Health Insurance for Diabetics – All You Want To Know

Diabetes has been a fast-growing disease in India in the last 16 years. As per International Diabetes Federation, there are about 72 million diabetic adults in India. This is a serious challenge to the country.

Health Insurance for Diabetics

It is not easy to live with diabetes as it takes a toll on the physical, mental, and financial health of a person. In spite of the widespread prevalence of the disease, there are not too many insurance providers that cover diabetes. Moreover, when a diabetic wants to purchase diabetes health insurance India, diabetes is considered as a pre-existing condition and gets covered with conditions only after a waiting period. In some cases, health insurance is denied to diabetics. People with diabetes may have multiple claims as it affects different parts of the body and also involves a lot of medication. Therefore, insurance companies are not keen to provide cover for it.

But there are a few insurance for diabetics that take cover diabetes and related conditions. Here is a comparison of some of those plans –

Must Read –How much Health Insurance do I need in India

We look at Policies That Cover Type 2 Diabetes among adults here 

Plan NameEnergy Insurance Policy Diabetes Safe Insurance Policy
Insurance ProviderHDFC Ergo General InsuranceStar Health Insurance Company
Types of Plans Two Plans –

Gold and Silver with and without options of co-pay

Two Plans –

Plan A – Medical screening required

Plan B – No medical screening

Coverage Covers Type II Diabetes or Pre-diabetes or Hypertension.

Covers 182-day care procedures, organ donation, emergency ambulance up to Rs. 2,000

 

Covers hospitalization expenses for complications of Type 1 and Type 2 Diabetes and complications apart from diabetes

All daycare procedures

Kidney transplant

Accidental Death

Outpatient expenses and diagnostic expenses up to a limit.

Eligibility18 years – 65 years with lifelong renewability.Diabetic between the age range of 18 years – 65 years with lifelong renewability.
Waiting PeriodNone for the covered diseases.

2 years for other pre-existing diseases

Plan A -None for diabetes.

Plan B – 12 months for diabetes and related complications.

Sum AssuredVarious amounts available in the range of Rs. 2,00,000 – Rs. 50,00,000Various amounts available in the range of Rs. 3,00,000 – Rs. 10,00,000
BenefitsRenewal premium discount of up to 25% based on claims and health conditions

Wellness tests, Wellness support, and services of a wellness coach.

Online health assessment

Free Health check-up included in Gold Plan

Plan can be taken on an individual and floater basis

Covers diabetes and other medical conditions

 

ExclusionsPre-existing diseases apart from the covered conditions will be covered after 2 years.

HIV and related diseases, congenital diseases, pregnancy, hospitalization due to war, and unproven treatments not covered.

Congenital defects

Use of tobacco, alcohol, and other intoxicating substances.

Cosmetic surgery, weight treatments, and fertility treatments

The premium for Sum Assured of Rs. 5,00,000 and age of 35 yearsWithout co-pay – Rs. 17,342

With 20% co-pay – Rs. 15,086

Plan A – Rs. 12,479

Plan B – Rs. 16,319

 

The policy from HDFC Ergo has a higher coverage available but includes co-pay. It is more expensive but offers more in terms of services as compared to the policy from Star Health. Star Health offers a floater policy which might be beneficial for some people.

insurance for diabetics

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Health Insurance for Senior Citizens with Diabetes –

 These Health Insurance for Diabetics cover senior citizens for Type 2 Diabetes –

PlansStar Senior Citizens Red Carpet Health InsuranceNational Insurance Varistha MediclaimOptima Senior
Insurance ProviderStar Health InsuranceNational InsuranceHDFC Ergo General Insurance
Types of PlansTwo options – Mediclaim and Critical Illness
CoverageRoom and nursing expense up to 1% of sum assured or Rs. 6,000 whichever is less

Emergency ambulance charges up to a limit

Outpatient consultation included up to a limit

Pre-existing diseases covered after 1 year of the waiting period.

Surgeon fees, Cataract, cancer, cardio-vascular diseases covered depending on sub-limits.

 

Hospitalization covers up to 1% of the sum assured on a daily basis.

Medicines, blood, and oxygen paid till 50% of sum assured

Emergency Transport

Critical illnesses like cancer and stroke

Illnesses such as diabetes covered from day one with additional premium else after one year of claim-free renewal

Cataract, Prostatic Hyperplasia, and Organ Transplant covered up to a certain limit.

Hospitalization

140-day care procedures

Emergency ambulance up to Rs. 2000 per hospitalization

Organ donation

Pre-existing conditions covered only after 3 years of policy coverage

Eligibility60 years – 75 years with lifelong renewability60 years – 75 years with renewability up to 90 years.

Premium is loaded by 10% for people in the age group of 76-80 till 85 years and by 20% till 90 years.

61 years and above with lifelong renewability
Sum AssuredVarious amounts available in the range of Rs. 1,00,000 – Rs. 10,00,000Under Hospitalization & Domiciliary Hospitalization – Rs.1,00,000

Critical Illness – Rs.2,00,000

Covers of Rs. 2,00,000; Rs 3,00,000 and Rs. 5,00,000 are available
BenefitsDiscount on premium for online purchases

No medical screening

Medical consultation charges up to a limit offered for consultation as outpatient

 

 

 

No medical screening if the insured had health insurance for the three previous years else it is required.

No maximum entry age

No claim discount of 5% on premium

E-opinion for critical illness

No sub-limits on claims

Discount of 7.5% on premium if a 2-year policy is purchased.

ExclusionsNo cover for 2 years of policy coverage for cataract, glaucoma, ENT diseases, and transplants.

Dental treatment, congenital conditions, weight control treatments and cosmetic surgery

Costs associated with hearing aids, spectacles, wheelchairs and contact lens.

Medical conditions due to war, nuclear materials and unproven medical treatments.

Existing ailments attributable to diabetes and/or hypertension even if diabetes is covered.

Contact lens, hearing aids, dental procedures, diagnostic tests

Many conditions such as cataract, sinus, lumps in parts of body are not covered in the first year.

Coverage:

HIV and AIDS

Cosmetic treatments, weight treatments and non-allopathic treatments.

Conditions arising due to drugs, alcohol and other intoxicants

Medical conditions due to war and nuclear radiation

Premium for a person who is 65 yearsRs. 21,240 for a cover of Rs. 5,00,000 and age between 60-75 years.Rs. 4598 for Mediclaim (including diabetes cover)

Rs. 6605 for Mediclaim+Critical Illness

 

Rs. 22,553 for a cover of Rs. 5,00,000

 

As you can see, there are not too many Health Insurance for Diabetics plans that cover diabetes. Moreover, the cover for diabetes for senior citizens is woefully inadequate. Hopefully, the insurance companies devise some more useful diabetes health insurance plans for diabetics. Till then, it is important to ensure that one leads a healthy life and creates a medical emergency fund to tide over the medical costs even if one buys diabetes health insurance.

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Some more advise 

Choose the best Diabetics health insurance in India, which has the least waiting time and helps you enjoy the maximum benefits offered as part of the plan. Group health insurance plans usually do not have a waiting period.

Choose the size of insurance coverage based on your age, health status, and increased health expenses. Make sure that the amount of health insurance is adequate and meets your needs and requirements. If your family has a history of diabetes, make sure you have the right plan. And if you don’t have diabetes, buy a plan to prevent rejection from the sidelines because of your diabetic background.

Before signing the dotted lines, be sure to read the policy’s terms to get up to speed and know about the inclusions and exclusions offered under health insurance in connection with a pre-existing illness.

If you have still any questions about Health Insurance for Diabetics – feel free to add them to the comments section.

Health Insurance for Diabetics

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