Health Insurance Coverage for PTSD in India

How Health Insurance Supports PTSD Treatment Costs

The Addiction Equity Act and Mental Health Parity regulate insurance coverage for Post-Traumatic Stress Disorder (PTSD), especially covering treatments. Most insurance policies include a variety of treatments for PTSD, including therapies along medications are usually covered under the insurance policy. 

PTSD is the most common mental health disorder that usually occurs after traumatic events. This mental disorder is related to morbidity but effective psychotherapy and pharmacotherapy are available to treat it. Approximately 3.9% of people worldwide have had this mental disorder, PTSD at some stage of life.

PTSD Coverage in India

Currently, everyone is vulnerable to psychological problems due to busy lifestyles and excessive stress. Recognising the importance of the well-being of mental health, IRDAI guides Indian health insurance providers in adding coverage for psychological disorders compulsively. In February 2023, IRDAI launched the circulation of mandatory healthcare coverage services against mental health problems. Coverage includes expenses of inpatient hospitalisation for both physical and mental illnesses.

Individuals who have experienced PTSD and have a family history of mental illness due to stress can purchase mental illness coverage.

Reason for Buying Coverage for Psychological Disorder

Neglecting treatment for PTSD can affect the livelihood of the patient who may need proper medical advice to manage the worst condition.  Treatment expenses can be costly. Acquiring good coverage for psychological disorders will provide financial security in emergencies. PTSD coverage will enhance an individual's accessibility to various care and treatment options.

Moreover, the policy includes hospitalisation, diagnostics, therapeutic expenses including ambulance fees and medicine costs, etc. So buying PTSD coverage can contribute to financial support through the treatment process.

Exclusions of Psychological Disorder Coverage

Insurance plan for PTSD coverage entails some exclusions. Here are the following exclusions you need to know:

• Psychological or Mental illness that occurs from excessive alcohol and drug abuse is excluded from medical insurance coverage.
• Operative and conservative treatment of joint diseases.
• Rest cure, respite care, and rehabilitation expenses come under exclusive options.

Coverage Claim Procedure for Emergency Condition

It is mandatory to file a claim within 15 days from the discharge date. Here is the process to claim coverage for emergencies.

• Contact the insurance company and inform them of the coverage ID number.
• Fill out the pre-authorised form and submit it to the hospital desk.
• Complete KYC with address and identity proof.
• Submit required documents such as policy documents, hospitalisation bills, ambulance bills, medical reports, medicine bills, and discharge papers.
• After a particular waiting period, the policyholder and family will get coverage.

IRDAI mandates insurance coverage for mental illness including any psychological and psychiatric disorders.