Psychological cover: Which conditions are covered & which not

Anyone who’s gone through mental health problems will tell you the deep impact their condition had on every aspect of their lives. It’s important to seek help and get on the road to recovery as soon as possible, but with long NHS waiting lists many people aren’t getting the help and support they need quickly enough. Using your private medical insurance policy could help you or a family member quickly access the treatment they need.

Mental health issues affect 1 in 3 people at some point in their life.

While some insurers offer no psychological benefit, other policies are quite comprehensive. There’s always the option to add additional psychological cover onto the core component of your policy, giving you and your family the peace of mind that comes from extra cover.

All psychological claims are generally handled by a condition management team of trained counsellors. As they are used to dealing with mental health issues they understand how difficult it can be to talk about. Although you do have to give information regarding your condition you won’t be put under any pressure. Once your claim handler has got all the information they need they’ll be able to come back to your with a decision, hopefully authorising a course of treatment.

As with all medical insurance claims you’ll need to see your GP initially for a referral, but once you’ve obtained this you’ll be able to call your insurer and arrange cover.

Most policies cover a variety of treatments and therapies including:

  • Counselling – Generally one on one treatment with a trained therapist. Your insurer will normally cover you for a block of sessions, usually lasting around an hour in length. It’s particularly popular with patients suffering from depression and anxiety.

  • Psychotherapy – Based on the Freudian approach to mental illness, psychotherapy is an alternative approach to counselling which takes place over a number of sessions.

  • Cognitive Behavioural Therapy – CBT focuses on specific problems and helping patients work through them to change the way they think. By challenging irrational thought patterns you can often recondition your behaviour so you react differently in future. It’s often used with patients suffering from phobias.

  • Group Therapy – Group work, perhaps with family members or groups of patients suffering from the same condition.

  • In patient stays – During periods of psychosis or extreme dysfunction it’s sometimes necessary to be hospitalised for the patients own safety. Some policies will cover an in patient stay up to a maximum number of days.

There are a huge number of mental health conditions which your insurer will look to cover, below are common conditions they’ll be used to dealing with:

  • Depression – Depression is the most common mental illness, comprising on a persistent low mood. Medication and therapy can be used to help patients get their lives back on track.

  • Schizophrenia – One of the most severe forms of mental illness, Schizophrenia is characterised by visual or auditory hallucinations and paranoid thought processes. Although there is no known cure it can be well controlled with the right combination of medications and therapies.

  • Bipolar/Manic depression – Often described as a roller coaster ride of extreme highs and lows, this condition responds well to medication and therapy. Many users can live a normal life if they stay on their medication, although its well documented that acute phases can occur in which it’s common for patients to be in extreme distress.

  • Stress and anxiety – Generalised anxiety and stress are common complaints. Often having a listening ear in the form of counselling can help, and these conditions respond well to CBT.

  • Panic attacks – Panic attacks occur for a variety of reasons and therapy and CBT can help you get to the bottom of this and readjust your thinking patterns.

  • Phobias – Phobias can massively impact upon an individuals quality of life. CBT can help you to face your fears and examine your through processes to overcome the problem.

  • Obsessive compulsive disorder – Obsessive thought patterns can make sufferers lives a living hell. Breaking the cycle is a difficult step to make, but with the help of therapy sufferers can make a full recovery.

  • Eating disorders – Eating disorders such as anorexia bulimia can ultimately be life threatening. Getting early access to treatment can set sufferers on the right track to recovery. Counselling and CBT are primarily used to treat these illnesses.

Unfortunately not all mental health conditions are covered by your policy. These are some examples of where cover may be unavailable or limited:

  • Bereavement – Following the death of a loved on grief is a normal reaction, you’ll only be covered for bereavement counselling or treatment after 6 months. However, many charities offer these services free of charge, so you’ll have no problem getting the help you need.

  • Addiction – All conditions related to drugs and alcohol are excluded from your policy.

Your insurer will be able to point you in the sight direction to seek treatment advice whether or not you are covered. Making a claim is the first step in getting better, so don’t be afraid to call them. If you’re unable to for any reason then provided you can give consent your insurer will be able to speak to any friend or family member.



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