Mental illness coverage mandatory in health insurance: IRDAI

Health Insurance News

Since COVID, there has been an increase in mental health problems. The pandemic is said to drastically impact mental health. However, numerous initiatives are being carried out to address this issue. According to a formal notice accessible on its official website, the Insurance Regulatory and Development Authority (IRDAI) has instructed insurance companies to include coverage for mental illness under health insurance policies before October 31, 2022.

“All insurance products must cover mental illness and adhere strictly to the requirements of the MHC Act, 2017.” As reported by the media, IRDAI urged the insurers to confirm compliance before October 31, 2022.

On May 29, 2018, the MHC Act, also known as the Mental Healthcare Act, went into effect. Every insurer is required to offer medical insurance for the treatment of mental illness on the same terms as are offered for the treatment of physical illnesses, according to Section 21(4) of the Act mentioned above. The Mental Healthcare Act 2017 was unanimously approved by the Lok Sabha on March 27, 2017. In April 2017, it received the President of India’s approval.

The 2017 MHC Act defines mental illnesses as…

The Mental Healthcare Act of 2017 strongly emphasises providing mental healthcare and services for people with mental illness as well as protecting, promoting, and upholding those people’s rights while providing those services.

It defines “mental illness” as a significant disorder of thinking, mood, perception, orientation, or memory that gravely impairs behaviour, judgement, the ability to recognise reality, or the capacity to meet the necessities of daily life. It also includes mental illnesses linked to drug and alcohol abuse.

Is there evidence of concern for mental health?

According to a report published in The Lancet Psychiatry, this is not happening.

“The Insurance Regulatory and Development Authority of India did nothing to make sure that insurance providers covered mental illness in their policies in 2018 or 2019. After the COVID-19 pandemic and subsequent lockdown in India, which increased the prevalence of mental disorder symptoms among the general population, the situation began to change.” This was in accordance with a report, which was released in October 2021, one year after the pandemic started.

The report also highlights an insurance claim for hospitalisation costs associated with a schizoaffective disorder diagnosis that was denied because the policy didn’t cover psychiatric illnesses.

What information about mental health insurance should people know?

If the patient needs to be hospitalised, the cost of the treatment will be covered by the mental insurance plan under the MHC Act of 2017. This will protect the price of the examination, the procedure, the medication, the hotel stay, and any other fees. However, this may differ from business to business.

To purchase insurance, you must first research the market. The plans’ costs and levels of coverage can change.

At the moment, neither mental retardation nor an intellectual disability is covered by the Act.