Insurance coverage for Mental Illness in India.🇮🇳

In India, insurance coverage for mental illness has significantly improved since the implementation of the Mental Healthcare Act, 2017, which came into effect in 2018. This Act mandates that every insurer must provide coverage for mental illnesses on par with physical illnesses. Here is an overview of the current situation:

Key Aspects of Mental Health Insurance in India:1. Mandatory Coverage: • The Mental Healthcare Act requires all insurance providers to cover mental health treatments, including hospitalization for mental illnesses, psychiatric consultations, and medications. • Insurers cannot discriminate between physical and mental illnesses while providing coverage. 2. Inclusions: • Inpatient care for mental health conditions, including therapy sessions and rehabilitation for severe disorders. • Coverage for conditions such as depression, anxiety, schizophrenia, bipolar disorder, and OCD. • Psychiatric consultations during hospitalization. 3. Exclusions: • Outpatient treatments (OPD), unless explicitly covered in the policy. • Experimental therapies or alternative treatments not approved by medical authorities. • Pre-existing mental conditions may have a waiting period, typically ranging from 1-4 years. 4. Challenges and Gaps: • Limited awareness: Many policyholders and even insurers’ representatives are unaware of this coverage mandate. • Narrow scope: While hospitalization costs are generally covered, OPD treatments (like regular therapy sessions or medication) are often excluded unless a specific rider is purchased. • Coverage caps: Mental health treatments are sometimes subject to lower limits compared to physical health treatments. • Stigma: The social stigma surrounding mental illness deters people from seeking insurance coverage for these conditions. 5. Steps to Ensure Coverage: • Review your policy document or speak to the insurer to confirm mental health inclusions. • Opt for comprehensive policies that offer broader mental health coverage. • File complaints with the Insurance Regulatory and Development Authority of India (IRDAI) if you face discrimination or denial of coverage.

Recent Developments:

Efforts by the IRDAI and mental health advocacy groups are encouraging insurers to offer better coverage for mental health. Some companies are now launching more inclusive policies to address the rising awareness and demand.

Dr. Ramanand Satapathy,
Former Superintendent,
Government Hospital for Mental Care,
Visakhapatnam.