 "Four-fold surge in mental health consultations: How much does insurance cover?")
There has been a four-fold surge in mental health teleconsultations in the 21-30 age group, as compared to the 31-40 age group this year. About 73 per cent of the consultation bookings are from people in the 21-30 age group, revealed a survey by insurance platform Plum.
Plum noted nearly 5500 bookings for mental health tele consultations this year. Analysing the data, Plum noted the following:
Anxiety, stress and coping; relationship issues; self-growth; grief and loss and clinical diagnosis are listed among the top reasons for people seeking consultation.
Approximately 55 per cent of women sought consultation, as compared to 45 per cent of men, indicating that women are more open to seeking assistance for their mental health.
Employees extended the benefit of mental health teleconsultations to their loved ones - 10% of all bookings come from their siblings, 6% from their spouse, and 4% from their parents and in-law.
The cost of mental health consultations for mental health are not cheap. In major cities like Mumbai, Delhi, and Bangalore, the base price for a single consultation typically ranges from Rs 1200 to Rs 2400. This cost can vary further depending on the years of experience of the Psychologist or Psychiatrist providing the service, all for a 50-minute session.
More From This Section
Mental health coverage in health insurance has improved since the Mental Healthcare Act of 2017, which made it mandatory for insurance companies to cover mental illnesses. However, the COVID-19 pandemic worsened mental health issues, leading the insurance regulator (IRDAI) to make it compulsory for insurance policies to include mental illness coverage from October 1, 2022.
Most health insurance plans in India cover inpatient care, while mental health often requires outpatient treatments like therapy and counselling hence outpatient mental health treatment is only covered during the hospitalisation and post hospitalisation period.
So, when picking a health insurance policy, it's crucial to carefully check what mental health coverage is provided. Make sure it includes the specific mental health conditions and treatments you might need.
"Nowadays, a majority of comprehensive health insurance policies provide coverage for hospitalization expenses that may arise due to potential mental health conditions such as anxiety, traumatic stress, acute depression, dementia, and bipolar disorder. A mental health insurance plan provided by a well-known insurer, with a strong track record of claim settlements, includes a wide range of inpatient hospitalization expenses. These expenses include various costs such as comprehensive treatment costs, diagnostic expenses, room charges, ambulance fees, pharmacy bills, and more. It is advisable for policyholders to consider adding an Outpatient Department (OPD) coverage option to address expenses associated with doctor consultations, pharmacy expenses, health check-ups, diagnostic tests, and similar medical services," said Siddharth Singhal, Business Head - Health Insurance, Policybazaar.com.
The coverage for psychotherapy treatment under health insurance policy can vary depending on the specific insurance plan and provider. Typically, health insurance policies do provide coverage for mental health treatment, including psychotherapy, but there may be limits and conditions.
Here are some general points to consider, according to Sharad Mathur, Managing Director & Chief Executive Officer, Universal Sompo General Insurance Company Limited.
Many insurance policies have a maximum limit for mental health treatment. This limit can vary significantly between policies.
Some insurance providers offer separate mental illness coverage, often referred to as "Mental Health Rider" or "Mental Health Cover." This coverage may include expenses related to therapy, counseling, and treatment for mental health conditions.
Some insurance policies may have waiting periods before you can avail mental health coverage. This means you may need to wait for a certain period after purchasing the policy before being eligible for mental health benefits.
Coverage for pre-existing mental health conditions may have certain restrictions or exclusions, so it's essential to understand these terms in your policy.
Like all other pre-existing illnesses, mental illnesses also have a waiting period. You need to check with the respective insurer about the waiting period.
Business Standard studied several medical insurance policies with OPD benefits only to find that counselling and therapy do not form a part of this plan. Point to note: Very few insurers cover consultations and counselling for mental illness under the OPD benefit.
You should check first if you are plan has the option for both OPD benefit and mental illness benefit, in your health insurance policy.
Mental health insurance covers expenses only when the patient has to be hospitalized. Very few insurers cover expenses for out-patient care like consultations. Any mental illness induced due to drug or alcohol abuse will not be covered. Also, if there’s history of recurring mental condition, the claim might not be accepted.
Business Standard studied several medical insurance policies with OPD benefits only to find that counselling and therapy do not form a part of this plan. Point to note: Very few insurers cover consultations and counselling for mental illness under the OPD benefit.
You should check first if you are plan has the option for both OPD benefit and mental illness benefit, in your health insurance policy.
Mental health insurance covers expenses only when the patient has to be hospitalized. Very few insurers cover expenses for out-patient care like consultations. Any mental illness induced due to drug or alcohol abuse will not be covered. Also, if there’s history of recurring mental condition, the claim might not be accepted.