least 13.7% of Indian adults suffer from mental illness, and 10.6% of them require immediate treatment and intervention.

With declining mental health, there has been an increase in the need for health insurance policies that cover both physical and mental health.

Recently, the Insurance Regulatory and Development Authority of India (IRDAI) made it mandatory for all insurance companies to cover the costs related to mental health treatment within the healthcare insurance plan. The IRDAI said that “all insurance products shall cover mental illness and comply with the provisions of the MHC Act, 2017, without any deviation”. 

According to the Mental Health Act of 2017, “mental illness means a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behavior, capacity to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with the abuse of alcohol and drugs, but does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterized by subnormality of intelligence.”  

The IRDAI has made it compulsory for all insurance companies to cover every expense that falls under the definition of mental illness given by the Mental Health Act of 2017. 

What does mental illness insurance cover?

The mental illness insurance cover includes a variety of expenses like room rent, diagnostic procedures, hospitalization charges, OPD consultations, counseling and therapy sessions, rehabilitation, medications, treatment costs, and road ambulance charges. However, all coverage depends on the policy purchased by the insured. 

Not sure which insurance company covers mental illnesses? Here’s our short guide.

1. HDFC ERGO Health Insurance

HDFC ERGO provides treatment for mental illnesses through their “my:health Suraksha Plan.” 

This plan covers: 

• Reimbursement of pre and post-hospitalization charges
• Cashless treatment
• Free health check-up on every renewal

This policy also includes your room rent and gives you the liberty to choose the room of your choice. It also allows you to avail home healthcare in case of severe psychiatric illness. 

This plan takes care of all your needs ranging from ambulance cover to your hospitalization expenses. However, it does not include outpatient consultation. 

2. Reliance Health Insurance

Reliance’s Health Infinity Insurance Policy includes all the costs of treatment related to mental illnesses, like your pre-hospitalization and post-hospitalization expenses, room rent, diagnostics, and cashless treatment. 

Immediate hospitalization is provided for cases like dementia, schizophrenia, and various anxiety disorders, depending on your chosen plan. The plan allows the policyholder to avail of the claims and benefits after a month of purchase. It provides coverage for pre-existing illnesses, and the claim is settled within 3 months. However, the policy excludes outpatient consultation. 

3. ICICI Lombard

This policy provides cover for all hospitalization expenses and outpatient consultations. The company provides cover for pre-existing diseases, emergency ambulance, and home healthcare in case of severe psychiatric disorders and allows you to benefit from cashless treatment so that you don’t have to worry about arranging the funds in case of a medical emergency. The policyholders can avail of benefits like free health checkups and no limit on hospital room rent, depending on the policy they opt for. 

4. Loop Health 

Best suited for companies and organizations, this policy focuses more on employee health and wellness and offers them a variety of benefits, like access to unlimited therapeutic counseling sessions and numerous holistic wellness webinars, which help individuals to process their thoughts and feelings in a better way. 

The policy provides coverage for 24/7 claim support, unlimited free consultation with doctors, and a team of experts available by text. The company allows the policyholder to customize their plans according to their needs and gives them the liberty to approach the experts anytime anywhere through the Loop app. 

5. Niva Bupa Health Insurance 

Formerly known as Max Bupa Health Insurance, this company covers various psychiatric disorders, from clinical depression to psychosomatic disorders like Alzheimer’s and Parkinson’s disease. The insurance plan covers all the expenses, even if the illness is caused due to an accident or general debility. The company allows consumers to customize their plans based on their needs and requirements. 

6. Aditya Birla Health Insurance

This company provides users with modern treatment methods, cashless home treatment in case of severe psychiatric disorders, 100% cover for diagnostic procedures, double insured sum in case of 2 claim-free years, and hospitalization expenses. 

This healthcare insurance allows you to customize the policy before purchase based on your personality type. Customers can avail of unlimited access to therapeutic counseling sessions under Activ Health, which is a product of this company. 

Deciding what insurance to opt for

Healthcare insurance companies provide a cover for a variety of mental disorders like post-traumatic stress disorder (PTSD), bipolar disorder, acute depression, eating disorders, schizophrenia, etc., but they do not cover cases of intellectual disability and outcomes due to substance abuse. No coverage is provided for pre-existing conditions like dementia, Parkinson’s, and Alzheimer’s disease. 

Despite the benefits these companies offer, it’s important that policyholders enquire about and go through the features of each policy, as different companies have their list of exclusions and inclusions.

Government insurance schemes

Apart from initiatives from the IRDAI, the Indian government has also been proactively trying to make mental healthcare accessible through the National Mental Health Program and programs like Ayushman Bharat. Here are a few such initiatives.

Ayushman Bharat

Initiated by the Government of India, Ayushman Bharat has two components, namely Health and Wellness Centres and Pradhan Mantri Jan Arogya Yojana (PM-JAY). Ayushman Bharat is known to be the world’s largest healthcare program providing coverage of INR 5 lakhs every year per family. The policy includes the costs for screening and diagnostic procedures, pre and post-hospitalization charges, therapeutic counseling, and regular follow-ups for patients with severe psychiatric disorders. 

Arogya Karnataka

This policy was initiated by the government of Karnataka for patients below the poverty line. It provides coverage for various mental disorders like schizophrenia, intellectual disability, depression, and anxiety disorders, depending on the package chosen.

Biju Swasthya Kalyan Yojana (BSKY) of Odisha

The BSKY scheme from the Odisha government offers physical and mental health treatment coverage in government hospitals.

Mental health insurance coverage has a long way to go in India. Factors like extended waiting periods, exclusion of out-patient consultations, and rejections based on severity and complications involved in the treatment inhibit the development of mental health insurance in India. 

However, well begun is half done, as they say.