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Do Health Insurance Plans Cover Me For Mental Illnesses?

Published On Jul 04, 2021, Updated On Jul 06, 2021

A health insurance policy is meant to cover you from the high costs of medical expenses that can incur from any uncertain emergencies. There is a defined list of diseases that are covered under the health insurance policies, some critical disorders are covered under the critical illness plans which specifically meet the requirements of the policyholders. IRDAI has made it a compulsion for all the insurers in the insurance market to include mental illness in their health insurance policies. 

With the change in lifestyle and the growing spread of the pandemic, many people have gone through difficult phases, that have made them realize the importance of the mental well-being of an individual. Mental and emotional well-being controls our daily activities like the way we interact and the way we make choices. Thus, mental disorders lead to retardation of cognitive capacities and hamper the daily life of an individual. 

Do Health Insurance Plans Cover Me For Mental Illnesses?

Why Is It Important to Include Mental Illness In Health Insurance Plans? 

Earlier, much importance was not given to the mental well-being of an individual, but as the times have changed, the awareness of psychological well-being has spread all over and everyone has come to realize its importance. Therefore, IRDAI has made it mandatory for insurers to include mental illness in their health insurance policies. Along with the mental illness, the insurers have also included psychological disorders, neural illnesses, stress, etc. With the help of such covers, people are getting access to quality treatment and the financial burden on their savings is also reduced. 

Benefits of Mental Illness Health Insurance Plans 

Following is the list of benefits of mental illness health insurance plans: 

  • According to the Mental Health Act, 2017, insurers provide you with a mental illness cover that you can avail of when needed. 
  • The average fees of a psychologist can be covered with the sum assured under this plan 
  • Certain plans offer sub-limits on pre-existing mental illnesses. 
  • Rehabilitation and hospitalization expenses are also covered. 
  • It comes with a hassle-free claim settlement option where you can claim your policy benefits smoothly. 

Coverage of Mental Illness Health Insurance Plan 

Let us look at the waiting period and coverage of the health insurance plans offering mental illness covers: 

  • It covers the expenses incurred during hospitalization, OPD treatment, doctor’s consultation, and rehabilitation. 
  • Mental illness covers come with an average waiting period of 2 to 3 years. Therefore, the benefits of this policy can be availed only after the completion of the waiting period. 
  • The sum assured under this policy ranges from Rs. 5 Lakh to Rs. 10 Lakh. You must choose the sum assured according to your financial capability and pre-existing conditions. 
  • Some insurers have specified certain illnesses for a particular age group of people. In the case of mental illnesses like autism, coverage benefits are provided to the age group of 3 to 25 years. 

Exclusions of Mental Illness Health Insurance Covers 

Mental retardation is not included under the coverage of the mental illness health insurance policy as it is not a mental illness that has occurred to an individual suddenly. Also, mental disorders that arise due to alcohol consumption or any other substance abuse will not be covered under this plan. 


By providing mental illness cover in the health insurance plans, IRDAI has released so much of our stress. Mental illnesses are quite common these days and need immediate medical or professional attention which can require a good amount of money. Therefore, to get quality treatment at the right time without losing your savings, you must invest in a health insurance plan. Always while buying a health insurance plan make sure that it includes the mental illness cover. You should never ignore the terms and conditions of your purchased policy as it covers the inclusions and exclusions of your policy. 

Also Read: Health Insurance Plans For Mental Well Being

How to Stay Physically & Mentally Fit at Home?

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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