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  11. Insurance Coverage For Mental Illness: A Review Through A Lens Of Bioethics And The Mhca, 2017

Insurance coverage for mental illness: A review through a lens of bioethics and the MHCA, 2017

Amiti Varma1, Nikhil Jain2, Sayali Mahashur1

  • 1Research Associate, Centre for Mental Health Law and Policy, Pune 411004, Maharashtra, INDIA.

Indian Journal of Medical Ethics
|March 5, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Health insurance policies in India often discriminate against mental illness, violating the Mental Healthcare Act, 2017. Advocacy is needed to ensure parity for mental health coverage.

Area of Science:

  • Health Policy
  • Bioethics
  • Mental Health Law

Background:

  • Health insurance is crucial for mitigating catastrophic health expenditures.
  • The Mental Healthcare Act, 2017 (MHCA) mandates equal insurance coverage for mental and physical illnesses.
  • Despite legal mandates, individuals with mental health conditions face insurance access barriers.

Purpose of the Study:

  • To analyze health insurance policies for adherence to the MHCA's Section 21(4) regarding mental illness coverage.
  • To assess policy wording against bioethical principles and mental health parity mandates.

Main Methods:

  • Analysis of 459 health insurance policy documents from the IRDAI webpage (2020-21).
  • In-depth review of 268 relevant policies for compliance with MHCA and bioethics.

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Main Results:

  • Six policies (from two providers) explicitly excluded mental illness, contravening the MHCA.
  • Most policies excluded coverage for suicide attempts (n=224) and substance use (n=267).
  • Out-patient mental health services were covered in only 23 policies.

Conclusions:

  • Current health insurance policies contain discriminatory clauses for mental illness, violating MHCA parity principles.
  • Differential treatment of mental illness in insurance policies contradicts bioethical standards.
  • Continued advocacy is essential for enforcing mental health parity in insurance policies.