Mental Health and Health Insurance: Understanding the Changes in Coverage

Thursday, 10 October 2024, 05:08

Mental health claims have seen a shift in health insurance policies, particularly following the Mental Healthcare Act. This article explores the current status of mental health coverage within Indian health insurance, highlighting inclusions and exclusions. Despite improvements, challenges persist in accessing adequate mental health support under health insurance. We delve into the practical implications of these changes and what they mean for policyholders.
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Mental Health and Health Insurance: Understanding the Changes in Coverage

Mental Health Status and Insurance Framework

As of 2024, mental health claims are becoming more recognized within health insurance policies, driven by regulatory changes. The Insurance Regulatory and Development Authority of India (IRDAI) made it mandatory for insurers to comply with the Mental Healthcare Act.

Progress in Mental Health Insurance Coverage

  • Hospitalisation Coverage: Insurance providers now offer coverage for hospitalisation related to mental health.
  • Outpatient Services: There is limited coverage for outpatient services, which are essential for ongoing treatment.

Understanding Exclusions

Prospective policyholders must declare all existing conditions, including mental health disorders, and carefully review exclusion clauses. Common exclusions can include intentional self-injury and substance misuse.

Looking Forward: Areas for Improvement

While there have been positive changes in coverage for mental health conditions, advocates continue to call for broader acceptance and treatment options within health insurance frameworks.


This article was prepared using information from open sources in accordance with the principles of Ethical Policy. The editorial team is not responsible for absolute accuracy, as it relies on data from the sources referenced.


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