Diabetes Health Insurance
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Diabetes Health Insurance

India has the second highest number of diabetes patients in the world. Diabetes is a chronic disease. Diabetes cases in India are on the rise. Yet, the number of people who know about diabetes health insurance is negligible. Many health insurance companies in India offer diabetes Mediclaim policy. These are health plans specifically designed to cover diabetes related medical costs. Diabetes, being a silent killer, needs timely, appropriate and long term care and the costs can be prohibitive. A dedicated insurance plan for diabetes can go a long way in mitigating your financial pinch.

Diabetes can be controlled through a strict diet. It is an expensive disease as the patient needs constant care, injections, and doctor visits. Diabetes patients have a weak immune system and hence they are prone to hospitalization due to other related ailments that the disease brings with it. One of the best ways to be prepared for and manage diabetes is to have a diabetes health insurance plan.

Diabetes is a chronic disease and can be fatal if left untreated. In this condition, the blood is unable to process the starch and sugars properly. There are two types of diabetes: Type 1 and Type 2. If not taken care of, diabetes can cause serious health issues related to the kidney, eyesight, and heart. Hence, it is essential to control diabetes and treat it continuously. That is why most doctors call diabetes the Silent Killer among Indians.

Do regular health insurance plans include diabetes? The answer lies in the nature of health plan you opt for. Typically, standard health insurance plans exclude diabetes and its related health effects.

Some insurance plans provide the option of covering critical illnesses at an additional premium. Those insurers who provide coverage for diabetic conditions in regular plans with an additional premium may ask them to undergo medical tests and have an extended waiting period. Besides, the premium may be higher as insurers predict a higher probability of claims.

Diabetes Health Insurance

Diabetes Health Insurance

Diabetes health insurance plans are specially designed to cover expenses related to diabetes related treatments and hospitalization. Diabetes health plans can be bought by people who already have the disease as well as pre-diabetes. Most health insurers request a pre-policy medical test. This helps the insurers determine the premium based on the extent of the affliction. The waiting period might differ depending on the insurers.

Diabetes Health Insurance Plans at a Glance

Plan

Features

Apollo Munich Energy

  • Sum assured: Rs.2 lakhs to Rs.50 lakhs
  • Pre and post hospitalization coverage
  • Organ donor treatment expenses
  • Wellness program – health coach, diet and fitness plan, regular monitoring
  • Premium discount up to 25% for staying fit
  • Ambulance expenses
  • No waiting period
  • Specific health check-ups included
  • 10% no-claims bonus or NCB
  • Tax benefit up to Rs.30,000 under Section 80D of the Income Tax Act

Star Health Diabetes Safe

  • For diabetic patients between 18 years and 65 years
  • Sum assured: Rs.3 lakh to Rs.10 lakh
  • Two types of plans – Plan A and Plan B
  • Network hospitals over 6000
  • Hospitalization
  • Pre hospitalization up to 30 days prior
  • Post hospitalization up to 60 days after
  • Organ donor treatment
  • Artificial limbs if amputated up to 10% of sum insured

Religare Care Freedom Plan

  • No pre-policy medical check up
  • Annual health check ups
  • Lifelong renewability
  • Tax benefit under Section 80D of the Income Tax Act
  • 2 years waiting period for pre-existing diabetes
  • Portability
  • Pre and post-hospitalization
  • Dialysis expenses
  • Ambulance cost
  • In-patient care – room rent, nursing, ICU, among others 170 day care treatments

Aditya Birla Diabetes Insurance

  • Different plans available – Activ Enhanced Health Plan and Activ Health Essential Plan
  • Doctor’s consultation fee
  • Diagnostic tests
  • Hospitalization – 60 days pre and 180 days post
  • Second e-opinion
  • No-claim bonus or NCB
  • Annual health check ups
  • 100% reload of sum insured
  • 527 day care procedures

HDFC Ergo Energy Health

  • Two types of plans – Gold (cost of wellness test included) and Silver (cost of wellness test excluded)
  • Type 2 diabetes
  • Age group – 18 years to 65 years
  • Sum insured: Rs.2 lakhs to Rs.10 lakhs
  • Hospitalization
  • Active wellness plan for health management
  • No-claim bonus or NCB
  • No waiting period
  • In-patient expenses

Expenses related to diabetes

Doctor’s fees

Diabetic patients require frequent doctor’s visits if they are unable to control their diabetes. The doctor’s consultation cost can add up to a considerable amount. Moreover, doctors may prescribe tests, which can add to the monthly medical bills of diabetic patients.

Medicine and insulin costs

Diabetic patients might need insulin, tests to check blood sugar levels, regular lab tests and other medicines adding up to a considerable amount. Diabetes health insurance can help to cover these costs. Diabetes can cause complications to other organs, too, which can add up to medical expenses. Some plans may cover only specific types of diabetes – Type 1 or Type 2 and there are other plans that cover all types.

Hospitalization

If diabetic patients do not take proper care of their health, they might require getting hospitalized due to related complications. Diabetes also causes complications to other organs in the body, leading to hospitalization if not treated properly. All these complications and hospitalization can cost a lot and can be covered partially or entirely by diabetes health insurance.

Key features & benefits of the Diabetes Plans

Covers doctor’s consultation: Diabetes health insurance plans are designed to offer coverage for all health conditions related to diabetes. At times, diabetes can affect other parts of the body. These conditions, too, are covered by diabetes health policies.

Covers diagnostic test: A diabetic patient needs to undergo many diagnostic tests at regular intervals. This is to check whether or not the disease is in control. These tests range from blood, urine and other samples. The cost of diagnostic tests depends on the hospital and the diagnostic test centre and can be a huge drag, depending on the test and the frequency. Diabetes health plans cover diagnostic tests and ease the policyholder’s financial stress.

Covers Hospitalization: Diabetes patients need to take proper care of their health. For example, they must not indulge in eating food that is restricted and they cannot miss taking medication. If they do not keep their diabetes levels under check, it can have serious consequences. They might require hospitalization due to complications. Diabetes also causes complications to other organs in the body, leading to hospitalization if not treated on time. All these complications and hospitalization can cost a lot and can be covered partially or entirely by diabetes health insurance.

Covers medicine costs: When you think of diabetes-related expenses, think of regular medicines, insulin and other costs too! Most diabetes patients have to take medication regularly; in fact, some even take these diabetes medicines daily.

Earn rewards: Many health insurance plans that cover diabetes offer rewards to policyholders. These rewards range from no-claim bonus or NCB to bonus towards staying fit to discounts for renewals and other such benefits.

Get a wellness coach: Many health insurance policies covering diabetes cover wellness coach expenses as part of the policy. The diabetes insurance policyholder is eligible to have a wellness coach, which is covered in the diabetes health insurance policy.

Eligibility criteria for diabetes health insurance

Most health insurance companies offer diabetes health insurance plans. Here are the eligibility criteria.

Children as young as newborn babies can have diabetes. The health insurance age eligibility varies from insurer to insurer. Generally, the minimum age for eligibility is three months. The maximum age can also differ. Persons under the age of 25 years can be covered under a family floater plan that covers diabetes.

Most health insurers require applicants to undergo a pre-policy medical screening when buying a diabetes insurance policy. However, pre-policy checks are under insurers' discretion, and many companies do not insist on such screening tests.

How diabetes health insurance helps a diabetes patient

Diabetes is an expensive disease. One way to meet its treatment expenses is by way of having a good diabetes Mediclaim plan.

  • A diabetes health plan helps the policyholder cover doctor’s consultation and visit expenses.
  • Having a diabetes policy allows the policyholder and their families to worry less about finances and focus more on controlling and recovering from the disease.
  • Diabetes health policyholders are eligible for tax benefits under Section 80D of the Income Tax Act.
  • Diabetes plans cover hospitalization expenses related to the treatment of the disease. Diabetes Mediclaim plans also provides coverage for pre and post-hospitalization.
  • Some diabetes plans cover dialysis, consumable allowance, and companion benefits too.
  • Diabetes health insurance plans are available in a range of sums insured, allowing the patient to buy a diabetes policy with an adequate sum insured.

How to buy a diabetes plan

Buying a diabetes health insurance policy is easy. Most health insurers offer diabetes plans online as well as offline. While some insurers make pre-policy checks mandatory, some don’t. Policyholders should follow some best practices before purchasing a diabetes plan.

Here are some such best practices:

  • One must check if the cost of a doctor’s consultation is included in the diabetes plan to get treatment from the best doctors.
  • The policy seeker should ensure that the diabetes plan considered by them offers a broad range of coverage.
  • One must check the network hospitals within the area of their residence so that it would be easier to get easy access to quality healthcare in the case of emergencies.

Health insurer’ insurer’s offerings to a diabetic patient in India

Diabetes is on the rise in India. India has the second-highest number of diabetes patients in the world. To help people tackle this disease’s high expenses, many health insurers have introduced different kinds of diabetes insurance plans that cater to people’s diverse needs.

Most health insurance companies offer in-patient treatment coverage, pre- and post-hospitalization, day-care procedures, organ donor and emergency ambulance.

What is not covered in a diabetes health insurance policy?

Diabetes health insurance plans typically do not cover cosmetic or aesthetic treatments, illnesses caused due to alcohol or drug abuse, HIV, and dental treatments, among others. Weight control treatment expenses, hospitalization due to war, nuclear/chemical causes, pregnancy, and experimental treatments are not covered.

Additionally, diabetes health insurance policy does not offer coverage under the following conditions:

  • Pre-existing diseases are not covered in diabetes health insurance plans. Many plans that offer coverage for pre-existing conditions have a waiting period of a few months to a few years depending on the policy and at the insurer’s discretion.
  • Diabetes health insurance plans do not offer hospitalization coverage without doctor’s recommendation. If policyholders claim hospitalization expenses without a doctor’s recommendation, the health insurer is entitled to legitimately reject the claim.
  • Pre-natal and post-natal expenses: Diabetes health insurance plans do not cover costs related to pre-natal and post-natal treatments.

Inclusions & exclusions of diabetes health insurance plans

INCLUSIONS EXCLUSIONS
Hospitalization expenses Pre-existing diseases
Pre- and post-hospitalization expenses Hospitalization without doctor’s recommendation
Coverage for dialysis expenses Pre-natal and post-natal expense
Organ donor expenses Dental treatment
Ambulance charges Cosmetic and aesthetic treatments
Room rent Conditions due to drug and alcohol use
Doctor’s consultation AIDS and HIV conditions

Faqs

How does diabetes health insurance work?

Typically, regular health insurance plans exclude diabetes and its related health effects. Some insurance plans provide the option of covering critical illnesses at an additional premium. Those insurers who provide coverage for diabetic conditions in regular plans with
an additional premium may ask the insured to undergo medical tests and even have an extended waiting period. Besides, the premium may be higher as insurers predict a high probability of claims. Many insurance companies offer dedicated diabetes plans. Buying a
specific health insurance plan designed for diabetes patients is an efficient way to overcome the financial stress and burden of the ailment.

How will I know when my policy will expire? Can I get alerts?

Health insurance companies send intimation emails, messages and even call up policyholders to remind them about their policy expiry date so that they can take the necessary steps to renew their diabetes health insurance policy and continue to enjoy the benefits of the same.

How can one buy diabetes health insurance plans online?

Most insurance companies offer the option of buying health insurance plans online. Buying insurance plans online is easy. The policy seeker must choose the plan, fill in all the details correctly, and pay the policy's premium to get started. There are several online health insurance marketplaces that offer diabetes health policies of different insurance companies, under one roof. This makes it easy for the policy seeker to compare the features and determine the best diabetes plan for their requirements.

What are the special features of a diabetes health insurance policy?

The most notable feature of diabetes Mediclaim plans is that they are designed for diabetes-related expenses; hence they offer comprehensive coverage towards diabetes treatments. Different types of plans may cover different types of diabetes and its costs. Most diabetes plans cover doctor's consultation fees, diagnostic tests, medical treatment and medicine costs, inpatient treatments (ICU, operation theatre), wellness programs, and ambulance charges.

What are the benefits of diabetes health insurance plans?

Diabetes health insurance policyholders can enjoy most of the benefits of general comprehensive insurance plans such as tax deduction, no-claim bonus, discounts, cashless hospitalization at network hospitals etc.

How do I make a claim from my diabetes health insurance plan?

Diabetes health insurance claims can be made quickly. Once the policyholder is hospitalized, they should intimate the health insurer immediately after the completion of the treatment, the policyholder should submit all the original documents, bills, medical proofs, doctor's prescription and discharge summary to the insurer within the pre-specified time limit.

Do I need to pay anything at the time of claim settlement?

Whether the policyholder has to pay any amount during the claim settlement depends on the clauses in the diabetes insurance policy. If there is a co-payment clause in the policy, then the policyholder has to pay a part of the amount. If there is no co-payment or sub-limit
(limits on some kinds of expenses, such as room rent limit), then the policyholder may not need to pay anything.

Do I get any tax benefits under diabetes health insurance plans?

Yes, diabetes Mediclaim policyholders can avail of tax benefits under Section 80D of the Income Tax Act annually against premiums paid.

Can I get insured for a pre-existing diabetes illness?

Whether or not your pre-existing diabetes illness is covered in a policy or not depends on that specific diabetes plan. Many health insurance companies do not provide coverage for pre-existing diabetes illness while others offer this facility. Many insurers might have a waiting period of a few months to a few years before the coverage kicks in.

Can diabetic people get a health insurance policy in India?

Yes, diabetic patients can get health insurance cover in India. Insurers have introduced many dedicated health insurance plans. specifically designed to cover diabetes-related health expenses. Apart from that, many policies offer coverage for chronic illnesses, including diabetes, albeit at an additional premium.

Is it easy or difficult to get health insurance for diabetes?

It is generally not easy for diabetic patients to get general health insurance because of the high risks involved, but not impossible. Diabetes is usually considered as a pre-existing disease by insurers for new plans. For pre-existing illnesses, they will apply a waiting period ranging from 1 year to 4 years. Hence, these plans would cover diabetes related expenses only after the waiting period. However, it is easy for diabetic patients to buy dedicated diabetes health insurance plans, albeit at a higher premium.

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