Does My Insurance Cover Therapy?


Does My Insurance Cover Therapy?

Due to various reasons, people often tend to ignore the signs of mental health problems. Be it the fear of societal judgement or self-doubt. Globally, every 1 in 8 persons suffer from mental illness, and only in India, there are more than 14% of mental health cases that need quick treatment. Out of these, around 80% of people receive no treatment, as per the World Health Organization. 

Mental Health: Not a Myth

Mental health has been gaining the attention of millions, yet people are deprived of treatment. It is high time that society breaks the stereotype and comes together for a happy future. Before purchasing a health insurance, people often wonder, 'Does my insurance cover therapy?'. 

Thankfully, since 31st October 2022, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated coverage for mental health for all health insurance companies. 

While health insurance companies offer mental health coverage, this blog includes our expert’s take on your query- “Does my health insurance cover therapy?

Does Your Medical Insurance Cover Therapy?

Owing to the rise of mental illness and the lack of treatment awareness, ‘Will my insurance cover Mental Health?’ should be the first question to pop up in your mind while choosing a health insurance plan.

The good news is that the answer is yes! 

Any mental health illness that may require a 24-hour hospitalisation is covered under the health insurance plans offered by Care Health Insurance. Additionally, with the help of Care OPD- an add-on benefit, you may even get coverage for up to 4 psychologist consultations per policy year per the policy terms & conditions under your health insurance plan.

What is Mental Health and Associated Problems?

The psychological well-being of an individual and a balance of emotions are broadly referred to as good mental health. No matter how physically healthy you are, it is always the will and the zeal towards life that keeps you going. Hence, having psychological well-being is very important.

However, sometimes, there can be incidents in life that may leave you shocked or give you long-term emotional trauma. Any of these may lead to certain mental health problems, such as:

1. Bipolar Disorder: Different from the everyday ups and downs of moods, a person with bipolar disorder may suffer extreme ups and downs of emotions, and it can be overwhelming.

2. Persistent Depressive Disorder: Also known as dysthymia, people with persistent depressive disorder may find daily activity tough to perform, and the condition may remain for around 2 years.

3. Major Depressive Disorder (MDD): People with MDD experience extreme sadness and hopelessness. It may continue for 2 weeks or longer. The sufferer may find it difficult even to live anymore. 

4. Generalised Anxiety Disorder (GAD): GAD is different from usual everyday anxiety. It may be extreme at some points, like anxiety before a big event. The patient may get extremely nervous.

5. Obsessive-Compulsive Disorder: OCD can cause people to have repetitive thoughts and uncontrollable compulsions. People with OCD may also feel a lack of control towards things they find unreasonable.

6. Post-Traumatic Stress Disorder (PTSD): PTSD is usually caused by serious, overwhelming incidents like the loss of a loved one(s), wars, accidents, etc. It may cause flashbacks and then continued sadness.

7. Social Anxiety Disorder: People with social anxiety may find it difficult to cope with many people around. Attending a social event or huge gathering may be mentally very tough for them.

8. Schizophrenia: Schizophrenia is a condition that needs quick treatment. It may cause hallucinations and other related problems.

What Therapy Does My Insurance Cover?

As aforementioned, a health insurance policy covers the cost of mental health. Here is what it covers:

1. List of Diseases Covered

  • Acute Depression
  • Bipolar Disorder
  • Schizophrenia
  • Post-traumatic Stress Disorder (PTSD)
  • Obsessive-Compulsive Disorder
  • Mood Disorders
  • Anxiety Disorders
  • Hyperactivity/attention Deficit Disorder
  • Psychological Disorders.

2. Consultation and Treatment Expenses

Usually a mental health insurance plan usually covers the hospitalisation,  consultation, and treatment expenses. Please note that coverage limitations may vary from insurer to insurer. .

3. Counselling and Psychotherapy Sessions

If you are wondering whether your mental health insurance plan covers counselling, reviewing the policy documents is the right way to find out. While most insurers may not offer coverage for OPD psychologist counselling sessions, you may get up to four consultations with a specialist psychologist by opting for the Care OPD add-on benefit under your Care Supreme- Health Insurance Plan.

4. Hospitalisation Expenses

In some cases, hospitalisations may be advised. In such a case, the pre and post-hospitalisation and the in-hospitalisation expenses are covered.

How Do I Know if My Insurance Covers Therapy?

After going through the aforementioned information, you may wonder 'how to know if my insurance covers therapy'. There are many ways in which you can know about it:

Ask Your Insurer

The best solution to “how to check if my insurance covers therapy”is to directly ask your healthcare provider. You may call them and clarify the arising doubts about mental health insurance coverage.

Refer to Policy Documents

You can simply log in to your health insurance account and check the coverage, exclusions and terms & conditions of the plan.

Let’s Conclude

Mental health problems are serious conditions, and one must not delay in seeking medical help. Now, all the health insurance companies are required to cover mental health, so that we can combat mental health ailments as a country.

Above all, it is important for everyone around, friends and family, to help each other come out of such a situation. Only when you start taking mental health as a normal health issue can the condition get better.

Under Care Supreme plan of Care Health Insurance, the counselling expenses are covered under mental health benefit.  You may check out the plan details and keep yourself updated with the coverage. 

We wish you good health!

>> Also Read: Importance of Pre-policy Health Insurance Check-up

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.

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