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Will Premiums Rise As a Result of Mental Illness Coverage?

When we talk about health insurance, usually we are referring to treatments pertaining to the physical aspects of our being. Hospital bills vary according to the severity of the ailment, and if you suffer a serious injury, without health insurance you are looking at a hefty medical bill.

That is why health insurance has become a need, and now that increasing focus is being given to mental health as well, it is only natural that mental health needs are also covered under insurance coverage schemes.

According to stipulations made under the Mental Healthcare Act of 2017, which was enforced in May of 2018, the insurance premiums to be charged to insurer shall also include a charge for mental health. This is obviously good news for those who are suffering from mental illness and do require insurance to cover costs. But what impact is it going to have on the premium paid?

Now that increasing focus is being given to mental health as well, it is only natural that mental health needs are also covered under insurance coverage schemes

The Definition of Mental Illness

If you are suffering from a mental illness, then to be covered under the new stipulations your illness needs to fall within the definition set by the Act. According to the Act, mental illness is a substantial disorder which affects the mood, memory, perception, thinking, as well as orientation of a person, greatly reducing his or her ability to make proper judgments, behave in a normal manner, distinguish between reality and fiction, and/or cope with daily life.

Those mental conditions which find root in alcohol abuse or drug addictions are also covered in this definition. Unfortunately, what is not covered is mental retardation which originates because of underdevelopment of the mind, whereby the intelligence of an individual is severely compromised.

The inclusion of mental problems linked with drug and alcohol abuse is particularly interesting because physical illnesses resulting from drug or alcohol abuse are usually not covered under insurance, and according to some analysts, these may soon be excluded from the insurance covering mental health as well.

As the inclusion of mental health in insurance coverage is relatively new, it remains to be seen what else will see the chopping block once exclusions are revised. If not excluded, then certain illnesses, especially those with a high-frequency of patients, may see a waiting period as insurers may place a cap on the number of people who may redeem their insurance pertaining to the occurrence of certain mental issues.

Mental Illnesses That Are Common

The diseases recognized and classified as a mental health issue by the WHO in the ICD are going to be covered in the insurance.

While you may think that mental illnesses are arbitrary and not classified as specifically as physical ailments, but that is an incorrect assumption. Thanks to the work of the World Health Organization, we have in existence what is called the International Classification of Disease, a database containing all the mental illnesses in existence today. As research progresses and more and more mental illnesses are being identified, this document is updated to keep the entire medical community informed.

According to the stipulations made under the Act, the diseases recognized and classified as a mental health issue by the WHO in the ICD are going to be covered in the insurance. This means that for example, diseases like schizophrenia will be covered as it is part of the list of mental health issues named in the ICD.

If the mental health issue leads to the hospitalization of an individual, then the diagnosis as well as analysis of the patient’s mental health in addition to the treatment and rehabilitation shall be covered under insurance. This will also make mandatory the 24-hour hospitalization which is usually included in the healthcare process pertaining to physical ailments.

How Will Existing Plans Be Affected?

If you are suffering from a mental illness, then to be covered under the new stipulations your illness needs to fall within the definition set by the Act

Clearly the impact of this Act will translate in to insurance coverage plans already in existence, and a price increase in the insurance premium being paid by us may be revised in the near future. Mental illness began being covered in insurance coverage plans as soon as the regulation mandating its inclusion came in mid-August.

Of course, the price increase will not come for a few months as insurance companies would have to indulge in the lengthy analysis of assessing the final price increment in insurance premiums to cover for the extra insurance costs. However, a price increase is imminent.

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