Why you should consider mental health coverage when selecting your health insurance?

Health insurance has always been about coverage for physical illnesses. There is a stigma surrounding mental health. But it is changing now. The Economic Survey 2023-24 mentioned mental health and its impact on government policies. The National Mental Health Survey 2015-16 states that 10.6% of adults in India have some form of mental disorder. Also, there is a treatment gap of 70% to 82%. Generally, mental healthcare access is limited, and costs are higher. Mental health insurance can bring about a massive change in the healthcare space. 

Role of mental health in over-all health

Mental health affects physical health in many ways. A person can maintain holistic wellness only when their mental well-being is well-managed.

1. Effects of mental health on physical health

Most cases of mental illness come out as symptoms of physical conditions. Stress elevates blood pressure, for instance, and it leads to the development of medical conditions, including heart disease and diabetes. Anxiety and depression are also known to make a person vulnerable to infections. Thus, treating mental issues can also result in an improvement in physical health. 

2. Impact of not treating mental illnesses

If not treated, the after-effects of poor mental health can last for many years. Long-standing stress or unresolved anxiety could contribute to various health issues, including chronic stomach ulcers, frequent migraine attacks, and hypertension. Undiagnosed mental illness can create more serious consequences while reducing overall quality of life. It can also worsen existing physical health issues.

Overview of the mental healthcare act

The Mental Healthcare Act, 2017 (MHCA) protects the rights of Indians with mental illnesses. The Act focuses on providing accessible, indiscriminative, quality mental health care without hassle. Some of its core provisions are:

• Right to mental health care (Section 18): Everyone must have access to government-subsidised mental health services without discrimination. It must be of low cost and high quality. 

• Equality and non-discrimination (Section 21): Healthcare providers must provide the same level of care for mental illness as they would for physical illness.

• Protection from cruel treatment (Section 20): Protects individuals with mental illness from inhumane treatment so that people are treated with dignity.

• Admission to mental health facilities (Section 89): Allows for admission up to 30 days of hospitalisation when there is a danger of harm to themselves or others. A registered mental health professional must sanction the process.

• Registration of mental health facilities (Sections 65 and 66): All mental health facilities must register with the appropriate authority and follow prescribed standards.

• Oversight by authorities: The Act establishes Central and State Mental Health Authorities to regulate mental health care and ensure compliance across facilities.

• Involvement of law enforcement and judiciary: Police must safeguard individuals with mental illnesses and address cases of neglect or mistreatment. Magistrates can intervene to ensure their protection. 

IRDAI mandates mental health coverage

In 2018, IRDAI issued a directive for insurance providers. Now, they must provide mandatory mental health coverage. Mental health treatment and physical health treatment must be treated equally. So, medical insurance for mental health must also be comprehensive, similar to existing physical health coverage. 

Benefits of mental health insurance

This regulatory change brings several key benefits, such as:

• Comprehensive health coverage means mental health treatments are not excluded or limited.
• Insurance now fully covers mental health care, ensuring financial security for any type of medical emergency. 
• The directive ensures that mental health care is treated on par with physical health care. It promotes equal access to necessary treatments.

Why is mental health coverage important for policy buyers?

Mental health coverage is part of any good health insurance coverage. It is important because:

1. More prevalent mental health disorders

A fast-paced lifestyle increases stress. Mental issues, such as depression, anxiety, and stress-related disorders, are becoming rampant. Most of them require long-term treatment, which may be expensive. In other words, without proper coverage, the costs must come out of pocket.

2. Early intervention and treatment 

When there is mental health coverage, individuals will seek early intervention to prevent the development of the condition. Most of the time, early intervention results in successful treatment and recovery with no dire consequences.

3. Less stigma and more motivation to seek help

With mental health as part of the scope of insurance, people reduce the stigma attached to it. Therefore, it encourages people not to fear needing professional help because it can become more common. Moreover, not having to pay for medical health care also makes them get help early. 

4. Improved general welfare

Prompt mental health care can improve physical health and improve general well-being. It can also lead to a better quality of life. 

5. Long-term cost savings

Untreated mental health conditions often have long-term cost and quality-of-life implications. Adequate insurance coverage ensures that the person receives the necessary professional help and may save money in the future by preventing hospitalisation or worsening of their condition.

Mental health insurance: Factors to consider

There are several factors to consider before finalising a mental health care plan so that it is available in a comprehensive and adequate manner. The following are some of the important things to consider:

a. Scope of coverage

Ensure the policy includes mental health treatments, which may include therapy, counselling, hospitalisation, or even medication and treatment for mental illnesses. Also, verify if it covers both inpatient and outpatient care. Outpatient care is common in treating most mental illnesses, and an insurer might not include this in a standard policy.

b. Exclusions and Limitation

Review the policy for any exclusions or limitations related to mental health coverage. Mental illnesses due to drug abuse, arrested brain development, etc, are often excluded. Some policies may place restrictions on the number of therapy sessions or the types of treatments covered. Choose coverage that aligns with your specific needs, particularly if long-term care is necessary. 

c. Waiting periods

Many health insurance companies require a waiting period before the policyholder can make a mental health claim. Understand the waiting period, especially for those who require speedy and immediate treatment.

d. Pre-existing condition

A few insurance companies offer waiting periods or exclusions on pre-existing conditions of mental health illnesses. Always check if this policy covers your pre-existing conditions and, if so, how long you would wait or what kind of conditions you must satisfy.

e. Network of providers

Consider the network of mental health professionals covered under the insurance plan. A large network ensures easy access to quality therapists, psychiatrists, and hospitals. 

f. Claim process and support

Look into their claim process, particularly on mental health treatment. Clear and simple claim processes with robust customer support ensure you will receive timely access to your cover. Determine whether the insurer has supportive services that are sensitive to mental health issues.

g. Premiums and Costs

Even though full mental health coverage is necessary, the premium for such coverage must also be reasonable. Compare the different plans and their premiums to find the best balance between coverage and affordability.

h. Additional benefits and wellness programs

Some of the best insurance for mental health plans offer additional wellness programs, like mental health helplines or stress management workshops. These can be useful for mental well-being and early diagnosis of mental health conditions.

Conclusion

Organisations like the WHO encourage mental health awareness and reduce stigma. The government also continues to work on the issues related to mental health. Collaboration between insurance providers and healthcare providers for mental health care and the gap in treatment can improve access to mental health solutions. Since health insurance for mental health is available, policy buyers need to look for options that help them manage comprehensive care for all family members.

ARN: Zuno/Marketing/Blog/Mental Health Coverage/03/25/04