Mental illnesses to be covered by health insurance. Here’s more

by Prarthana Mitra

According to the latest regulatory guidance issued by the Insurance Regulatory and Development Authority of India (IRDAI), insurers are not to discriminate between mental and physical illnesses while offering health cover.

In a country where one in five adults suffers from mental health issues, this directive enables “provisions for medical insurance for treating of mental illness on the same basis as is available for treatment of physical illness”. According to the 2015-16 survey of National Mental Health Survey of India, Common mental disorders (CMDs) which includes depression, anxiety disorder and substance abuse/addiction are a huge burden.

Millions of Indians would rather ignore and suppress their symptoms than opt for active intervention, because of lack of health coverage, and this often has fatal consequences. Mental illnesses require prolonged medical attention, continuous care and support from professionals, which takes a financial toll on lower-income families. As the cost of treatment rises, more patients drop out of the treatment cycle. The stigma around mental health further compounds the problem.

Broadening the level of health coverage

Mayank Bathwal, CEO of Aditya Birla Health Insurance told Livemint, “This move is in line with offerings in developed nations, ensuring long-term growth for the industry and certainly is a positive step.”

Most developed countries around the world today regard psychological disorders at par with physiological ailments, offering cover for visits to the psychiatrist, medication to deal with stress and anxiety, and compensation for asylum bills if necessary.

With this move, India enters a new and progressive phase in health insurance awareness. The sector has recently seen immense growth, with an increasing health-consciousness among young professionals and millennials who insist on health coverage.

Possible terms, inclusions and conditions

The introduction of the Mental Health Act needs to be supplemented with insurance policies to place mental health treatment at par with physical health, said Varun Gera, Founder and CEO of HealthAssure. It is now time for insurance policy providers to figure out the structure and fine print for a new comprehensive health cover, that ensures fair pricing as well as adequate financial assistance to the beneficiary.

However, covering mental health concerns under existing insurances may cause a slight rise in the premium since mental conditions are treated on an out-patient department (OPD) basis, says Neerja Birla, Founder of Mpower. According to Medical Trends Around the World Survey Report 2018 by Mercer Marsh Benefits, mental treatment requiring hospitalisation is far less compared to expert consultations, counselling and medication. This move will, therefore, correct the ongoing trend to reimburse the insured only if they are hospitalised.  “With technological advances, many procedures and treatments that required hospitalisation can now be accomplished through day care,” noted IRDAI on Sunday.

Dismantling stigma and improving mental health

Including mental health in the mainstream medical conversation is important and with the incorporation of the same in existing insurance policies, customers will be able to avail of multiple services under one cover. This is likely to include hospitalisation, counselling, medication, access to specialists and rehabilitation services.

The decision is expected to improve public access to mental treatment and develop the mental health delivery infrastructure. It will also encourage more people to reach out for professional help and thus shine a light on mental health awareness in the country.


Prarthana Mitra is a staff writer at Qrius

insurance policyIRDAIMental Health