homepersonal finance NewsDo health insurance plans cover psychological disorders?

Do health insurance plans cover psychological disorders?

In most cases, health insurance only covers in-patient hospitalisation costs — and not OPD — when it comes to mental health issues. 

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By CNBCTV18.com Jun 28, 2022 7:34:22 PM IST (Published)

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Do health insurance plans cover psychological disorders?

The COVID-19 pandemic has brought discussions about mental health issues to the forefront. From depression to anxiety, a whole host of mental health issues can result from genetic predisposition to stress and burnout. Today, awareness about mental health issues is gaining importance. With this greater impetus, many health insurance policyholders wonder if their policy covers psychological disorders.

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The Insurance Regulatory and Development Authority (IRDAI) issued orders to all insurance companies to cover mental illnesses under existing and new policies. Since the order was passed in 2018, disorders like acute depression, obsessive-compulsive disorder (OCD), anxiety disorders, bipolar disorder, post-traumatic stress disorder, schizophrenia, dementia, psychotic disorder, attention deficit or hyperactivity disorder, and mood disorder are starting to be covered under health policies.

But policyholders should be aware that in most cases health insurance only covers hospitalisation costs when it comes to psychological disorders. Most comprehensive policies do not cover OPD costs. Thus, when buying a policy, individuals should carefully go through the terms of the policy. Much like other settlements, policyholders do have to first go through a waiting period for the policy to kick in for issues relating to psychological disorders.

“Generally, health insurance plans offered by these insurers cover in-patient hospitalisation expenses for mental illness. But outpatient counselling or therapy is covered only if the policy offers outpatient department (OPD) benefits," said Ankit Agrawal, Chief Executive Officer and Co-Founder, InsuranceDekho, to the Mint.

Some insurers like Max Bupa Health Insurance, ICICI Lombard, Aditya Birla Health Insurance Company, HDFC Ergo General Insurance and Digit General Insurance have come up with health insurance policies that specifically cover those suffering from mental health issues.

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