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Guide

Mental health insurance explained

Did you know that in England 1 in 4 people will experience a mental health problem of some kind each year (Mind, 2020)? Mental health problems can be extremely difficult to live with and could prevent you from working. Fortunately, the range of mental health support available is growing.

In the UK, the NHS provides mental health services. But the waiting time to receive help can be long. Paying for private care is often expensive too. And this is where insurance with mental health cover can help.

Does health insurance cover mental health?

It depends on the provider and your medical history. Certain providers offer cover for mental health treatment as part of their core cover. But others don’t. For many providers, if you would like cover for mental health treatment, you may have to select this option on your plan.

Insurers usually cover treatment for acute conditions. This includes treatment to deal with the causes of anxiety and depression. But, they don't necessarily cover chronic, or long-term treatment to keep the symptoms under control. Conditions such as dementia, and learning and development disorders, are usually excluded.

Insurers may offer different levels of cover too. They may pay for out-patient, in-patient or day-patient treatment.

You should speak to the insurer to check what they will cover. You can then select the level of mental health cover on your plan.

What counts as a mental health condition?

A mental health condition is any disorder that affects your mood, the way you think or how you behave. They are often distressing and can affect your social life, work and relationships.

There are many kinds of mental health conditions. Some mental health conditions have a biological cause. Dementia, for instance, is caused by physical changes in the brain as people get older. Others may be caused by social factors. For example, a big change in your personal circumstances, such as a divorce.

Depression and anxiety are the most common mental health conditions, but there are many others. These include:

  • bipolar disorder
  • schizophrenia
  • eating disorders like bulimia
  • PTSD.
Other common mental health problems can be found on the Mind website.

What do I need to disclose to an insurer?

If you’re taking out health insurance that covers mental health, you should disclose any conditions you may have. Mental health cover is just like cover for other health conditions. Chronic and pre-existing conditions aren’t usually covered.

How do I claim if I develop a mental health issue?

Mental health conditions can be very distressing. But having health insurance that covers mental health means you can at least get help fast.

The first thing to do is to get a named or open referral. This is when you get referred to a certain type of specialist, but not a specific individual. You can get a referral by visiting your GP. Some insurers also have apps where you can speak to a doctor on video. This lets you access and speak to a GP remotely at any time – and they can provide open referrals. There is also sometimes the option to refer yourself without speaking to a doctor.

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