scorecardresearchHealth insurance: Does your policy cover depression too?

Health insurance: Does your policy cover depression too?

Updated: 12 Apr 2023, 03:33 PM IST
TL;DR.

Health insurance policies in India may provide coverage for depression, though there may be restrictions and exclusions to the benefits provided.

Government recently rolled out the Ayushman Transgender health insurance which entitles each transgender person to receive a medical cover of  <span class='webrupee'>₹</span>5 lakh per year

Government recently rolled out the Ayushman Transgender health insurance which entitles each transgender person to receive a medical cover of 5 lakh per year

Depression is a leading mental health condition in India, affecting a significant portion of the population. It can have severe effects on an individual's overall well-being, including their work, relationships, and overall quality of life.

As per a report by the National Mental Health Survey of India conducted in 2016, mental health conditions like depression are prevalent in India, with around 7.5% of the population affected by some form of mental illness.

The report highlights the need for increased awareness and access to mental health services, including coverage for mental health conditions under health policies.

Also, the World Health Organization (WHO) has identified depression as a major public health concern and a leading cause of disability worldwide. In their 2017 report on depression, the WHO highlighted the need for increased access to mental health services, including mental health coverage under health plans.

While seeking treatment for depression is crucial for recovery, the high cost of treatment can be a barrier for many individuals. This has led to the question of whether depression is covered by health insurance policies in India.

In recent years, there has been an increased awareness of mental health issues in India, and health insurance providers have started to recognize the need for coverage for such conditions. However, coverage for mental health conditions is still relatively new in India, and there is a lack of clarity on what is covered and what is not.

In this article, we will explore whether depression is covered by health insurance policies in India.

Is depression covered by health insurance policies in India?

Yes, depression is covered by some health insurance policies in India. However, the coverage for mental health conditions including depression can vary widely among different insurance providers and policies. In 2018, the Insurance Regulatory and Development Authority of India (IRDAI) issued guidelines that mandate insurance companies to provide coverage for mental illnesses, including depression, under health insurance policies.

The guidelines state that every insurer must provide coverage for mental illnesses on the same basis as physical illnesses. However, it is important to note that there may be certain limitations and exclusions in the coverage provided for mental illnesses, including depression. For instance, some policies may have a waiting period before mental health conditions are covered, or may limit the coverage amount for mental health treatments.

What are the types of health insurance policies that coverdepression?

Health insurance plans that cover mental diseases like depression typically fall into following categories:

Individual health insurance plans: These policies are appropriate for people who want to protect themselves from having to pay expensive medical bills. They pay for hospitalisation costs, including those required for depression therapy.

Family health insurance policy: This policy provides coverage for the entire family and can cover treatment for depression and other mental health conditions as per the terms and conditions of the policy.

Group health insurance plans: These plans are made available to a certain group of people, such as a company's employees or an association's members. It is important to carefully study the policy paperwork because the coverage offered by group health insurance policies may be different from that of individual policies.

Critical illness insurance policy: This policy provides coverage for specific critical illnesses, including some mental health conditions like major depressive disorder.

Personal accident insurance policy: This policy provides coverage for accidental injuries, including those that may result in mental health conditions like depression.

What are the limitations to coverage for depression?

Although depression is covered by health insurance in India, there could be certain restrictions on the benefits. Some of the restrictions include:

Waiting periods: Before covering mental diseases like depression, insurance providers may impose certain years of the waiting period.

Sub-limits: The amount covered for mental diseases like depression may have sub-limits in some health insurance policies.

Pre-existing conditions: Insurance companies may only provide coverage after the waiting period if a person has a pre-existing ailment, such as depression.

Exclusions: Certain treatments or procedures related to depression may not be covered by health insurance policies.

Other additional steps that could help manage mental health

There are additional actions people may take to manage their mental health, even while health insurance can help with the cost of depression treatment. They include taking care of oneself, asking friends and family for help, and doing things that make you happy and fulfilled. In India, several groups and hotlines also provide resources and support for people with mental illnesses.

Conclusion

Depression is a serious mental health condition that can have an impact on a person's daily life. Although getting help from a professional is essential for healing, doing so can be pricey. In India, mental diseases like depression are covered by health insurance policies, albeit the level of protection may vary. It is crucial to carefully study the insurance document to comprehend both the coverage as well as the exclusions.

Rakesh Goyal is the Director of Probus Insurance, an InsurTech broking company selling both life and non-life insurance policies.

 

 

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First Published: 12 Apr 2023, 03:32 PM IST