You can now get cashless insurance for inpatient mental health care

Sukoon Health has collaborated with five insurers to offer cashless coverage for mental health treatments, enhancing accessibility and affordability in India

 Sukoon Health, a chain of mental healthcare hospitals, has inked a pact with five private insurance companies to provide cashless insurance coverage for patients seeking psychiatric inpatient care.

The comprehensive mental health insurance offers coverage for a wide range of conditions, including Bipolar disorder, Acute Depression, Anxiety disorders, Schizophrenia, Mood disorder, Psychotic disorder, Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorders, and Attention-deficit/hyperactivity disorder. 

"By ensuring the inclusion of these diagnoses, Sukoon guarantees that policyholders can access the care they need without fear of claim denial," the company said in a release.

 Sukoon has partnered with HDFC Ergo and Plunes HealthCare, an aggregator where in leading insurers like; Magma HDI, ICICI Lombard and Aditya Birla Capital are empaneled, enabling patients to seamlessly avail cashless insurance benefits. However, individuals are required to undergo a minimum hospitalization period of 24 hours, acting as the necessary duration for initiating insurance claims within the mental health coverage.

Certain treatments, such as those for alcohol dependence, substance dependence , self-harm, and talk therapy, are excluded from coverage and are ineligible for cashless insurance benefits. It is crucial to be aware that insurers are not liable to cover pre-existing mental diagnoses under the policy, emphasizing the need for careful consideration and understanding of coverage terms.

During Mental Health Awareness Month in October 2023, Sukoon conducted a survey which revealed s substantial knowledge gaps regarding various mental health conditions and insurance coverage. 

In 2020, the Insurance Regulatory and Development Authority of India (IRDAI) directed all health insurance providers to cover mental illnesses, which include psychological disorders. 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. 

"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.

At least 82% of respondents were unaware that insurance can cover the costs of mental health treatment. The survey, conducted across India and encompassing a wide age range, revealed some key findings that point to both progress and persisting challenges in the realm of mental health care.

Notably, 33.8% had limited to no knowledge about Alcohol & Drugs Addiction, while 22% had a moderate understanding. Knowledge gaps persisted for conditions like bipolar disorder (25.7% limited knowledge), psychosis (54.67% minimal knowledge), schizophrenia (23.86% limited knowledge), Severe Anxiety (24.18% minimal knowledge), and Severe Depression (22.87% minimal knowledge). 

Approximately 24 per cent of respondents indicated that either themselves or someone they knew had experienced a serious mental health disorder. This statistic underscores the widespread impact of mental health conditions within Indian society, emphasizing the urgency of prioritizing mental health on a societal level. 

A significant 29 per cent of participants agreed that mental health conditions require proper diagnosis and treatment, demonstrating a broad understanding of the importance of mental health care and the need for support and intervention. Approximately 33 per cent of individuals actively seek treatment from therapists or counsellors for serious mental health conditions.