CoverSure CEO warns policyholders to check OPD limits for mental illness coverage
Why in news: CoverSure CEO Saurabh VijayVergia warned policyholders to scrutinize OPD limits and session caps for mental illness coverage under the Mental Healthcare Act, 2017.
The Mental Healthcare Act, 2017 mandates that insurers treat mental illness similarly to physical illness. However, routine outpatient therapy (OPD) may be subject to specific limits, such as session caps or provider eligibility.
Prelims pointers (3)
- Act / BillMental Healthcare Act, 2017: Mandates insurance coverage for mental illness equivalent to physical illness
- FactExample of recurring costs: Rs 72,000 annually for sessions at Rs 1,500 each
- PostSaurabh VijayVergia: Founder and CEO of CoverSure
Mains angle
Q. Examine the challenges in ensuring comprehensive insurance coverage for mental health services despite the mandates of the Mental Healthcare Act, 2017.
- Regulatory gap: Lack of standardized OPD caps across private insurers leading to out-of-pocket expenses
- Awareness deficit: Complexity in policy fine print regarding session limits and provider eligibility
- Economic barrier: High recurring costs of outpatient therapy impacting long-term treatment adherence
Keywords: Mental Healthcare Act 2017 · Outpatient Department (OPD) · Insurance Coverage · Mental Health Policy · Financial Accessibility