Do Health Insurance Plans Cover Mental Illnesses?

The Mental Healthcare Act 2017 has given a definition to mental diseases, which every insurance company has to follow. According to this Act, if a person has a marked change or deficit in his mood, thinking, perception, orientation or memory, due to which his behaviour, decision making, inference or ability to carry out normal day-to-day activities are affected, it would be considered a mental illness. However, mental retardation is excluded from this definition, as it is usually caused by incomplete and stunted mental development.

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Any person who has a mental illness, a family history of mental illness, a traumatic experience or is prone to mental illness needs coverage for mental illness in health insurance. Mental health coverage is also required for a person who is going through post-accident trauma or has been traumatized by the death of a close person. In fact, given the stressful lifestyle and living conditions these days, almost every person needs health coverage against mental diseases.

If you have made up your mind to take a health insurance plan, then you must definitely consider myUpchar Bima Plus. In Bima Plus, you get the facility of 24x7 free tele-OPD along with many other facilities. The premium of Bima Plus is also lower as compared to any other health insurance.

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Very few insurance companies provide OPD cover for counselling in case of mental illness. It is very important for you to know whether your insurance company is providing OPD and mental illness benefits in your policy or not so you must read and understand your health insurance policy thoroughly. If mental illness cover is available in your policy and you have also taken OPD cover, then you can also claim for consultation and counselling. Apart from this, if you have to be hospitalized, then at least 24 hours of hospitalization is required for you to be able to claim it. If you go to the network hospital of the insurance company, then the facility of cashless treatment is available, whereas if you get treatment in any other hospital, you will have to pay the bill and claim reimbursement later.

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Like all other pre-existing conditions, there is a waiting period for mental illness cover and it may differ from company to company. However, most health insurance companies offer a waiting period of two years for mental illness insurance. This means that if you buy a health insurance plan that has mental illness cover, you will have to wait for two years to get coverage on the treatment of mental illnesses. That's why we always tell you to take health insurance at a young age so that your waiting period ends as soon as possible and the premium is also low at that time.

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Some well-known diseases that come under the list of mental diseases covered by health insurance are:

• Acute depression
• Bipolar disorder
• Schizophrenia
• Anxiety disorder
• Obsessive-compulsive disorder
• Attention deficit hyperactive disorder (ADHD)
• Post-traumatic stress disorder
• Mood disorder
• Psychotic disorder

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Under mental illness cover, the claim is received only on hospitalization. There are only a few companies that provide coverage for consultations as well. Most insurance companies do not cover mental retardation. An insurance claim will not be available for any condition caused due to alcohol and drug abuse. If there is a history of recurring mental conditions, then the insurance company can refuse to pay the claim as such a situation is often caused by indiscipline in taking treatment and medicines. Insurance companies have only just started covering mental illnesses; it is expected that companies will soon come out with new plans, in which the conditions covered and not covered will be more clear.

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