COVID-19 and mental health: Is it covered under health insurance?

With mental health awareness reaching new heights during this pandemic, health insurance providers are being instructed by the government and regulatory bodies to ensure that the best health insurance plans cover the treatment of mental illnesses as well.

COVID-19 and mental health Is it covered under health insurance

The past few months have seen the world getting impacted by COVID-19 on various fronts – the threat to our physical health, the slowing down of the economy, the sudden change in our social structures, and the way we live our lives on a daily basis, among other things. All this has led to feelings of uncertainty, fear, worry, and stress among a large section of people. This has, in turn, led to increased conversations about mental health.

While mental health has gained its rightful place of importance in the public sphere in the last decade or so, it has become even more crucial in these testing times. Not only are we worried about the possibility of falling prey to the novel coronavirus and the resultant health consequences, we are also racked with concern about other short- and long-term problems: loss of jobs, adjusting to the concept of working from home everyday, homeschooling our children, reduced or lack of physical contact with the outside world, and the high level of uncertainty about what the future looks like. 

A key fallout of the pandemic is that the situation has resulted in many people complaining that they experience symptoms of anxiety, depression, and other mental health problems. With treatment of mental illnesses slowly but steadily taking up a significant chunk of the average expenditure on healthcare, it’s important to understand if this is covered by health insurance providers in India, and if so, to what extent.

Related: Why I started paying attention to my health at 40? 

Making a difference

While health insurance plans have typically covered only the treatment of physical ailments, the enforcement of the Mental Healthcare Act, 2017, has brought about a change. It defines mental illness as ‘a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behaviour, capacity to recognise 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 the mind of a person, specially characterised by sub-normality of intelligence.’ It stipulates that health insurance providers must provide mental health insurance that is in line with that for physical ailments.

The Act enforces the coverage of a person’s mental condition with a 24-hour mandatory hospitalisation, which is the case with physical ailments as well. This includes the process of analysis and diagnosis of the mental condition, as well as the care and treatment for the same. The Act does not cover mental retardation. 

Related: Are unprecedented pandemics covered under health insurance? 

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Regulatory steps

While the best health insurance plans in India should have included mental health in their coverage by now, this is unfortunately not the case. In fact, in June 2020, the Supreme Court of India issued a notice to the Central Government and the Insurance Regulatory and Development Authority of India (IRDAI) to strictly enforce the same. 

The reason for the delay in health insurance providers complying with this rule lies largely in the ambiguity associated with various aspects of mental illnesses, right from their diagnosis and treatment to the prevailing costs for the same. Another quandary faced by both the regulators as well as health insurance companies is that most mental illnesses are treated in the OPD and do not require hospitalisation. Many leading insurance providers, who claim to provide the best health insurance in India, are looking for ways to make inroads into solving this problem.

The IRDAI has mandated that all basic indemnity plans should cover mental illnesses and that these should be treated on par with physical ailments. The deadline for doing so has been set as October 2020. Health insurance providers are working on providing either hospitalisation or OPD coverage, or optimally a combination of both, which would truly make it the best health insurance policy. Any physiological symptoms that occur due to mental ill-health will also be covered.

Last words

With this directive from the IRDAI, the future looks brighter for those suffering from mental illnesses. While efforts towards mental health awareness have done wonders to reduce the stigma associated with this condition and those who suffer from it, this new initiative will surely make things much easier for those who battle mental health problems. Here are a few things to note when purchasing health insurance during COVID-19 pandemic. 


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