Can a Diabetic Patient take Health Insurance?

India is known as the “diabetic capital of the world”. It ranks second in terms of number of diabetic patients after China. From 32 million in 2000, the number of diabetic patients has reached to 63 million in 2013 and it is expected that by the end of 2030, there will be more than 100 million diabetic patients.

In India, only 7.2 % of diabetic cases occur because of the medical history of the family while the major chunk is suffering because of their unhealthy and competitive lifestyle. While diabetes is not a fatal disease like cancer, but it requires frequent medical attention which digs a big hole in the pocket of patients and rising prices of health care are widening that hole. And this is where a health insurance policy plays a major role by covering the expense of health care.

Even with almost 63 million people suffering from diabetes, very few of them are covered under a health insurance policy. Many people have this perception that being a diabetic patient, they can’t take a health insurance policy. Well, that’s just a myth. A Health insurance policy gives cover for pre-existing diseases like high blood pressure and diabetes also. But it’s a bitter truth that very few insurers are providing health insurance policy for a diabetic patient, but still it doesn’t stop you from taking a health insurance policy.

So through this article, we will try to look at the various perspectives of taking health insurance as a diabetic patient.

What are the Types of Diabetes?

It is very much necessary to know the types of diabetes because health plans provide insurance according to the types of diabetes. Diabetes can be categorized into three categories

Type 1 Diabetes – It is a severe form of diabetes in which the patient is insulin dependent because of the inability of the body to produce insulin to convert sugar/glucose into energy. This is the reason why Type 1 diabetic patient need insulin shots to convert sugar/glucose into energy. The immunity system of the body sees insulin producing cells as foreign and attacks them, which results in the inability of the pancreas to produce insulin.

Type 2 Diabetes- It is the most common form of diabetes in which cells become insulin resistant or even if the insulin is produced, it is not enough for the body. Due to dysfunction in insulin production, the glucose stays in the blood and doesn’t get converted into energy.

Type 3 Diabetes –  It is a type of Alzheimer disease which occurs because of resistance of insulin in the brain

Gestational Diabetes – This type of diabetes occurs in women during pregnancy. If not cured, it has chances of getting converted into type 2 diabetes.

What options do you have?

Being a diabetic patient, you have two options to get a cover under a health insurance plan:-

Individual Health insurance plan You can get an individual health insurance plan which covers pre-existing diseases like diabetes. With the evolution in health insurance and increasing number of diabetes cases, some companies have launched an individual health insurance policy specially designed for diabetic patient. To avail the benefits of an individual health insurance policy, generally you have to wait for a certain period of time.

Group Health insurance plan – You have the option to get cover for diabetes through your employer provided group health insurance policy also. Most of the employer’s health policies cover pre-existing diseases like diabetes and hypertension. The employer’s provided health insurance policy will stay till your job only, but diabetes will not.

What is the scope of coverage?

In India, there is no cover for type 1 diabetes, but if you are suffering from type 2 diabetes, you can get a cover under a health insurance policy (which is designed for diabetes or covers pre-existing disease like diabetes). Gestational diabetes is generally covered under the maternity benefit (if any) of health insurance policy.

Being a diabetic patient, your premium will be higher than the regular health insurance plan because of your higher chances of making the claim and frequent medical attention.  In most of the polices, there will be a waiting period of generally 2-4 years, after which you can avail the benefits of the policy. Before taking the policy, you will have to go through medical check-up to diagnose type of diabetes and other health related issues.

Health plans don’t only cover diabetes only, but problems arising due to diabetes in different parts of the body like eye, kidney and feet (specific treatment) are also covered under the policy. For example, Star health diabetes safe policy covers cost of kidney transplant (to the limit of sum assured) and if the first transplant fails, you will be covered for the second transplant also.

There is also a condition which is called as pre-diabetic in which the glucose level is higher than normal but not high enough to be called as diabetes. People suffering from pre-diabetic condition have higher chances of developing type 2 diabetes. There are some health insurance policies which provide health cover for pre-diabetic condition also.

What you should look for?

Always look for a health insurance policy with a minimum waiting period, which will help you in getting the benefits of your policy as soon as possible. Group health insurance policies have no waiting period. Decide the cover amount according to your age, diabetic condition, city and rising cost of health care. Look at your need and requirements and go for an adequate amount of cover.

Buy health policy as early as possible, especially if you have a family history of diabetes. Even if you are diagnosed with diabetes, it’s always better to buy at an early stage to avoid rejection due to severe diabetes condition.

Always go through the various clauses of the health insurance policy, so that you can know what is included and what’s not. Some policies also offer added benefits like in the case when you are able to control your diabetes, insurer rewards the insured through various ways. Limitations and benefits should be well analyzed before buying a health insurance policy.

Which Health Insurance plans in India cover diabetes?

Following are some of the health insurance plans which cover diabetes in India:-

Health Plan Eligibility Entry & Exit Age Sum Assured (INR) Coverage
Star Health Diabetes Safe Insurance Policy Any person who is suffering from Diabetes Mellitus

 

18 years to 65 years 3 lakh to 10 lakh ·Complications of Diabetes, all other ailments/injuries
·Coverage for outpatient expenses
·Coverage for personal accident
Apollo Munich Energy Insurance Policy Individuals who are diagnosed with Type II Diabetes or pre-diabetes 18 years to 65 years 2 lakh to 10 lakh ·Day one coverage for all hospitalization arising from Diabetes and Hypertension
·In-patient hospitalization coverage
·Health reward program
National Insurance Varistha Mediclaim Any person between 60 to 80 years of age 60 years to 80 years 1 lakh/ 2 lakh Cover diabetes after 30-day waiting period.

A diabetic person can buy health insurance in India by paying extra premium. The options of health insurance policy for diabetes are limited, but there are some plans which are specially designed for diabetes. You just need to do some research and choose the best health insurance plans for diabetes.

Harjot Singh Narula

Harjot Narula is founder and CEO of ComparePolicy.com, an IRDAI approved insurance web aggregator focussed on selling online insurance for companies. Harjot has more than a decade of experience in software development and has also spent 5 years in US working for the mortgage and risk management industry.

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