Mental Health Insurance

Quick Overview

Mental health insurance is a type of coverage that pays for hospitalization and treatment of conditions like depression or anxiety. The IRDAI circular does not maintain a fixed list of mental disorders that must be covered under health insurance. Still, it directs the insurers to offer coverage for the treatment of mental illness, stress, or psychological disorders like schizophrenia, panic attacks, Post-traumatic stress disorder, or bipolar disorders that are deemed ‘medically necessary.’

The Mental Healthcare Act, 2017, requires insurers in India to provide medical insurance for the treatment of mental illness on the same basis as physical illness. IRDAI reiterated this requirement and asked insurers to confirm compliance by October 31, 2022.

At Ditto, we’ve helped thousands of families understand these complexities of mental health insurance claims. Drawing from IRDAI rules, insurer practices, and real claim cases, this guide explains how mental health insurance in India works, why coverage matters, and what to watch for when choosing a plan.

How Does Mental Illness Health Insurance Work?

Mental health insurance coverage includes inpatient treatment, such as hospitalization, counseling, prescription medication, and other medically necessary interventions. Here’s how it usually works:

Coverage Activation: Complete waiting periods or pre-existing condition clauses specified in the plan.
Seeking Treatment: Consult healthcare providers or mental health professionals within the insurer’s network.
Claim Process: Depending on your policy, you may receive cashless treatment at network hospitals or pay out-of-pocket and claim reimbursement.
Financial Assistance: Insurance covers costs up to the policy limits for hospital stays, medications, and diagnostic procedures.

Best Health Insurance for Mental Health Coverage in India

All health insurance plans in India cover hospitalization for mental illnesses by default, but some offer extra benefits like outpatient therapy and counseling. Here are some notable plans with enhanced mental health features. But remember, coverage and issuance always depend on the insurer’s underwriting.

1) Care Supreme

The Care OPD Rider under Care Supreme offers the insured mental health support through specialist psychiatrist and neurologist consultations up to ₹500 per visit, for 4 in-person visits, and unlimited e-consultations with general physicians.

Here’s a quick look at how premiums for this plan vary for a sum insured of ₹15 lakh for someone residing in Delhi who has also opted for an OPD care add-on.

Premium Comparison for Care Supreme

Profile	OPD Care Premiums	Total Premiums
Self (25 years)	₹578	₹15,689
Self (31 years) + Spouse (32 years)	₹1,155	₹22,683
Self (31) + Spouse (32) + Children (5 and 8 years)	₹2,310	₹35,104
Parent/ Senior Citizen (Father and Mother - Both 60 years)	₹1,155	₹66,564

2) TATA AIG’s Medicare Select

The mental wellbeing rider is available with Tata AIG’s Medicare Select Plan. It enhances your health insurance by covering annual mental health screenings and essential diagnostic tests each policy year. The plan also offers up to 10 cashless psychological therapy sessions and four diet consultations every year. Its unlimited stress management rider offers continuous support in the form of consultative services for anxiety, work-life balance, and emotional wellbeing.

Take a glance at how premiums for this plan vary for a sum insured of ₹15 lakh for an individual choosing the mental wellbeing rider:

Premium Comparison for TATA AIG Medicare Select

Profile	Mental Wellbeing Premiums	Total Premiums
Self (25 years)	₹899	₹10,463
Self (31 years) + Spouse (32 years)	₹1,798	₹18,493
Self (31) + Spouse (32) + Children (5 and 8 years)	₹3,596	₹27,068
Parent/ Senior Citizen (Father and Mother - Both 60 years)	₹2,000	₹61,478

3) HDFC ERGO Optima Secure

The Optima Wellbeing Add-on is available with HDFC Ergo Optima Secure, providing clear mental illness hospitalization coverage. With this rider, the insured can access unlimited e-counseling with psychologists for mental health, stress, anxiety, and related disorders via digital platforms. These sessions, available via video, audio, or chat, offer convenient, on-demand mental health care support.

Here’s how premiums for this plan vary for a sum insured of ₹15 lakh for a person choosing the Optima wellbeing add-on:

Premium Comparison for HDFC ERGO Optima Secure

Profile	Optima Wellbeing Premiums	Total Premiums
Self (25 years)	₹949	₹15,079
Self (31 years) + Spouse (32 years)	₹1,899	₹24,171
Self (31) + Spouse (32) + Children (5 and 8 years)	₹1,899	₹32,807
Parent/ Senior Citizen (Father and Mother - Both 60 years)	₹1,899	₹68,903

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Did You Know?

Ayushman Bharat and PM Health Insurance (PM-JAY) includes treatment for mental health procedures like schizophrenia, autism spectrum disorders, and intellectual disability. It provides cashless healthcare services for 1961 procedures across 27 medical specialties, including 22 procedures under Mental Disorder Speciality.

Benefits of Buying Health Insurance for Mental Illness

Rising Prevalence

India’s national helpline Tele-MANAS has already handled over 29.8 lakh calls, reflecting the rising need for mental health support and insurance for effective management.

High Treatment Costs

Health care for psychological and neurological conditions can be expensive. Mental health insurance helps cover costs, reducing financial strain.

Early Intervention

Encourages early treatment and ongoing support, vital for effective management and recovery.

Peace of Mind

Provides financial security and reassurance, allowing you to focus on your mental health without worrying about costs.

Inclusions and Exclusions of Mental Health Insurance

Inclusions	Exclusions
Inpatient hospitalization for diagnosed mental illnesses and daycare procedures (if policy treats it as covered)	OPD consultations and therapy sessions may not be covered or may have sub-limits
Treatment for conditions like depression, anxiety, bipolar disorder, schizophrenia (as defined in policy)	Pre-existing mental health conditions during the waiting period
Room rent, doctor fees, medicines, and diagnostics during hospitalization	Treatments not prescribed by a registered psychiatrist and rehabilitation/long-term residential programs
Cashless treatment at network hospitals (if available)	Experimental, alternative, or unproven therapies
Pre- and post-hospitalization expenses related to covered admission	Self-inflicted injury or suicide attempts (as per policy wording)
Day care procedures related to mental health, if listed	De-addiction and substance-use related admissions unless specifically covered

Who Should Buy Mental Health Insurance?

Mental health is not something to opt for because it is present across all policies and is best suited for:

Anyone buying health insurance should ensure their plan does not exclude mental illness hospitalization (this is now expected to be covered).
People who actively want therapy/counseling coverage should shortlist plans with OPD riders
People with prior diagnosis should plan for underwriting and consider the “specific cover” option if standard retail underwriting becomes hard

How to Choose a Mental Illness Health Insurance Policy?

Coverage Scope: Ensure the policy includes a wide range of mental health conditions and covers inpatient and outpatient treatments.
Network of Providers: Access to a broad network of hospitals and mental health professionals is crucial.
Exclusions and Waiting Periods: Review exclusions and understand waiting periods before claims.
Policy Limits: Check treatment and therapy coverage limits.
Claim Process and Support: Assess the insurer's claim process and customer service.

How to Claim Health Insurance for Mental Health?

The process for making mental health insurance claims is the same as for other conditions. Refer to our guide on how to claim health insurance for further details.

Ditto’s Experience with Mental Health Insurance Claims

Akshat Bhatia, our Claims Manager, says:

We understand that mental health care is deeply important. At Ditto, we have received a few claims related to mental health conditions, but most of them were denied because the need for hospitalization couldn’t be medically justified. In many cases, mental health treatments such as therapy and counselling are appropriately provided on an outpatient (OPD) basis. Since OPD isn’t covered in most plans, the claims don’t qualify for admission-based coverage.

Why Choose Ditto for Health Insurance?

At Ditto, we’ve assisted over 8,00,000 customers with choosing the right insurance policy. Why customers like Pallavi below love us:

No-Spam & No Salesmen
Rated 4.9/5 on Google Reviews by 15,000+ happy customers
Backed by Zerodha
Dedicated Claim Support Team
100% Free Consultation

Confused about the right insurance? Speak to Ditto’s certified advisors for free, unbiased guidance. Book your call or chat on WhatsApp us now!

Ditto’s Take on Mental Health Insurance

Many insurers offer policies supporting your mental well-being through OPD riders or add-ons. While choosing a plan, look for clear mental illness coverage, reasonable waiting periods, and easy claims processing.

Always disclose your mental health history honestly, as non-disclosure can lead to claim denials or cancellations. Ask yourself, “Will this plan support me when I need it most?” If yes, you’ve found the proper coverage. You can also seek expert guidance if you are still unsure if the plans offering mental health insurance are the right fit for your needs.

Disclaimer

This article is based on Ditto’s independent evaluation framework. We do not claim these are the only suitable policies, but they are among the stronger performers shortlisted by our in-house IRDAI experts. Always review the policy wording and consult a licensed advisor before making a purchase. To learn more about how we evaluate plans, refer to Ditto’s Cut.

Frequently Asked Questions

Why choose health insurance for mental health?

Mental health insurance helps cover therapy, consultations, medicines, and hospitalization costs. It protects savings, supports consistent treatment, and reduces financial stress during recovery, subject to policy terms.

I already have a diagnosis. Can I get insured?

The Mental Healthcare Act, 2017, requires insurers to create standardized, non‑denial covers for persons with mental illness. So even if you have a mental health history, you can still get insured. However, you might not get a very comprehensive policy depending on diagnosis.

What if my policy application is denied due to the severity of my condition?

Insurers may present you with standardized solutions, such as Care Saksham or HDFC EquiCover, as a counteroffer if comprehensive plans like Care Supreme or HDFC Optima Secure are denied due to the severity of your mental health condition.

Do loading charges apply to pre-existing mental illnesses?

Yes, loading charges apply for pre-existing conditions. In case of mental illnesses, the insurer may increase the premium by 10% to 50%, or more, depending on the severity of the condition. If the condition is severe or there are comorbidities, applications may be rejected or result in permanent exclusion from the health cover.

What if the mental illness is diagnosed post insurance purchase?

If the diagnosis happens after policy purchase, it's not considered a pre-existing condition, so coverage applies by default. Inpatient treatment is covered like any other illness, after the standard 30-day initial waiting period.

Last updated on: 15 Feb, 2026