How medical health insurance safeguards your mental health amid recurring COVID-19 outbreak, Health News, ET HealthWorld


By Amit Chhabra

Two years have passed, however the effect of COVID-19 on humankind hasn’t worn off. The virus attack stays to be in focus, in latest forms or variants – Delta, Omicron or the newer sub-variants, which has only added more uncertainties and concerns in all points of life. The whole lot from physical fitness, and financial well-being, creating fear of unemployment or reduced income, limiting social relations, and most significantly fear of losing family members has taken an infinite toll on people’s mental health worldwide.

Going by the information, the 2020 survey by the Indian Psychiatry Society confirmed that over 40 percent of Indians suffered from mental health issues. This has only grown multi-fold after recurrent pandemic waves. The frontline staff have also been witnessing the added impact on mental wellness as they suffer from burnout, stress, and insomnia due to round the clock, excessive workloads. Thus, as a step towards safeguarding a positive mental state for the Indian population, the IRDAI issued fresh guidelines in 2020 for mandating mental health or psychological disorders treatment coverage under medical health insurance. This also covers psychological disorders, stress and neural illnesses.

Nonetheless, the attention still tends to be low regarding this update. As we observe the Mental Health Awareness Month, let’s understand higher about this feature that goals to safeguard the policyholder’s mental health, especially amid the pandemic.

What’s defined as mental illness?

All insurers must abide by the definition of The Mental Healthcare Act of 2017 which defines this illness as a major disorder within the mood, pondering, perception, orientation or memory of a person because it deters behaviour, decision making, judgment or competence to fulfill extraordinary each day activities.

What all is roofed under medical health insurance policies?

Under the IRDAI’s latest directive, mental health together with physical being is now covered under medical health insurance coverage. This can protect the policyholder from expenses that will arise as a result of a probable mental disorder. Also, the insurance company cannot deny coverage to individuals who have used opioids or anti-depressants prior to now. Policyholders with a proven history of clinical depression, personality or neurodegenerative disorders, sociopathy and psychopathy shall even be covered.

The coverage shields the policyholder from-

  • Charges incurred due to patient’s diagnostics, medications, treatment costs, room rent, ambulance charges etc.
  • Any expenses incurred in case of being hospitalised under in-patient care as a result of any mental illness.
  • Some plans might guard the insurer against the fee of outpatient counselling or therapy and even rehabilitation for mental illness. So, review your existing medical health insurance plan for each options – mental illness and OPD. As a advice, purchase the policy that covers OPD as in case of mental ailment, the patient will potentially need private care in the shape of counselling or therapy. The coverage for IPD shall be as per the IPD advantages of the policy.

Correspondingly, a number of the diseases that fall under the mental condition and are covered under the insurance are:

  • Acute depression
  • Bipolar disorder
  • Schizophrenia
  • Anxiety disorders
  • Obsessive-compulsive disorders
  • Attention-deficit/hyperactivity condition
  • Post-traumatic stress sickness
  • Mood unrest
  • Psychotic upheaval

Who can get it?

Other than the defined and the mentioned ailments, the opposite individuals who should purchase mental medical health insurance coverage include those with a history of using antidepressants or opioids. All of the insurer must do is declare it as a PED, and it’s as much as the insurer to underwrite the chance or not. Nonetheless, the likelihood of most mental conditions getting a policy is high as insurers have innovated and significantly eased the revaluation.

Moreover, individuals with a proven record of clinical depression, personality or neurodegenerative disorders, sociopathy and psychopathy insurance are also eligible. Alternatively, the opposite straightforward scenario is that if any individual buys a policy after which gets a mental illness.

What is just not included?

The essential exclusion from the policy is mental retardation. This can be called Mental disability because it is principally an inability as a result of a neurodevelopmental disorder that characterizes and impairs mental and adaptive functioning.

Is there a waiting period applied?

If anyone has a pre-existing mental disorder, the insurer won’t provide the good thing about the policy immediately but can have a waiting period. This implies to say the expenses; the policyholder can have to attend for a certain time from the date of the problem of the policy. This era can range anywhere from 2-3 years, depending on the insurance purchased. Hence, it is suggested to begin early, i.e. make it a component of your first coverage plan itself.

Furthermore, an individual should definitely go for this policy in the event that they have a family history or have passed through any traumatic experience at any point of their life. These scenarios increase their likelihood of acquiring the cognitive ailment, and hence, coverage like this could protect them from unplanned expenses.

To encapsulate, the inclusion of mental illness in healthcare policy is an ideal move, especially in the present environment where life with different COVID-19 variants is making people more vulnerable and stressed. As well as, this may also help bring psychological disorders to the forefront as people can claim coverage for his or her treatment fairly than hushing it down.

By Amit Chhabra, Head – Health and Travel Insurance,

(DISCLAIMER: The views expressed are solely of the creator and ETHealthworld doesn’t necessarily subscribe to it. shall not be chargeable for any damage caused to any person / organisation directly or not directly)


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