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Diabetic Health Insurance

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Diabetic Health Insurance

Diabetes is no longer an ailment of the old or middle-aged. Even youngsters can fall prey to the illness, especially Type 1 diabetes which is an autoimmune disease common in children. 

India is considered to be the youngest country as more than 50% of its population is below 25 years of age and 65% fall under the 35-year age bracket. In this demography, type 1 and type 2 diabetes is prevalent in 40% to 45% of individuals. Moreover, the onset of type 2 diabetes in India is found to be 20 years before that of Western countries. So, finding youngsters suffering from diabetes is not uncommon.

Diabetes is not usually life-threatening. However, it can lead to various medical complications like –

  • Cardiovascular diseases 

  • Kidney failure

  • Nerve damage

  • Eye damage like glaucoma

  • Skin conditions

  • Depression

  • Increased chances of infection

If these complications arise, you might need medical attention or hospitalisation. The cost of such attention or hospitalisation might put a financial strain. As such, you need a health insurance plan to cover your medical costs.

Health Insurance with Diabetes Cover

If you think they don’t, you are wrong! Health insurance plans do provide coverage if you are suffering from diabetes. Even when you are young and suffer from diabetes, you can opt for a health insurance policy to cover possible medical complications. Here are a few points to remember about the coverage –

  • If you are suffering from diabetes when buying the health plan, your illness would be considered as a pre-existing condition. Coverage for diabetes and its related complications would be provided after a waiting period. This period might range from 12 months to 48 months.

However, some health insurance plans allow you to reduce the waiting period at the payment of an additional premium. So, if you seek coverage for your diabetes earlier, look for such plans and choose the available option.

  • In the case of severe diabetes, insurance companies might reject your policy. This, however, is not very common. Usually, insurers accept the proposal but might restrict coverage for diabetes-related complications. So, read the policy wording carefully.

  • The premium would, usually, be higher given the increased health risk that you present.

  • You might be required to undergo pre-entrance health check-ups before the policy is issued.

What is diabetes and what are its different types?

There are two types of diabetes and managing each is different. Have a look

  • Type 1 diabetes 

Type 1 diabetes is an autoimmune condition wherein the pancreas either does not produce any insulin or produces very minimal amounts of it. Type 1 diabetes is also known as juvenile diabetes as it is commonly found in children or young adults.

Management of Type 1 diabetes

Insulin injections are quintessential in treating Type 1 diabetes. Such injections provide the body with the insulin needed.

  • Type 2 diabetes 

Type 2 diabetes is more of a lifestyle condition in which the body’s ability to process glucose (sugar) is impaired. Under this condition, the body either does not produce the required quantum of insulin or resists insulin altogether. Type 2 diabetes is a chronic condition which usually continues lifelong.

Management of Type 2 diabetes 

Type 2 diabetes can be managed with lifestyle changes and medication. Changing the diet to exclude sugar, regular exercising and medication can help you manage this form of diabetes. In some cases a doctor may prescribe oral or injectable medication.

Why Should You Opt for Health Insurance with Diabetes Cover?

Diabetes is not usually life-threatening. However, it can lead to various medical complications like –

  • Cardiovascular diseases 

  • Kidney failure

  • Nerve damage

  • Eye damage like glaucoma

  • Skin conditions

  • Depression

  • Increased chances of infection

Group health plans cover diabetes from Day 1. So, if you are employed and your employer offers group health coverage, you would be covered. However, only a group health plan might not suffice your medical needs. Though the policy would cover your complications without any waiting period, you need an independent health plan too for supplementing your coverage. Here are some reasons why –

  • To avail of a higher sum insured

  • To get customised coverage features

  • For lifelong renewability

So, despite having a group plan, invest in an independent health plan too for enhanced coverage. Use the group plan during the waiting period for the independent plan. Thereafter, both the policies would provide an all-around scope of coverage.

Features of Health Insurance with Diabetes Cover

1. Provide coverage for existing conditions


A two- to four-year waiting period will apply if you are diagnosed with diabetes before purchasing a health insurance plan because it is a pre-existing condition. You may submit claims for diabetic pre-existing disease coverage following the expiration of this time frame. Diabetes will not be regarded as a pre-existing condition if symptoms appear within three months of the policy's issuing date, and you may submit claims pursuant to the terms and conditions of your policy.


2. Cashless Hospitalization


A cashless feature of health insurance with diabetes coverage allows your insurance company to pay the network hospital immediately for your medical bills and expenses. As a result, you might not need to pay anything out of pocket and can avoid making large medical bills


3. Pre- and post-hospitalization insurance


Any costs, from diagnostic testing before hospitalisation to after-care and medication needs after hospitalisation, will be covered if you choose health insurance with diabetes coverage.


4. Daycare Procedure Coverage


Your diabetes-specific health insurance plan would even reimburse you for daycare procedures that only take a certain amount of time.

Benefits of Health Insurance with Diabetes Cover

You can benefit from a variety of advantages through your complete health insurance plan with diabetes coverage such that you avail:

  1. In-Patient Treatment 

  2. Coverage for ambulance

  3. Diagnostic Expenses

  4. Domiciliary Treatment

  5. Regular health checkups

  6. AYUSH Treatment

Eligibility for Health Insurance with Diabetes Cover

Diabetes sufferers can obtain health insurance without as much difficulty as they might think. There is only one condition, however, that typically applies: If you have diabetes, you can file claims after a waiting time of two to four years has passed if you had it before purchasing the health insurance policy. However, you have three months from the purchase date of the policy to file claims if you do not have diabetes at the time of purchasing health insurance. Make sure your policy offers the option for lifelong renewability because health insurance companies have age restrictions that prevent you from keeping your current coverage.

Exclusions Under Health Insurance with Diabetes Cover

To prevent future claim denials, it is imperative that you carefully study the diabetes coverage provisions of your chosen health insurance plan. Under such comprehensive health insurance policies, there are some exclusions, such as waiting period provisions and coverage that exclude some costs for type 1 and type 2 diabetes. Therefore, before investing in such important policies, thoroughly examine the terms and conditions.

Consult OneAssure partner to know more about exclusions under your plan or visit to get all your queries resolved.

Claim Process for Health Insurance with Diabetes Cover

If you are admitted to the hospital for diabetes-related conditions you should contact your insurance provider at once to begin the claim procedure. Both cashless and reimbursement claims are possible. Let's take a look at the procedure:

  1. Submit the correctly filled in claim form after informing the insurance provider via the website or toll-free line.

  2. The hospital will verify and then deliver to the insurance company the required documentation that you have submitted.

  3. If you are admitted to a network hospital, the insurance company will pay the hospital immediately as part of the cashless claim payment after verification.

  4. If you are unable to be admitted to a network hospital or if your claim for cashless payment is denied for whatever reason, you will be entitled to payment under the reimbursement process

  5. For reimbursement, you will pay the hospital upon being discharged. However, you will be reimbursed after submitting the documentation and bill to the insurer.


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