Does My Insurance Cover Therapy?

• Written by Jyotsana Shekhawat

  Reviewed by Akhil Pillai

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People often tend to ignore the signs and consequences of mental health conditions. This often stems from a lack of awareness or fear of social judgment.

Globally, one in eight individuals experiences mental illness, and in India alone, over 14% of the population requires prompt mental health treatment. However, approximately 80% of those in need receive no treatment, according to the World Health Organization. These statistics highlight the critical need for increased awareness and improved access to mental health care.

Mental Health is not a Myth

Mental health has been increasingly gaining attention, yet people are deprived of treatment. It’s crucial for society to break the stereotype and comes together for a

happy future. However, access and costs of these treatments are beyond the scope of the majority of people. This is where health insurance comes into play. A common question before purchasing health insurance is, 'Does my insurance cover therapy?

Thankfully, since October 31, 2022, the Insurance Regulatory and Development Authority of India (IRDAI) requires all health insurance companies to provide mental health coverage.

Does Your Medical Insurance Cover Therapy?

Given the rising prevalence of mental illness and limited awareness of treatment options, the question 'Will my insurance cover mental health?' is often the first concern when considering a health insurance plan. This should be the first question when choosing a health insurance plan.

Care Health Insurance plans cover any mental health illness that requires 24-hour hospitalization. Additionally, with the Care OPD add-on benefit, you can receive coverage for up to 4 psychologist consultations per policy year, as per the policy terms and conditions.

What is Mental Health and Associated Problems?

Good mental health refers to an individual's psychological well-being and emotional balance. Regardless of physical health, a positive outlook and zeal for life are crucial, making psychological well-being very important.

Life events can sometimes cause shock or long-term emotional trauma, leading to mental health conditions such as:

• Bipolar Disorder: More than just typical mood swings, bipolar disorder involves extreme emotional highs and lows that can be overwhelming.
• Persistent Depressive Disorder: Individuals with persistent depressive disorder may struggle with daily activities, and the condition can last for about two years.
• 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.
• Generalised Anxiety Disorder (GAD): GAD is more severe than everyday anxiety and can cause extreme nervousness, even before common events.
• 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.
• 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.
• 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.
• Schizophrenia: Schizophrenia is a condition that needs quick treatment. It may cause hallucinations and other related problems.

What Therapy Does My Insurance Cover?

As mentioned earlier, health insurance policies do cover mental health. Here's a breakdown of what's typically included:

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

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.

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.

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.

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

Let’s Conclude

Mental health problems are a topic that needs more attention than it already does. This involves being proactive when it comes seeking medical help. Nowadays, allthe health insurance companies are required to cover mental health so that we can combat mental health ailments as a country. The right medical insurance can help your sort out your expenses for the counselling and treatment needed to treat the condition.

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. 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.

We wish you good health!

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.