Diabetes Health Insurance: What You Need to Know

If you are diagnosed with diabetes, your family’s finances could take a hit due to the unexpected loss in income. The problem is further compounded if you factor in the cost of treatment. Common cases affecting diabetics include diabetic foot, amputation, diabetic retinopathy and other expensive procedures. Among the more serious cases, diabetes could even lead to kidney problems which means that there will be recurring costs involved as well.

Thus, when it comes to diabetes, it is better to take preventive measures, which should not only be limited to diet, lifestyle or health checks but financial safeguards as well. This is what you need to know when it comes to investing in health insurance for a diabetes-specific cover.

Diabetes Health Insurance- Deciding the cover amount

When it comes to deciding how much health insurance you need, you should factor in your gender, age and location. According to studies conducted, diabetes is known to generally affect more men than women.

Further, most claims are made by people who are between 36 to 60 years of age. Some premiums on renewal may change due to a change in the age of the policyholder, like in the case of the Energy Health Insurance Plan by Apollo Munich Insurance.

Also, most claims are seen to be made from major cities, where the cost of medication is far more expensive than in smaller cities and towns.

This list is only indicative and there could be more plans as per need.
Buying a cover as a preventive measure

If you have a family history of diabetes, it is important that you purchase adequate cover at the earliest. You can avail of a regular health indemnity plan which is a standard hospital cover that includes diabetes. This cover will be far cheaper than a specialised health insurance cover for diabetes.

Under a regular plan, you would have to pay Rs.6,000 a year for a Rs.5 lakh cover, whereas for a specialised diabetes plan, you would have to pay Rs.17,000 for the same cover amount.

You should note that if you purchase a regular health plan, it might have a waiting period of 2-4 years for pre-existing ailments, since it might not cover diabetes across all stages. You can instead add a critical rider to a basic health plan that covers diabetes, in such cases. Critical rider plans can also be purchased as a standalone health cover.

If you opt for a plan in the early stages of detection, you might get coverage for the waiting period as well, before the need for hospitalisation arises. There are however, some plans that do not have a waiting period, like in the case of the Star Diabetics safe plan, where Type-1 and Type-2 diabetes does not have a waiting period.

Buying a Heath Insurance cover if you are already diagnosed with diabetes

There are a myriad of diabetes-specific plans available, offering specialised cover for diabetes-specific complications that might be excluded from regular plans.

Most plans cover Type-2 diabetes and associated diseases related to the kidneys, heart, amputation costs, kidney donor-related costs and recurring costs for dialysis, to name a few.

Picking the right health plan

If you have not yet been diagnosed with diabetes, you should purchase a regular indemnity plan (base policy). However, do not purchase the entire cover under this plan; opt for either a top-up plan, critical illness plan or family floater in addition to your base policy. Ideally, your indemnity cover should not be more than Rs.10 lakh.

Most health insurance companies cover diabetes under top-up plans and these plans are not as expensive as regular indemnity plans.

If you choose a family floater health insurance as your base policy, you could save on premiums. However, since there are risks of exhausting the floater if a family member should fall ill, you can instead opt for a floater on your top-up plan.

There is of course the added option of opting for a standalone critical illness plan or combining it with a base policy as well. The advantage of a critical illness plan is that you can claim the entire sum assured as soon as you are diagnosed; you can spend the money as you like and there are no sub-limits, inclusions or exclusions on the same.

If you are already diabetic, opt for a specialised diabetes plan that covers all diabetes-related ailments, where you will be covered as soon as you sign up.

Terms you should be familiar with

• Type-1 Diabetes – In Type-1 Diabetes, the insulin-producing cells in the pancreas are attacked by the body, where the body stops making insulin and blood sugar levels soar. Treatment generally involves having to take insulin injections. Type-1 diabetes usually affects children and teenagers in most cases. This condition is not as common as Type-2 diabetes, but it is very dangerous nevertheless. There are not as many health insurance policies available for Type-1 diabetes as for Type-2.

• Type-2 Diabetes – Type-2 Diabetes, or Diabetes Mellitus as it’s called, is the most common form of diabetes. In such cases, the body is unable to use the insulin produced by the pancreas effectively. This condition is called insulin resistance. Initially, extra insulin is produced by the pancreas to make up but in time they are unable to make enough to ensure that blood glucose levels stay normal.

• Pre-existing Diseases – A pre-existing disease is an ailment which an individual has at the time of buying a health insurance policy. In most cases, pre-existing diseases are excluded from the scope of the policy coverage for a few years, known as the waiting period.

• Waiting period – All health insurance plans have a waiting period, when it comes to pre-existing ailments. This waiting period is generally between 2-5 years and varies from one policy to another.It is advisable that one opts for the policy with the minimum waiting period.

• Premium Loading – This is an increase in the premium amount that is borne by the policyholder. The premium for health insurance might rise depending on the severity of the disease or because the insurer faces a higher than anticipated cost of insuring a person prone to some form of risk.