Psychiatric Care Coverage – What You Need to Know

Now more than ever, individuals are grappling with the ramifications of the COVID-19 pandemic and how it impacts our daily lives, including our mental health. Whether you are concerned about the safety of children returning to school, the security of your job, are having trouble adjusting to social isolation, or are worried about contracting the virus, the pressure to remain calm during uncertain times can prove overwhelming. It takes courage to seek help for anxiety, depression, and other mental health concerns. However, due to the expensive out of pocket costs, many people simply can’t afford services to help manage their mental health challenges.

As an add on to your Health Insurance policy, Psychiatric Care Coverage is designed to offset any unforeseen costs in theory.

How do I ensure that my mental health is covered?

Always make sure that your advisor is clear about your insurance requirements. Most of the market’s insurance products might not sufficiently cover mental health conditions, such as psychiatric and psychological treatments.

Although there are a few local health insurance policies covering mental health conditions, extensive coverage will be available with international medical insurance providers to provide an adequate amount of sessions and higher annual limits for treatments.

To kick start things is to advise your specific requirements, and based on that, options would be provided to the client. Once a tentative plan is chosen, a medical insurance form is a pre-requisite for taking any medical cover.

This document is a questionnaire where you will need to declare any of your preexisting medical conditions, the status of your current health or any future course of treatment. Transparency is of utmost importance as it will help your advisor do a proper needs assessment and advise you on the best-suited health insurance cover for you.

Any suppression of facts can result in insufficient cover. It is also imperative to go through the detailed policy benefits with your advisor and exclusions before confirming the cover.

Process of getting coverage

The process will start with submitting your documents and the medical application form to your advisor, after which the team would review the documents for accuracy and completeness. Upon receiving the client’s confirmation, the team shall coordinate with the insurance provider and make sure your policy is in place in the agreed upon turnaround time.

what you need to know about mental health coverage

What is the average cost of the upgrade?

This depends on various factors, such as:

  1. The insurance provider,
  2. The chosen tier,
  3. The benefits covered,
  4. The limit of cover as well as the
  5. Demographics, i.e. age, gender and
  6. The present medical condition of the client.

The percentage hike in premium to upgrade to the next tier can be anywhere between 20-30% for any standard cases without a declaration.

Together with an insurance professional, you’ll work to find the ideal Psychiatric Care Coverage to best complement your current health insurance policy and budget. As you consider policy options and pricing, we recommend considering the following criteria:

  • Coverage inclusions (what services are included in your coverage)
  • Out-of-pocket maximums (the total amount you have to pay)
  • Co-payments (a fixed amount you pay for a health care service)
  • Co-insurance (your share of payment for a health care service)
  • Deductibles (the amount you have to spend before your insurance company starts to pay)
  • Usability (which providers in your area accept your insurance)

Would it be beneficial to get an upgrade?

The answer to this is a solid yes. You never know what life will throw at you; 2020 is an excellent example of this, especially mental health.

Being sufficiently covered is the best solution. When it comes to mental health conditions, having upgraded insurance will offer you various benefits like a higher annual cover, more flexibility to choose the amount of coinsurance and deductible, and additional options like yearly health checkups.

You can also opt for access to elite healthcare providers.


The article was written by Ramzi Ghurani, Managing Partner at Petra Insurance Brokers.