Health Insurance for Diabetics
You must have seen somebody around, who has suffered from diabetes and its dangerous consequences at once. Being in the category of a lifetime disease, diabetes is dominantly chronic and barely goes away if a person has got it once. Diabetes can be a threat to your life as it comes with various complexities related to your health, financial damage, and mental distress. In such scenarios, a health plan with coverage of diabetes can save you from all the worries of life.
This particular article covers in detail health insurance for sugar patients, the benefits of having diabetes insurance, and several other aspects of buying it in this era. Read further to know more about what health insurance for diabetics unfolds.
What is diabetes?
A diabetic condition arises when our body stops responding to the production of insulin or when our pancreas stops secreting the required insulin hormone. Due to this, the blood sugar level increases and causes our blood cells (bloodstreams) to neglect using glucose (a form of sugar) for energy generation inside our body.
Diabetes is caused when there is extreme glucose circulating in our body which increases our blood sugar level. Diabetes can be caused due to certain conditions of insulin resistance, autoimmune disease, imbalanced hormones, damage caused in the pancreas, or even genetic mutations/hereditary or neonatal conditions.
What are the types of Diabetes?
Below mentioned are the kinds of diabetes which are majorly categorised into three types:-
Type 1 Diabetes
Type 1 diabetes is a condition where our body stops producing enough insulin and the patient needs to intake insulin supplements or injections to maintain the normal level of sugar. In this type of diabetes, our body's immune system attacks the cells of the pancreas which produces insulin. This kind of diabetes can be developed at any age including youngsters and children.Type 2 Diabetes
This kind of diabetes is caused due to an inappropriate lifestyle that triggers your immune system to not respond against insulin. The resistance to insulin-producing cells decreases inside our body.Gestational Diabetes
This diabetes type is developed inside a female's body while pregnant. In most cases, the symptomatic risk of gestational diabetes goes away post-pregnancy, but it can aid in developing a type 2 category of diabetes later in life.
Eligibility Criteria of Health Insurance Plans For Diabetics in India
Below mentioned prospects are the eligibility criteria for buying health insurance plans for diabetic patients:-
Age
An individual between 18 to 65 years (for adults) and 19 days to 18 years (for children, under family floater health plans) of age, can apply for diabetic health insurance.Pre-existing diabetes disease
You must look after the coverage of the policy you're buying. Some of the policies may cover Type 1 or Type 2 diabetes or maybe both. You can buy a plan depending on your diabetes level and the need for treatment. The insurer will ask the diabetic policyholder to go through a medical examination for diabetic symptoms such as insulin resistance, drug dosage, level or type of diabetes, etc. If the applicant is going through a higher level of diabetes conditions or gets extremities during the policy year, the health insurance company will impose loading charges over the policy.Waiting period
You must check for the waiting period while buying a plan, as some plans may have a waiting period of 2-4 years. Whereas, some health plans may come with zero waiting period.Medical examination
A thorough medical examination helps the insurance company recognise any pre-existing medical condition a policyholder has possessed other than diabetes.Family medical history
If you have a family history of diabetes, it's more likely for you to pay a higher premium or there must be a criterion of an elongated waiting period in such cases.
Premium Calculation of Diabetics Health Insurance Plans
The premium for any health insurance policy, including a diabetes-specific policy, depends on various factors, and these calculations are approved by the IRDAI.
Some of the basic factors that are considered while calculating the insurance premium are:
- The age of the insured person
- The medical history of the individual and his family
- Pre-existing diseases
- The seriousness of diseases related to diabetes like type 1 or type 2 diabetes, usage and frequency of insulin injected, and dosage of medications related to diabetes.
A few other subsidiary factors are:
- Marketing expenses by the insurance company
- Policy underwriting
- Mortality rate
- Investments (in the case of ULIPS)
Why Should You Buy Diabetes Cover Health Insurance?
Health insurance for diabetics allows individuals to look after their healthcare needs and helps them tackle diabetes. With an effective specialized diabetes insurance plan, one can ensure to avail of the best possible treatment.
- Out-patient expenses will be covered, allowing you to visit with the top physicians without being concerned about the consultation expenses.
- A diabetes insurance plan covers the price of diagnostic costs, encouraging you to closely check your health status.
- Instead of stressing about hospital fees and costly medicines, you may concentrate on your recovery with your diabetic health insurance.
- Diabetes health insurance provides insurance holders with tax benefits under Section 80D of the Income Tax Act.
- Insurance holders are covered for other complications that arise due to diabetes.
- No requirement to go through a waiting period for diabetes coverage, unlike the majority of health insurance plans that cover diabetes after a certain waiting period (say, 2-4 years).
- Diabetes Health Insurance covers dialysis for diabetic patients which is a huge part of diabetes treatment.
What does a diabetes insurance plan cover
A comprehensive health insurance policy with coverage benefits for diabetes provides an extended cover for the policyholder. Let's have a look over the coverage benefits of diabetic health insurance:-
AYUSH treatment
AYUSH Treatments (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) are covered under the health insurance for diabetes patients.In-patient treatment
Hospital admission for 24 hours or more for the treatment of diabetes-related issues depending on the severity is covered under the policy.Domiciliary hospitalisation
Those who are unable to receive diabetes-related treatment at the hospital due to some reasons, can avail of domiciliary treatment which means hospitalisation at home.Daycare treatment
The diabetic treatment that needs not more than 24 hours of hospitalisation such as small surgeries, or a medical procedure is covered under the plan.Ambulance services
For a situation of emergency, diabetes health insurance plans also cover the transporting expenses or ambulance services to provide the patient with a hassle-free hospitalization.Pre & post-hospitalisation expenses
This kind of health insurance for sugar patients allows them to get free treatment throughout. All the medical expenses incurred before and after getting admitted to the hospital would be borne by the insurer itself.Advanced diagnostics coverage
Medical treatment has become more convenient and time-saving with advanced technology. So, a health plan with diabetes coverage bears all such advanced diagnostic expenses.Portability benefit
The policyholder has the freedom to port their policy to another insurance company with similar policy features from the existing insurer. Insured can port their policy to another insurer only at the time of renewal and the policy can even be customised according to current coverage requirements.Dialysis coverage
Most of the patients with sugar condition who is suffering from a higher level of diabetes (say Type 2) needs to be treated with frequent dialysis. Hence, all the dialysis expenses are covered in the policy depending on your coverage amount and the specifications of the plan type.Alternate/regular health check-ups
Diabetes is a serious health illness that needs regular checkups. But spending hefty amounts for an annual or monthly checkup may be tough. In such cases, you need not worry about medical expenses or consultation fees, as your policy for sugar issues covers that all.No-claim bonus
If the policyholder does not raise a claim in the policy year, they are likely to get a no-claim bonus benefit over their policy renewal.No waiting period
Some insurance companies offer health plans for diabetes patients with zero waiting periods. However, the criteria of zero waiting period are only valid when a certain type of diabetes is covered under the policy or the diabetes insurance plan is standalone.Tax Benefits
The policyholder can also avail of tax benefits under Section 80 D of the Income Tax Act with a diabetic health plan.
Exclusions of Diabetes Health Plans
However, a health plan with diabetes coverage in India particularly provides all the accessibilities related to diabetes-related issues. But, depending on the type of policy and your insurance provider, a diabetes health plan may not have the below-mentioned coverage:-
Pre-existing diseases excluding diabetes
Any other medical condition than diabetes such as joint replacement surgery, arthritis, cancer, tuberculosis, osteoporosis, etc are not covered in a diabetes plan.
Self-inflicted injuries
Intentional self-inflicted injury that aggravates existing diabetes is not covered under the policy.
Prenatal and postnatal care
Any condition of pregnancy, either pre-natal or post-natal treatment would be excluded from the sugar treatment plans.
Voluntary hospitalisation
If the policyholder is unable to show a doctor's medical prescription for hospitalisation, insurance companies are entitled to reject the insurance claim for such voluntary hospital admission.
Sports/war injuries
Warships, deadly nuclear spots, adventurous activities, injuries that are caused by participating in professional sports like racing, scuba diving, aerial sports, or any other dangerous sports, etc that trigger diabetes are not covered.
Cosmetic or aesthetic treatments
Any beautification treatment, facial or body surgery is not covered under the diabetes plans. Apart from this, obesity or liposuction treatment is excluded from the diabetes health plan.
Best Health Insurance Plans for Diabetics in India 2024
Below are some of the diabetes insurance plans that are specially designed to keep the healthcare needs of a diabetic patient in mind. Have a look and choose the best health insurance for diabetics in India.
Activ Health Platinum Enhanced
A unique Plan with features such as a chronic management program, modern treatments, covid-19, and more.
Unique Benefits
- High SI
- Affordable Premiums
- Wellness Benefits
Activ Health Platinum Enhanced (Pros)
- Earn 100% Health Return
- Cover for Dental Consultations
- Modern Treatment Cover
- Wellness Coach
- Mental Illness Cover
Activ Health Platinum Enhanced (Cons)
- Illness due to intoxicants
- Change Of Gender Treatment
- Hazardous Activity not covered
- HIV/AIDS not covered
- Cosmetic Surgery unavailable
Activ Health Platinum Enhanced (Other Benefits)
- Chronic Management Program
- Premium Waiver Benefit
- Reload of SI
- Road Ambulance Cover
- Second e-opinion
Activ Health Platinum Enhanced (Eligibility Criteria)
- Entry Age - Years
- Max Entry Age - Years
- SI - 1 L to 1 Cr
- Waiting Period - 30 Days
Get medical coverage for pre-existing diseases like BP, diabetes without any waiting period by bearing a co-pay of 20-30%.
Unique Benefits
- No pre-policy checkup needed
- Dialysis cover available
- Annual Health Checkup
- Cashless Healthcare
- No pre-policy check-ups
- SI Recharge
- Lifelong Renewability
- 15-day free-look period
- Change of Gender Treatments
- Obesity Treatment Unavailable
- Hazardous Activity Not Covered
- HIV/AIDS not covered
- Cosmetic Surgery unavailable
Care Freedom (Other Benefits)
- 2 Plan variants
- Consumable Allowance
- Annual Health Check-up
- Long Term Discounts
- Dialysis Cover
Care Freedom (Eligibility Criteria)
- Entry Age - 91 Days
- Max Entry Age - Lifelong
- SI - 3 to 10 L
- Waiting Period - 30 Days
Designed especially for people with pre-existing diabetes or hypertension. Get coverage for diabetes and hypertension from Day 1 without any waiting period.
Unique Features
- Stay fit & earn reward points
- 100% SI restoration
- Health coach & wellness programs
Energy Diabetes Policy (Pros)
- In- Patient Hospitalization
- No Waiting Period for Diabetes
- Restore Benefit
- Cumulative Bonus
- Pre and Post Hospitalization
Energy Diabetes Policy (Cons)
- 2 Year Waiting Period
- Abuse of Intoxicant Not Covered
- War Operations Injury
- Sexsually Tranmitted Diseases
- Pregnancy Not Covered
Energy Diabetes Policy (Other Benefits)
- Monthly Newsletter
- Organ Donor Benefit
- Earn Rewards for Staying Healthy
- 25% Discount On Renewal
- 2 Variant Options(Silver,Gold)
Energy Diabetes Policy (Eligibility Criteria)
- Entry Age - 18 Years
- Max Entry Age - 65 Years
- SI - 2 L to 50 L
- Waiting Period - 2 Years
A specified plan for Type 1 or Type 2 Diabetes with flexible plan options. Offers automatic sum restoration with accident cover.
Unique Features
- Cataract Cover
- Affordable Premiums
- Flexible Payment Options
Diabetes Safe Policy (Pros)
- Road Ambulance Cover
- Pre and Post Hospitalization
- ICU Cover
- Room Rent Cover
- Day Care Treatment Cover
Diabetes Safe Policy (Cons)
- Obesity Treatment Unavailable
- Hazardous Activity not covered
- HIV/AIDS not covered
- Cosmetic Surgery unavailable
- Injuries due to breach of law
Diabetes Safe Policy (Other Benefits)
- Dialysis Cover
- Kidney Transplant Cover
- Artificial Limbs Cover
- Personal Accident Cover
- OPD Cover
Diabetes Safe Policy (Eligibility Criteria)
- Entry Age - 18 Years
- Max Entry Age - 65 Years
- SI - 3 L to 10 L
- Waiting Period - 30 Days
A comprehensive plan for you and your family covering
Unique Features
- Swine Flu Treatment Covered
- Pre Existing Disease Covered
- Cumulative Bonus upto 50 %
- No health check-ups
- Domestic Air Ambulance
- 24x7 Customer Support
- Newborn baby and vaccine cover
- Health rewards
- No Non-allopathic Treatments
- Unproven treatment not covered
- HIV/AIDS treatments not covered
- 3-Year Waiting Period
- Obesity treatment not covered
Health AdvantEdge (Other Benefits)
- Bariatric surgery cover
- Maternity Expenses Covered
- Orthopaedic Expenses Covered
- Chemotherapy Covered
- Eye Surgery Covered
Health AdvantEdge (Eligibility Criteria)
- Entry Age - 18 Years
- Max Entry Age -65 Years
- SI - 2 L to 5 L
- Waiting Period -30 Days
Niva Bupa Reassure 2.0 provides insurance holders with a high sum insured through their platinum, titanium, and bronze variants along with a multitude of other features.
Unique Features
- Booster+ Benefit
- Lock premiums at entry age
- Health check-ups from day 1
Health ReAssure 2.0 Plan (Pros)
- Personal accidents covered
- Acute Care
- Emergency Ambulance
- Three Plan variants
- Home Care Treatments
Health ReAssure 2.0 Plan (Cons)
- No OPD Cover
- No Maternity Cover
- No Sleep Disorder Covered
- Pre-Existing Diseases after 3 yrs.
- Alcoholism not covered
Health ReAssure 2.0 Plan (Other Benefits)
- Air Ambulance
- Modern Treatments
- Second Opinion
- Booster Benefit
- Shared Accommodation Benefit
Health ReAssure 2.0 Plan (Eligibility Criteria)
- Entry Age - 18 Years
- Max Entry Age - No Age Limit
- SI - 5 L to 1 Cr
- Waiting Period - 30 Days
Features of Diabetes Health Insurance Plans
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Star Diabetes Safe Insurance Policy
The Star Diabetes Safe Insurance Policy specifically designed for individuals diagnosed with diabetes covers both type 1 and type 2 diabetes and complications arising from the illness. Other illnesses associated with diabetes are also covered under the plan.
Key Features
- The policy is designed for individuals and dependent family members.
- Star Diabetes Safe Insurance Policy offers flexible plan options.
- Automatic Sum restoration is offered under the plan.
- Personal Accident Cover.
- The policy premium can be paid in instalments.
-
HDFC Energy Diabetes Policy
The HDFC Energy Diabetes Policy is Unique health insurance for diabetics with multiple attractive features such as an active wellness program, no waiting periods, reward bucket, sum insured restoration, and more.
Key Features
- Day Care treatments are covered under the HDFC energy plan.
- Up to INR 2k road ambulance is available for insurance holders under the HDFC Ergo Energy Plan.
- Organ Donor expenses are covered.
- Lifelong renewability.
- The wellness program offers insurance holders a personal health coach to manage their health.
-
Care Freedom Plan
The Care Freedom Plan offers coverage against pre-existing diseases such as diabetes, high BMI, and hypertension. The plan offers a high range of sum insured up to INR 10 lakh and focuses on providing the best health care services to its customers.
Key Features
- The plan offers lifetime renewability to provide lifetime coverage benefits to its customers.
- The plan is available as an individual and family floater plan with the provision of covering a newborn baby for 90 days.
- Provides free annual health check-ups to help customers keep their health on track.
- The plan covers day Care Treatments.
- The plan offers dialysis coverage to the customer.
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Aditya Birla Activ Health Platinum Enhanced
The Aditya Birla Activ Health Platinum Enhanced plan covers modern treatment methods and a chronic management program that covers chronic illnesses such as diabetes, hypertension, high cholesterol, and asthma. Insurance holders can focus on the recovery and treatment of chronic illnesses.
Key Features
- Avail of Cashless Home Treatment.
- Chronic illnesses are covered from day 1.
- Access to expert health coaches for all customers.
- Coaching on nutrition, fitness, and medical consultation under the plan.
- Insurance holders can avail of the feature of doubling the sum insured in 2 claim-free years (max up to 1 cr).
-
ICICI Health AdvantEdge
ICICI Health AdvantEdge plan is a customizable plan that offers multiple add-ons to its customers. It is a holistic plan designed to cater to every individual for their healthcare needs.
Key Features
- Pre and post-hospitalisation are covered under the plan.
- A wellness program is available for individuals to encourage everyone towards a healthier lifestyle.
- Domestic Air Ambulance coverage is available up to the sum insured to insurance holders.
- Lifelong renewability feature.
- Annual Health Check-up is available under the plan.
-
Niva Bupa Reassure 2.0
The Niva Bupa Reassure 2.0 plan has three different variants namely, bronze, silver, and platinum. It is an individual and family floater plan providing coverage for diabetes and hypertension from day 1 as an additional disease management feature.
Key Features
- High-sum insured variants are available starting from 5 lac to 1 crore for efficient coverage for insurance holders.
- Unlimited e-consultations are offered under the plan.
- The plan offers personal accident benefits equal to 5 times the Base Sum Insured. Maximum up to INR 1 Crore.
- Niva Bupa Reassure 2.0 offers health check-up coverage from day 1 to its customers.
- Avail second medical opinion for any condition in one policy year.
How To Buy an Insurance Policy For Diabetes from PolicyX?
PolicyX.com is an insurance portal that has been designed to allow you to search, compare, and buy an insurance policy in an easy and hassle-free manner. The IRDAI has approved the portal and is one of the best platforms for selecting insurance policies that suit your financial and physical needs. If you need to buy an insurance policy for diabetes, the following steps will help you:
- Scroll down to the bottom of this page and click on 'Buy Now' or "Get a Quote".
- You will get a list of all the different insurance plans and insurance companies.
- Select the insurance plan that suits your needs and proceed with the instructions given.
- Fill in all the asked details like your name, contact number, age, etc.
- You will be then taken to the insurance company's portal, where you can make the payment using the available payment options. Once the payment is verified, the soft copy of your policy document will be mailed to you.
Claim Process for Diabetes Health Insurance
Below are the steps that you can follow to proceed with raising a claim against your health plan with diabetes coverage:-
Process for Cashless Claim
- Submit the duly filled claim form at the networking hospital facilitation. Ensure that you've already pre-authorized your hospitalisation
- Once your form is submitted and verified, you'll get approval from the authorities
- Once the documents are approved, you'll be able to avail your claim against the policy's terms and conditions.
Process for Reimbursement Claim
- Submit the duly filled claim form for reimbursement to your insurer
- Take your original policy documents, KYC documents, and other documents along with other requested documents from your insurance provider
- Submit the hospital/medical bills, doctor's consultation records, Prescription lists, and other documents asked to submit for verification
- Once all the documents are submitted for approval, the claim management authorities will enquire about further information
- If the claim is proven to be true, your claim will be accepted and settled.
Conclusion
Since the complexities of diabetes are so tricky to manage for an average individual. Therefore, health insurance plans for diabetic patients come to the rescue. The only way to stay fit and beat diabetic symptoms is with a healthy lifestyle. To maintain your health, you should intake nutritious food, do physical workouts, limit alcohol doses, maintain your sleep cycle, and manage mental stress. Similarly, if you've any possibility of getting diabetic any further in life, you should choose one of the best health insurance plans for diabetic patients. The best way to buy a diabetes health plan is to reach out to the experts at Policyx.com and get a quote for the best sugar health insurance plans available.
