‘Atrangi Re’ Brings Focus On Mental Health Issues. What Do Mental Health Insurance Plans Cover?

Recently, the lead character of Bollywood movie Atrangi Re, played by Sara Ali Khan, was also shown as facing mental health issues, which were dealt by other characters without any taboo or judgement. In general, awareness about mental health has gone up with many celebrities, including Bollywood actor Deepika Padukone, American gymnast Simon Biles and tennis player Naomi Osaka, discussing their own issues in the past.

The need for mental health insurance is an oft-debated topic too. The Supreme Court ruling of June 2020 has further introduced a paradigm shift in the insurance sector by including mental illnesses coverage in health insurance plans.

“With the given ruling, now health insurance plans must consider mental illness treatments at par with physical illness as mental illness can also lead to the risk of life if the treatment is given to the patient on time. Above all, the cost of mental illness treatments is quite expensive in the country that put a huge burden on the pockets of patients. Therefore, health insurance must provide compensation to the patients suffering from mental diseases or disorders,” says Naval Goel, founder and CEO, PolicyX.com, an insurance aggregator.

What Is Covered By Mental Health Policies?

As per the ruling, health insurance plans cover all kinds of mental illnesses. However, the features would depend on a plan and the company providing it as each company decides its own inclusions and exclusions. Also, the pre-existing mental diseases won’t be covered in the plans.

“After the SC ruling, insurance companies such as HDFC Ergo General Insurance, Aditya Birla Health Insurance company, Niva Bupa Health Insurance, ICICI Lombard General Insurance, and Digit General Insurance are a few popular insurers planning to introduce health insurance policies specifically designed to cover people suffering from mental illnesses,” says Goel.

Generally, health insurance plans offered by these insurance companies include in-patient hospitalization. However, in the case of OPD (out-patient department) treatment, the policyholder must have an OPD feature either in-built or as an additional rider to avail OPD facility for mental illness treatments.

Notable Exclusions: “As per the definition of mental illness, there are a few exclusions in health insurance,” says Goel. First, the policies would not cover mental retardation. Second, they would also exclude outcomes due to abuse of drugs or alcohol. Also, if a patient is suffering with mental disorder attempts for suicide or self-injury, then it would not be covered by the insurance company.

Things You Should Check

“Most importantly, the applicant must probe into the policy’s features, benefits, inclusions and exclusions to understand if the policy provides relevant and desired coverage,” says Goel.

Also, sometimes certain mental illnesses may be genetic or run in the family. In such cases, if a person is looking for a health insurance policy with a cover for mental illnesses, they must check that if the disorder requires hospitalisation or therapy, or just medication would suffice to treat the illness.

In case of expected hospitalisation needs, the patient must select a comprehensive indemnity policy. In the case of medication and therapy, one must go for a policy that covers OPD expenses. Also, check for waiting periods, if any.