Mental Health Cover: Is Your Policy Paying ₹0?

Since 2018, Indian health insurers must cover mental illness like any physical illness. But most families don't know this, don't claim it, and still pay out of pocket. Here's what your policy owes you.

Here's what happened: The Mental Healthcare Act, 2017 legally prohibits discrimination between mental and physical illness in health insurance — IRDAI reinforced this with a directive requiring insurers to cover mental health hospitalisation on par with other medical conditions.. Inpatient psychiatric treatment — including hospitalisation for severe depression, bipolar disorder, schizophrenia, and medically supervised de-addiction — must be covered under all standard health insurance policies sold in India after 2018.. OPD mental health expenses like therapist consultations and counselling remain excluded from most standard plans, meaning most day-to-day mental healthcare costs still fall entirely on the insured individual..

What you should do: Pull out your health policy document and search for 'mental illness', 'psychiatric', or 'psychosis' — any blanket exclusion clause in a post-2018 policy can be formally contested with your insurer in writing.. If your insurer rejects a valid mental health hospitalisation claim, file a grievance on the IRDAI Bima Bharosa portal (bimabharosa.irdai.gov.in) — unresolved grievances can be escalated to the Insurance Ombudsman at no cost.. When renewing or buying a new policy in 2025-26, compare whether OPD mental health cover is included — some comprehensive plans from IRDAI-approved insurers now explicitly include psychiatrist OPD visits up to a fixed annual limit..

Pre-existing mental illness waiting periods cannot be used to deny acute hospitalisation claims. If your episode began suddenly, get your psychiatrist to document 'acute onset' explicitly — this is your strongest counter to a waiting-period rejection.

For complaints against banks or NBFCs, our RBI complaint guide explains the free RB-IOS 2026 route.