Can a Diabetic Patient take Health Insurance?

India is known as the “diabetic capital of the world”. It ranks second in terms of the number of diabetic patients after China. From 32 million in 2000, the number of diabetic patients has reached 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, 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 covers pre-existing diseases like high blood pressure and diabetes also. But it’s a bitter truth that very few insurers are providing health insurance policies for diabetic patients, 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 patients 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’s disease which occurs because of resistance to insulin in the brain

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

What options do you have?

Being a diabetic patient, you have two options to get covered 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 an increasing number of diabetes cases, some companies have launched individual health insurance policies specially designed for diabetic patients. To avail of 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 diseases like diabetes). Gestational diabetes is generally covered under the maternity benefit (if any) of the 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 policies, 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 a medical check-up to diagnose the 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 the eye, kidney, and feet (specific treatment) are also covered under the policy. For example, Star health’s diabetes safe policy covers the cost of kidney transplants (to the limit of the 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 pre-diabetic in which the glucose level is higher than normal but not high enough to be called diabetes. People suffering from pre-diabetic conditions have higher chances of developing type 2 diabetes. There are some health insurance policies that provide health coverage for pre-diabetic conditions 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 the rising cost of health care. Look at your need and requirements and go for an adequate amount of coverage.

Buy a 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 conditions.

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, the insurer rewards the insured in 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:-

A diabetic person can buy health insurance in India by paying an 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.