“I wish people could understand that the brain is the most important organ of our body. Just because you can’t see mental illness like you could see a broken bone, doesn’t mean it’s not as detrimental or devastating to a family or an individual.”
— Demi Lovato
With the increase in awareness about mental health there should be options as well to increase the availability and affordability of therapy for those who wish to get treated. That’s where mental health policy plays an important role in the time of need. “Section 21 (4) of the Mental Healthcare Act (MHCA) 2017 mandates all insurance companies to provide medical insurance for the treatment of mental illness on the same basis as for physical illness. What this means is that insurance companies can no longer exclude treatment of mental illness from the coverage provided to physical illnesses.”
However, the truth is that even after the IRADI (Insurance Regulatory and Development Authority of India), in 2018, issued a notice to all insurance companies to provide insurance for mental illness, till date there are very few companies that provide the same, and nearly 0 that have an exclusive policy for the same.
As the youth of the nation, we decided that if the insurance companies can’t or don’t want to make such a policy then we will do it, and hence we framed a draft exclusive mental health policy, based on a survey that assessed the needs of the people aged between 18 – 35, from all over India. We specifically chose this population since mental illnesses in India are experienced the most by individuals in this age group.
This policy is the need of the hour since India has been termed as the most depressed country in the world.
We are aware that insurance terminologies are not easy to understand. Hence, we will first provide a basic understanding of:
a) What an insurance policy is
b) What a mental health insurance policy is
c) Basic features in existing mental health insurance policies
a) Insurance policy
Insurance is a contract, represented by a policy, in which an individual or entity receives financial protection or reimbursement against losses, from an insurance company. The company pools clients’ risks to make payments more affordable for the insured.
b) Mental health insurance policy
Mental health policies define a vision for the future, which in turn helps to establish benchmarks for the prevention, treatment, and rehabilitation of mental disorders, and the promotion of mental health in the community.
c) Basic features in existing mental health insurance policies
- Medical expenses incurred towards treatment taken during in-patient hospitalization of the insured person, arising out of a condition caused by or associated with a mental illness, stress, anxiety, depression, or a medical condition impacting mental health.
- Pre-hospitalization medical expenses incurred for up to 30/60/90 days
- Post-hospitalization medical expenses incurred for up to 60/90/180 days.
- Disorders usually covered: Severe Depression, Schizophrenia, Bipolar Disorder, Post Traumatic Stress Disorder, Eating disorder, Generalized Anxiety Disorder, Obsessive-compulsive disorders, Panic disorders, Personality disorders, Conversion disorder, Dissociative disorders.
- Therapies are not covered.
- E consultation not covered.
- Cashless hospitals – psychiatry specialty hospitals not provided.
Before we begin with explaining the mental health insurance policy that we drafted, we would like to give a disclaimer that this has not been approved officially, it is something we have personally worked on.
Brief about our mental health policy
- Our policy’s name is ‘Mental Health Insurance’. And the tagline is: ‘Mental health se hai Pyaar, MHI hai na Yaar!’
- This is how our logo looks.
- Meaning behind this logo – We all know how important it is to integrate the mentally ill into the community. There is a circle of people to show community support towards the mentally ill. The brain, which represents mental illness, has been placed in the center. The arrows, which are the ‘greater than’ mathematical symbols, represent that mental health is crucial.
- Our policy consists of features that will support you through all aspects of your mental health treatment, which is the primary goal. The sub-goal of this policy is psychoeducation.
- We have made an exclusive mental health policy and not an integrated one because, in the latter, the cover for mental health is only 50,000 INR. The cover should be much more because mental health treatment expenses can go up to 8 lacs.
Here are some important terminologies used in our policy
Reading this is important because the meaning of a word in English and the meaning of the same word in psychology can be very different. For the definitions, we have referred to the Diagnostic and Statistical Manual of Mental Disorders (DSM) – 5 and the APA (American Psychological Association) dictionary of psychology.
- Psychoeducation – “Psychoeducation refers to the process of providing education and information to those seeking or receiving mental health services, such as people diagnosed with mental health conditions (or life-threatening/terminal illnesses) and their family members.”
- Mental health – “A state of mind characterized by emotional well-being, good behavioral adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life.”
- Mental illness/Mental disorder – “Any condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these.”
Our mental health policy includes all the illnesses that are there in the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders.) Hence covering each and every disorder that happens to people. We did this because we saw mostly no policy that provides cover for all disorders that are there in the DSM 5.
The cover of the policy is 10 lacs, with a premium of 8163 INR.
Exclusions – Suicide, Alcohol/Drugs – However, this falls as substance abuse under our rehabilitation feature.
The following are the highlights of the features in our draft policy
- No claim bonus – You will get a 10 percent increase to your already increased cover if you attach valid proof of the same.
- E consultation – Due to the pandemic, everything has shifted online. For the purpose of customer safety, we are providing this service. If you are taking consultation from the following apps then we will cover your e-consultation charges.
- Critical illnesses – are life-threatening critical diseases. The critical illnesses, in terms of psychological disorders, include – anorexia, schizophrenia, bipolar disorder, and, major depression.
- Seasonal illnesses – Seasonal depression (Seasonal affective disorder).
- OPD Services – Therapies.
- More than 2000 INR cover for transportation charges.
- Cashless hospitals – list of it that specifically deal with mental illnesses.
- Special Pandemic Cover – As a consequence of the pandemic, mental health issues are on the rise, such as Adjustment Disorder, Depression, Anxiety, and panic disorder. These mental illnesses will be covered only when they are due to the following causal factors – quarantine, social distancing, work from home.
- Hospitalization and or Therapy at home – It will be provided for the following mental illnesses since they are chronic and or incurable in nature – “Schizophrenia, severe mood disorders, and some personality disorders (such as schizotypal, schizoid, or borderline) since it may lead to chronically disabling symptoms.” (This is given since integration in the community for such people is very important. Also, institutionalizing them will only deteriorate their condition.)
- Air ambulance – From one psychiatric hospital to the other. The cover for this will be 2 lacs.
The following are the benefits that are available under our policy
- Mental health routine check-up – This is just like your regular physical health routine check-up. As a benefit, if you buy this mental health insurance policy then every year you will be eligible to get a free mental health routine check-up.
- Mental health awareness program – As a part of the psychoeducation goal, on the same day as the mental health routine check-up, you will avail of a free application-based program. Here, psychologists will teach you how to keep yourself mentally healthy. Practicing gratitude, affirmations, effective goal setting, applying positive psychology, are a few things you will learn. Therapy will not be provided in this program. However, you will learn art therapy and dance therapy, which will motivate you to go to therapy.
That’s not it. There are some more unique perks
- There is no maximum age entry limit. We have kept this because old people also have several psychological illnesses which need to be addressed.
- Another feature is our reduced waiting period – Waiting period – 0 (Acute cases), 1 year (Non-acute cases). (The mental health cases that go to hospitals are usually acute in nature, hence waiting periods will cause greater harm to the individual.) (1 year because in the DSM 5 symptoms have to exist for a minimum of 3 months and a maximum of 2 years, which varies from disorder to disorder, hence the middle ground is a waiting period of 1 year.)
- You get to pay the premium in installments if you choose to do so. We provide 4 types of installments – Monthly, Quarterly, Half-yearly, and yearly.
What’s in it for the people who buy our policy?
- Minimum documentation
- Maximum cover at a low price
- The same premium for the 18 to 80 plus age group
Mental health is very important, so make sure you buy your mental health insurance policy today! Here is a list of existing integrated mental health policies that you can look into: Health Premia Policy, Heartbeat Policy, Max Bupa Health Pulse, Niva Bupa Health Reassure, Manipal Cigna Life Time Health.
As we say, insuring mental health = prioritizing mental health ≥ physical health. The day you insure your mental health is when you have prioritized the most important aspect of your life.
Aashna Khosla and Alphy Hari are pursuing M.Sc in Psychology from Amity University, Mumbai. They have published research papers on mental health and social issues in leading journals. If you liked their policy and the above quote, share it on Instagram and tag them at @aashna_khosla and victorious_lilliput.