Health Insurance Plans for Mental Health Coverage

Is mental health covered under health insurance India? Yes, since October 2022, IRDAI mandates that all health insurance plans in India include mental illness coverage at par with physical ailments, per the Mental Healthcare Act, 2017. That means hospitalization for conditions like depression, anxiety, and more must be included. However, unless specifically covered by your health plan, out-patient services (OPD) such as counseling sessions, ongoing therapy, medical consultations, and medicines are typically not reimbursed. Therefore, before presuming that your policy covers these services, be sure it offers OPD coverage.

Mental health is no longer a taboo subject in India. With rising awareness and regulatory backing, insurance plans now include coverage for mental illnesses. As stigma continues to decline, mental health insurance claims in India have surged 30% to 50% over the past 2–3 years, especially in urban areas. These claims are dominated by anxiety and depression, underscoring the growing need for accessible mental health care.

At Ditto, we’ve helped thousands of families navigate the 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.

Which Mental Illness is Covered under Health Insurance?

The IRDAI does not maintain a fixed list of mental disorders that must be covered under health insurance, but directs the treatment of mental illness, stress, or psychological disorders. Health insurance typically covers recognized mental health conditions requiring clinical treatment which include:

• depression
• anxiety disorders
• Post-traumatic stress disorder
• bipolar disorder
• schizophrenia
• Panic attacks

Coverage usually includes inpatient treatment, such as hospitalization, counseling, prescription medication, and other medically necessary interventions. As awareness grows, mental health and emotional well-being are gaining long-overdue recognition in health insurance, marking a shift toward more inclusive, holistic healthcare.

Did You Know? Ayushman Bharat PM-JAY, the public health insurance scheme, includes 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. There are 47 government-run mental hospitals that are functional in the country, including 3 Central Mental Health Institutions

Ask yourself: “Does this help me?” If yes, this coverage is vital to accessing quality care without exhausting finances.

Health Insurance for Mental Health Coverage: Ditto’s Take

 While health insurers have made impressive strides in covering lifestyle diseases like diabetes, hypertension, and high cholesterol, with many offering day-one benefits, mental health coverage still lags.

Despite IRDAI's clear mandate for mental health parity, most insurance plans stop at hospitalization cover. Therapy sessions, counseling, and psychiatric consultations are examples of outpatient mental health care that are either nonexistent or inadequately covered. Regretfully, very few insurance companies include complete, hassle-free access to counseling or mental health drugs in their basic plans or add-ons. 

Customers need to exercise extra caution until this gap is closed. Seek out health insurance policies that specifically cover mental health consultations as part of their OPD coverage. "Mental health coverage" does not imply therapeutic availability. To find out what's covered, read the fine print closely.

What is not covered under Health Insurance?

Not everything is covered. OPD counselling and therapy, which is common for mental health, may be excluded unless you have opted for a health plan with an OPD benefit as an add-on. Some policies still exclude outpatient sessions entirely. 

Other exclusions span specific unproven alternative therapies, self‑harm treatment, or substance abuse breakdowns, even though they could be critical. 

Most importantly, plans may cap the number of therapy sessions or total claim limit per year.

Did You Know? As of April 2025, 53 Tele-MANAS Cells are active across 36 States/UTs, and offer 24×7 tele-mental health services in 20 languages. The helpline has handled over 20.05 lakh calls. In addition, over ₹230 crore has been allocated to the National Tele-Mental Health Programme (NTMHP) in the past three years to strengthen mental health access across India.

What if mental illness is a pre‑existing disease?

Thinking of getting health insurance with a history of mental illness? Here's what you need to know before you apply.

• Coverage isn't guaranteed: Issuance depends on the insurer's underwriting process and risk appetite.
• Waiting Periods May Apply: Expect a 1–3 year waiting period and possible sub-limits or premium loading.

Things to Remember: In conditions of pre-existing mental illnesses, Loading charges apply, and the insurer may increase the premium by 10% to 50%, or more, depending on the severity and nature of the condition. If the condition is severe or in case of comorbidities (multiple mental health ailments), applications can be rejected or may result in a permanent exclusion from the health cover.

• Non-denial is not absolute: IRDAI mandates that mental illness can't be automatically excluded, but it doesn't force insurers to approve every proposal.
• Equal Coverage After Waiting Period: Once the waiting period is over, coverage for mental illness is on par with physical illnesses for hospitalization by default, and OPD if your policy includes it.

Take Note: The Mental Healthcare Act, 2017 requires insurers to create standardised, non‑denial covers for persons with mental illness. So even if you have a mental health history, you can still get insured. Insurers may present you with standardized solutions like Care Saksham or HDFC EquiCover as a counteroffer if comprehensive plans like Care Supreme or HDFC Optima Secure are denied because of the severity of your mental health condition. These IRDAI-approved plans guarantee coverage for mental illness on par with physical problems by adhering to the Mental Healthcare Act.

What if the mental illness is diagnosed post insurance purchase?

Wondering what happens if you're diagnosed with a mental illness after buying health insurance? Here's what you need to know.

• Coverage Starts Automatically: If the diagnosis happens after policy purchase, it's not considered a pre-existing condition, so coverage applies by default.
• Hospitalization is Covered: Inpatient treatment is covered like any other illness, after the standard 30-day initial waiting period.
• OPD Services Are Usually Excluded: Therapy, counselling, and outpatient consultations are not covered unless OPD benefits are explicitly included.

Regardless of these points, it is always important to inform your insurer of your mental health needs proactively and obtain written acknowledgement to avoid complications during future claims.

IPD vs OPD in Mental Health Insurance: What’s the Difference?

When it comes to mental health coverage, one of the most common (and costly) misunderstandings is around IPD vs OPD treatment.

IPD (In-patient Department) Treatment

This involves hospitalization when a patient is admitted for psychiatric care, typically for more than 24 hours. This includes treatments for severe mental illness episodes, such as schizophrenia or bipolar disorder crises that require hospitalization, medication management, and intensive therapy.

Under IRDAI guidelines, health insurance policies are required to cover such inpatient (IPD) mental health treatments. This includes essential hospital expenses like:

• Hospital room charges
• Psychiatric evaluation
• Medication administered in the hospital
• Emergency admissions due to acute episodes

But ask: How often is IPD really required for mental illness? For most, it isn’t.

OPD (Out-patient Department) Treatment

OPD covers therapy sessions, psychiatrist consultations, and medication, the kind of treatment most mental health patients actually need. However:

• Most health insurance plans in India do not cover OPD by default
• You often need an add-on (The Optima Well-being add-on available with HDFC Optima Secure) or a specialised plan for OPD benefits (Like Niva Bupa Health Premia)

Ask yourself: Will I need regular therapy or medication outside the hospitalisation cover? If yes, pick a policy with OPD coverage—it’s where real value lies for mental health.

TAKE NOTE: From a cost-benefit perspective, if you only expect 2–3 therapy sessions a year (around ₹1,000 each), paying extra for a mental health OPD rider may not be the most value-for-money choice.

Health Insurance Plans for Mental Health Coverage (2025) That Make Ditto’s Cut

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

Before we jump into the list, here’s how we decide what “best” means. At Ditto, every plan goes through our six-point evaluation framework. This framework is why we’re comfortable using the word “best.” It doesn’t mean these are the only good plans, but that they stand out after being scored across all six pillars. You can learn more about how we evaluate the plans here.

1. Care Supreme Plan with the Care OPD Rider offers the insured mental health support through specialist psychologist consultations up to ₹500 per visit for four in-person visits and unlimited e-consultations. This provides flexible and affordable access to mental wellness care.

Here’s a quick look at how premiums for this plan vary for SI of 15 lakh:

Self (38 years)	₹18,051
Self (38 years) + Spouse (34 years)	₹26,069
Self + spouse + children (son and daughter both 5 years)	₹36,825
Parent/ senior citizen (father and mother both 60 years)	₹61,348

*premiums are inclusive of gst

2. TATA AIG’s mental well-being rider available with its Medicare Select Plan enhances your health insurance with annual mental health screenings with essential diagnostic tests once every policy year. To promote holistic care, the plan offers up to 10 cashless psychological therapy sessions and four diet consultations every year. In addition, its unlimited Stress Management Rider offers continuous support for anxiety, work-life balance, and emotional well-being. 

Take a quick glance at how premiums for this plan vary for SI of 15 lakh:

Self (38 years)	₹15,340
Self (38 years) + Spouse(34 years)	₹22,688
Self + spouse + children	₹34,067
Parent/ senior citizen	₹74,484

*premiums are inclusive of gst

3. HDFC ERGO’s Optima Secure with the Optima Wellbeing Add-on, provide clear mental illness hospitalization coverage. With this combination, 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 support, making mental health care more accessible and consistent for enhanced wellbeing.

Here’s how premiums for this plan vary for SI of 15 lakh:

Self (38 years)	20,513
Self (38 years) + Spouse(34 years)	29,958
Self + spouse + children	39,794
Parent/ senior citizen	80,913

*premiums are inclusive of gst

Disclaimer: This list 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 against our six pillars and shortlisted by our in-house IRDAI experts. Always review the policy wording and consult an advisor before making a purchase.

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Conclusion

Mental health coverage is no longer optional—it’s essential. 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. Still unsure? Book a free call with Ditto’s experts to find the perfect plan for you.