Does your health insurance policy cover mental health issues like depression too?

New Delhi: Depression stands as a prominent mental health issue in India, impacting a substantial segment of the population. It can exert profound consequences on an individual's holistic well-being, encompassing their professional life, interpersonal relationships, and overall quality of existence.

According to findings from the 2016 National Mental Health Survey of India, mental health disorders, such as depression, are widespread in the country, affecting approximately 7.5% of the population. This report underscores the imperative for heightened awareness and improved accessibility to mental health services, including the inclusion of mental health conditions within health insurance policies.

Furthermore, the World Health Organization (WHO) has recognized depression as a significant global public health challenge and a primary contributor to disability on a global scale. In their 2017 report addressing depression, WHO emphasized the necessity for expanded availability of mental health services, including the incorporation of mental health coverage within healthcare plans.

Though seeking treatment for depression is pivotal for one's recovery, the exorbitant expenses associated with such treatment can pose a formidable obstacle for numerous individuals. Consequently, this has prompted inquiries into whether health insurance policies in India include coverage for depression.

In recent times, there has been a growing recognition of mental health concerns in India, leading health insurance providers to acknowledge the necessity of including coverage for these conditions. Nevertheless, the incorporation of mental health conditions within insurance coverage is a relatively recent development in India, and there remains a lack of clarity regarding what is included and excluded from such coverage.

Does health insurance in India typically include coverage for depression?

Some health insurance policies in India do provide coverage for depression. Nevertheless, the extent of coverage for mental health conditions, including depression, may vary significantly depending on the insurance provider and the specific policy. In 2018, the Insurance Regulatory and Development Authority of India (IRDAI) introduced guidelines that require insurance companies to include coverage for mental illnesses, such as depression, in their health insurance policies.

The guidelines specify that each insurer is obligated to offer coverage for mental illnesses at the same level as they do for physical illnesses. However, it's crucial to be aware that there could be specific restrictions and exceptions in the coverage pertaining to mental illnesses, including depression. For instance, certain policies might impose a waiting period before extending coverage for mental health conditions or could place a cap on the amount covered for mental health treatments.

Categories of health insurance plans that cover depression

Health insurance policies that provide coverage for mental health conditions such as depression generally fit into the following categories:

Individual health insurance plans: Individual health insurance plans are well-suited for individuals looking to safeguard themselves from substantial medical costs. These policies encompass hospitalization expenses, including those related to the treatment of depression.

Family health policies: This policy offers coverage for the entire family and can include treatment for depression and other mental health conditions in accordance with the policy's terms and conditions.

Group health insurance: These plans are offered to specific groups of individuals, such as employees of a company or members of an association. It's essential to thoroughly review the policy documentation since the coverage provided by group health insurance policies may diverge from that of individual policies.

Critical health insurance: This policy offers coverage for designated critical illnesses, which may include certain mental health conditions such as major depressive disorder.

Personal accident insurance: This policy offers coverage for accidental injuries, including those that could lead to mental health conditions such as depression.

Restrictions on coverage for depression

While depression is included in health insurance coverage in India, there may be specific limitations on the benefits. Some of these restrictions comprise:

Waiting periods: Insurance providers may require a waiting period of several years before extending coverage for mental illnesses such as depression.

Sub-limits: Some health insurance policies may impose sub-limits on the coverage amount for mental illnesses such as depression.

Pre-existing conditions: Insurance companies may grant coverage for pre-existing conditions like depression only after the waiting period has elapsed.

Exclusions: Some health insurance policies may not cover specific treatments or procedures associated with depression.

Added measures to aid in managing mental well-being

While health insurance can assist with the expenses related to depression treatment, there are supplementary steps individuals can take to maintain their mental well-being. These measures encompass self-care, seeking support from friends and family, and engaging in activities that bring joy and fulfillment. In India, various organizations and helplines also offer resources and assistance for individuals dealing with mental health issues.

Depression is a significant mental health disorder that can profoundly affect an individual's daily life. Seeking professional assistance is crucial for recovery, but it can come with a substantial cost. In India, health insurance policies do provide coverage for mental illnesses like depression, although the extent of coverage can vary. It's imperative to thoroughly review the insurance documentation to fully understand the scope of coverage and any exclusions.