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Do Health Insurance Plans Cover Psychological Disorders?

Published On Aug 23, 2022 11:00 AM By InsuranceDekho

Issues concerning mental health concerns have become more prominent as a result of the COVID-19 epidemic. Genetic susceptibility to pressure and exhaustion may lead to a wide range of mental health conditions, including everything from anxiety to depression. Understanding problems with mental health is becoming more important nowadays. With this increased pressure, many people who have healthcare coverage ask if their plan covers psychiatric issues.

Do Health Insurance Plans Cover Psychological Disorders?

Psychological Illnesses Are Covered By Healthcare Policies?

The inclusion of mental diseases in healthcare plans has begun as a result of increased attention being paid to individuals' psychological health. According to the Mental Health Act of 2017, IRDAI has mandated that all healthcare companies cover psychological disease the same as any other health sickness. 

Similar to a medical problem, the mental illness included by the healthcare policy takes care of the healthcare bills generated in the treatment of psychological disease and pays for hospitalization, medicine, consultations, ambulance fees, etc. Since mental illness is not a sickness but rather an insufficient development of the brain, it isn't covered by these insurance policies.

Advantages Of Insuring Mental Health

Buying a policy of healthcare that also includes mental diseases has several advantages. Following are a few of these:

  • The expense of hospital stays, therapy, and diagnostics, as well as any necessary ambulance fees, rent of the room, and medication costs are all covered by the psychological healthcare plan.
  • The plan also includes healthcare coverage for individuals with mental illnesses that impair their memory, cognition, analysis, behavior, and mental capability.
  • Several insurance providers additionally include OPD expenses, like doctor's consultation, counseling, and rehabilitation.
  • There are differences between healthcare companies in terms of the premium, features, limitations, and extra perks.

What Does Mental Health Condition Insurance Not Cover?

For psychiatric problems, the usual limitations that apply to other ailments also apply. While several healthcare companies may not include medical visits for mental diseases, other perks, such as stays at the hospital and coverage of rent of the room, remain the same. In addition, psychological health conditions brought on by alcoholism or other substance misuse are not insured by medical coverage. Since drinking alcohol is seen as a kind of harm to self, the limitations here are the same as those that are applicable to alcoholic liver disease.

Does Mental Healthcare Coverage Have A Waiting Period?

To avail of the advantages, one must be admitted for at least 24 hours in order for the medical coverage policies to pay for it. Additionally, like with other already existing illnesses, there may be an extra waiting time of around six months to 24 months if psychiatric problems are included as already existing conditions. 

The precise length of the waiting time will vary depending on the company and policy. Although several variations could have a lengthier waiting period, some more unique plans for healthcare coverage might have only six months long. Examining the policy terms is the best approach to determine the waiting time for psychiatric problems under health insurance policies. You should also confirm if the illnesses are covered by your mental health coverage as already existing or general.


To comprehend your plan's benefits and avoid misunderstanding throughout the procedure of claim settlement, thoroughly read the small print of any policy-related paperwork. Throughout the past several years, the psychological state has become incredibly important, so you should also pay attention to it and take steps to avoid stress.

Also read: How To Pay Universal Sompo Health Insurance Premium Online?

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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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