New Delhi: Form the longest time mental illnesses were never given the attention they deserved. Celebrities like Deepika Padukone and Ellen DeGeneres have battled depression and shared their experience with the common people to understand how mental illness can take a toll in a person’s everyday life. Even Todd Phillips’s film talks in depth about the Joker. The film’s protagonist is a man who deals with mental and neurological problems, who eventually transforms into a criminal.
With all the attention that mental health is finally peaking, it became necessary for the Insurance Regulatory and Development Authority of India (IRDAI) to work towards bringing mental illnesses under the purview of health insurance.
IRDAI recently issued guidelines on the standardization of exclusions in health insurance contracts stating that treatment of mental illness, stress or psychological disorders would no longer be allowed as exclusions in health insurance policies. The Mental Healthcare Act, 2017, which was enacted last year, directs every insurance company to offer health insurance products to cater to mental illnesses as well as physical illnesses or injuries to policyholders.
What is covered?
The Mental Health Act, 2017 defines mental illness as “a substantial disorder of thinking, mood, perception, orientation, or memory, that is judgments, behavior, the ability to recognize reality or to meet life’s normal demands, Is associated with mental conditions. Alcohol and drug abuse, but do not include mental retardation which is a state of arrested or incomplete development of a person’s brain, is particularly characteristic of colonization of intelligence. “Any policy holder who has a mental condition which falls under the above mentioned categories. May file for health insurance claim.
The Mental Healthcare Act, 2017 states that every person with mental illness will be treated equal to persons with physical illness when it comes to healthcare including health insurance. The regulator has also set standard terms for health insurance exclusions to remove ambiguity, which may result in a policyholder’s claim being dismissed.
what does this mean?
Health insurance will now cover treatment for mental illness, stress or psychological and Neuro degenerative disorders, among other physical illnesses. But whether a policyholder will be covered only for hospitalization or for OPD (out-patient department) services will depend on the type of policy purchased.
The guidelines state that the insurer cannot discriminate against any illness being mental or physical. So if a policy covers physical illness for hospitalization, then it also has to cover mental illness for hospitalization.
Similarly, if the policy covers OPD expenses for physical illness, the same will apply for mental illness as well. Note that, generally, health insurance policies do not cover patient care, but some insurers are now offering some products, including OPD.
