Do health insurance plans cover psychological disorders?

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

The Insurance Regulatory and Development Authority (IRDAI) has ordered all insurance companies to cover mental illness under existing and new policies. Since the ordinance 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 beginning to be covered by health insurance policies.

But policyholders should be aware that in most cases, health insurance only covers hospitalization costs when it comes to mental disorders. Most comprehensive policies do not cover OPD costs. So, when purchasing a policy, individuals should read the terms of the policy carefully. Just like other settlements, policyholders must first go through a waiting period before the policy applies to issues related to psychological disorders.

“Generally, the health insurance plans offered by these insurers cover hospitalization costs for mental illness. But outpatient counseling or therapy is only covered if the police offer outpatient service benefits (OPD),” Ankit Agrawal, chief executive and co-founder of InsuranceDekho, told 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 developed health insurance policies that specifically cover people with mental health issues.

(Edited by : Shoma Bhattacharjee)

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