experts like Fist-established Chetan Divan, president, Center for Mental Health and Disabilities, Karve Institute for Social Service. Now all health insurance policies will be required to cover major mental illnesses, said Diwan, who recently presented a paper on mental health insurance at a national conference in chandigarh saying indianexpress.com.
Q. What is the provision of the Mental Health Act 2017 and why was there a delay in the provision of insurance facilities for mental illness?
Divan: The Mental Health Act 2017 was enacted on May 29, 2018. Section 21 (4) of the Act states that “every insurer shall provide health insurance for the treatment of mental illness on the same basis as is available to the treatment of physical illnesses. disease’ and now it is the responsibility of the welfare state to make insurance facilities available for all types of mental illness. The IRDAI in 2018 mandated Indian insurance companies to cover mental disorders under the Mental Health Act 2017. Despite this, insurers did not change their policies and did not include the mental illness component to be covered by policies. for sure. A Public Interest Litigation filed in the Supreme Court pointed out that the companies were violating the provision of the 2017 Law. The high court intervened and eventually the IRDAI had to instruct all insurance companies to introduce policies for mental illness by October 2020. Despite the two-year delay, it will now be implemented.
Q. What types of illnesses are covered by mental health insurance? Will you cover the costs of therapy?
Divan: The Mental Health Act 2017, which lays the foundation for insurance for psychological disorders, defines “mental illness” as “a substantial disorder of thought, mood, perception, orientation, or memory that seriously affects judgment , behavior, ability to recognize reality or ability to meet the ordinary demands of life, mental conditions associated with alcohol and drug abuse.’ Medical insurance will therefore cover the treatment of mental illnesses that fall within the scope of the above definition.
Q. What disorders will be covered by insurance?
Divan: Although the scope of coverage varies according to the insurer, some of the disorders whose treatment will be insured are bipolar affective disorder, acute depression, schizophrenia, panic disorders, attention deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), personality disorder (PD), eating disorders, and dissociative disorders.
Q. What diseases will not be covered?
Divan: The Mental Health Law, 2017, does not include mental retardation in its definition, which it considers as ‘a condition of arrested or incomplete mental development of a person, especially characterized by subnormal intelligence’. Therefore, problems related to mental retardation will not be covered by insurance.
Q. Will suicide or attempted suicide be covered by insurance? What about substance abuse and addiction-related disorders?
Divan: No. Treatment for intentional self-inflicted injuries or attempted suicide is also not insured. Complications related to intoxication, dependence, abuse and withdrawal disorders caused by alcohol and other substances will not be considered in mental health insurance either.
Q. What benefits will be provided under the insurance?
Divan: Many plans cover medical expenses only when the patient is hospitalized. The benefits are the same as those of insurance for physical health ailments, such as cashless treatment and pre- and post-hospital coverage according to the policy. Depending on the insurer, coverage may include treatment costs, medications, diagnostic procedures, roadside ambulance charges, and room rental, among others.
Q. Is counseling and consultation covered by mental health insurance?
Divan: Coverage differs from insurer to insurer. Not all insurers provide health insurance that covers mental illness under the outpatient department (OPD) benefit. While many insurers had already expanded coverage for mental illness under the Mental Health Act of 2017 guidelines, more clarity on the changes is expected to emerge after insurers release their revised policy documents.
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