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Health Insurance For Diabetes

The cases of diabetes in the country are on the increase owing to lifestyle habits. More and more individuals are prone to diabetes due to erratic sleep routines and eating habits. Diabetes is a digestive disorder wherein there is an increase in sugar levels in the bloodstream due to insulin resistance. Insulin aids the breaking down of sugar into energy. The mounting treatment cost of diabetes and diabetes-related health conditions warrants the need for health insurance for diabetes. It gives you peace of mind that you are financially equipped for any medical emergencies arising due to diabetes.

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Health Insurance For Diabetes

What is Health Insurance for Diabetes?

Health Insurance for Diabetic Patients
March 27, 2025

Table of Content

 

Health insurance for diabetes patients is a plan for those with type 1 and type 2 diabetes or a family history of diabetes. The health insurance for diabetes covers the hospitalisation and medical costs incurred for the treatment of the condition and related diseases. Generally, diabetes is considered a pre-existing health condition and has a waiting period. However, plans with no waiting period are also available. To get the best deal, compare different diabetic health insurance plans before the purchase.

What is Diabetes and How Does it Affect the Body?

When the body does not produce sufficient insulin there is a spike in the blood sugar level. Diabetes is a health condition in which the blood sugar levels are beyond the prescribed levels. The increase can be due to insulin resistance i.e., the body does not respond to insulin. The body breaks down carbohydrates in your food into glucose that enters the bloodstream. The pancreas responds and produces insulin. Insulin aids the cells in converting glucose into energy immediately or storing it for energy conversion later. 

Regular blood tests help detect diabetes. Among these, checking the fasting blood sugar levels and your HbA1c is a good way to help diagnose whether you are suffering from this lifestyle disease or not. HbA1c indicates your body's average blood sugar levels for the past 2 to 3 months. The table below gives insight into the type of diabetes based on blood sugar and HbA1c levels.

Category

Blood Sugar (mg/dL)

HbA1c (%)

Normal blood sugar

Below or equal to 99 mg/dL

4% to 5.6%

Prediabetes

100 to 125 mg/dL

5.7% to 6.4%

Diabetes

126 mg/dL or more

6.5% or more

 

You will be more susceptible to diabetic-related health conditions if you are diagnosed as pre-diabetic or diabetic. Health insurance for diabetes is the best way to be prepared for any medical emergencies that might result from this condition.  

Types of Diabetes 

The different types of diabetes are:

  • Type 1 Diabetes

People suffering from Type 1 diabetes are suffering from an auto-immune disease wherein the body’s immune system itself destroys the cells that are responsible for producing insulin. With insufficient or no insulin, glucose remains in the bloodstream, and the increased sugar levels cause type 1 diabetes. 

Type 1 diabetes is also referred to as juvenile diabetes or insulin-dependent diabetes. Persons affected by this condition should take insulin to regulate their sugar levels. Though this type of diabetes surfaces during childhood, it can affect young adults also.

  • Type 2 Diabetes

Type 2 diabetes is a more common condition. This occurs when the pancreas cannot produce adequate insulin, does not produce insulin at all, or the body stops responding to insulin. Type 2 diabetes mainly affects adults, but children may also develop this type of diabetes.

  • Gestational Diabetes

Gestational diabetes is linked to pregnancy. Pregnant women develop gestational diabetes, which vanishes soon after delivery. However, women with gestational diabetes are more likely to develop type 2 diabetes and should be cautious about their lifestyle habits.

Health Insurance for Diabetic Patients 

Diabetic patients need to have a diabetes insurance plan to meet the treatment costs without any financial stress. The benefits of insurance for diabetes treatment are:

  • Scope of Coverage Offered

The best health insurance for diabetics covers hospitalisation, treatment costs, ambulance services, and diagnostic tests. It also covers diabetic-related diseases like kidney failure, heart disease, etc, but after a waiting period. Some health plans for diabetes management provide domiciliary hospitalisation wherein you can receive treatment at home when the condition is critical, and the insured cannot be admitted to the hospital for treatment. 

  • Short Waiting Period

Regular health insurance plans have a waiting period of 2 to 3 years, whereas the waiting period for health insurance for diabetes is short and some plans provide coverage from day 1. Compare health insurance policy for diabetic patients offered by different insurance companies to make an informed decision. 

  • Premium Discounts

Most insurance providers offer premium discounts for multi-year policies. Some health insurance for diabetic patients provides no claim bonus benefits during renewals i.e., premium discounts for every successive claim-free year.

  • Payable Premiums

The premiums payable are calculated based on age, type of diabetes, lifestyle habits, how regulated the sugar levels are, overall health condition, etc. However, the premiums payable for health insurance for diabetics are more affordable than premiums for insurance for pre-existing diabetes.

  • Mode of Reimbursement

Under the best health insurance for diabetics, you have two options for reimbursement. You can opt for cashless hospitalisation or claim for reimbursement after incurring expenses. However, cashless hospitalisation is permitted at network hospitals included in the plan. 

Who Needs Health Insurance for Diabetes in India?

Persons with type 1 or type 2 diabetes need health insurance for diabetes. Also, persons with the risk of developing diabetes due to factors such as family history, sedentary lifestyle, obesity, etc., need health coverage for diabetics. 

Elderly individuals, persons with non-alcoholic fatty liver disease (NAFLD), women with PCOS who are more prone to gestational diabetes, and to-be mothers diagnosed with gestational diabetes should have the best insurance for diabetes care to manage the treatment costs. These insurance plans cover annual health check-ups and regular screenings and minimise out-of-pocket expenses. They offer long-term financial security for diabetes care. 

What is Covered Under a Diabetes Insurance Plan? 

Health plans for diabetes management cover the following:

  • In-patient Hospitalization

If hospitalised for a minimum of 24 hours, the health insurance for diabetic patients covers the room charges, and treatment costs including surgery, ambulance service, and doctor’s consultation.

  • Daycare Treatment

This diabetes-friendly health insurance covers expenses incurred for treatment without hospitalisation.  You can claim the cost incurred for OPD treatments such as therapies, diabetes-specific medical care, dialysis etc. 

  • Dialysis Coverage

A specific amount is provided for dialysis. The number of sittings covered depends on the insurance company chosen. Dialysis coverage does not include any renal complications identified before the policy purchase.

  • Emergency Ambulance

This affordable insurance for diabetics provides for the ambulance service required to transport the patient to the hospital which otherwise enhances the policyholder’s out-of-pocket expenses. Considering the safety of the patient, this facility is a bonus. 

  • Modern Treatments

GLP-1 receptor agonists, insulin therapy, and continuous glucose monitors are some modern treatments available to keep diabetes at bay. Medical insurance for diabetes covers these modern treatments and the policyholder can take advantage of newer options to keep the disease in control. 

What is not Covered in the Diabetes Insurance Plan?

Health insurance with diabetes coverage does not cover the treatment expenses incurred for the following:

  • Treatments undergone abroad.

  • Cost of external devices and aids required to control diabetes.

  • Artificial systems or technologies are used for life maintenance when natural processes fail. 

  • Treatments which are not scientifically proven.

  • Dietary supplements and substances consumed to manage the condition.

  • Procedures involved in controlling obesity.

Eligibility for Medical Insurance for Diabetics

The eligibility criteria for health coverage for type 1 diabetes or insurance for type 2 diabetes varies with the insurance provider. Some insurance companies have entry-age specifications depending on the plan chosen.

  • 18 years for adults and 91 days for children.

  • 46 years for an individual policy. For family floaters, the age of the eldest insured should be 46 years. For other policies, 18 years for adults and 90 days for children. 

  • The maximum entry age for adults is lifelong and 24 years for children.

  • The exit age, however, is maximum. 

It is imperative to consider various Diabetes care insurance options for an informed decision.

Things to Consider Before Buying Health Insurance for Diabetes

It is critical to consider the following before purchasing diabetes treatment insurance plans:

  • Coverage for Diabetes Treatment

Make sure that maximum coverage for diabetes treatment is available under the plan to avoid financial stress in the future. Coverage for modern treatments such as insulin therapy, glucose monitoring, etc is crucial. In addition, the policy should cover daycare treatments, treatment for diabetes-related complications, etc., besides in-patient hospitalisation, domiciliary treatment, pre and post-hospitalisation care, ambulance cover etc.

  • Pre-existing Condition Clause

Some medical insurance for diabetics  have pre-existing condition clauses such as waiting periods and restrictions on diabetes-related treatments. Ensure that the plan you choose has coverage for continuous care.

  • Premium Costs

The reason for purchasing health insurance for diabetes is to make it more cost-effective than health insurance with critical illness insurance as an add-on benefit*. Compare the premium costs of plans from different insurance companies for an affordable insurance for diabetic patients

  • Diabetes Complications

Some of the diabetes complications you may develop are diabetic neuropathy i.e., nerve damage that may lead to digestive issues, numbness, tingling, and pain in the hands and feet, etc., nephropathy leading to kidney failure, retinopathy concerning eye issues. Ensure that the plan you buy covers treatment costs for these issues.

  • Claim Process

Comparing the claim process of different types of health insurance whether it is health insurance for chronic conditions or standard health insurance is crucial. Looking for health insurance with a simple claim process, preferably insurance that provides an online claim facility is critical to avoid complications.

Conclusion 

Diabetic patients need regular medications and financial security for their families. Health insurance for diabetes ensures access to medical treatments without financial burdens, while life insurance provides peace of mind and protection for loved ones. With rising medical costs, selecting the best insurance plan tailored for diabetic patients is a necessity to secure a better quality of life. Additionally, life insurance helps secure your family’s financial future in case of an untimely demise, ensuring they have the necessary funds for their needs.  Choosing a plan with wide coverage is a wise decision for those managing diabetes. 

FAQs on Health Insurance for Diabetes 

Q. Can diabetes be covered by insurance?

Yes. Diabetes can be covered by insurance. Some insurance plans cover diabetes as a pre-existing illness with a waiting period of 2 to 3 years. However, health insurance policy for diabetic patients with coverage from day 1 is also available. Research thoroughly before purchasing the plan and select the one that has the least waiting period. 

Q. Can a diabetic patient get health insurance?

Yes. Diabetic patients with type 1 diabetes, type 2 diabetes, or geriatric diabetes can get health insurance. While some plans provide coverage from day 1, others stipulate a waiting period of 2 to 3 years. 

Q. Is Type 1 diabetes covered in health insurance?

Yes. Type 1 diabetes is covered by health insurance. Insulin, diabetes-related treatments, and glucose monitors are generally covered under the policy. You should review various plans for premium costs, out-of-pocket expenses, inclusions and exclusions, claim process, etc., before purchasing health insurance for diabetes. 

Q. Where can I check diabetes health insurance costs?

You can check the costs for health insurance for type 1 or type 2 diabetes using the health insurance premium calculators available on the insurance company’s website. You can also contact the service provider’s customer care team for the details. 

Q. What is the diabetes health insurance claim procedure?

The claim procedure for health insurance for diabetes is simple. You have to produce a duly filled and signed claim form along with the required documents such as hospitalisation bills, prescriptions, discharge summaries, etc. For cashless hospitalisation, the insurance company will coordinate with the hospital for the expenses and settle the bill directly. 

Related Article

Everything About Health Insurance for Cancer Patients in India

Health Insurance Guide for Disabled Persons

Reference:

1. https://www.ncbi.nlm.nih.gov/books/NBK597725/

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Francis Rodrigues Francis Rodrigues

Francis Rodrigues has a decade long experience in the insurance sector, and as SVP, E-Commerce and Digital Marketing, HDFC Life, manages the online sales channel, as well as digital and performance marketing. He has had hands-on experience in setting up sales channels and functional teams from scratch over a career spanning 2 decades.

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Vishal Subharwal Vishal Subharwal

Vishal Subharwal heads the Strategy, Marketing, E-Commerce, Digital Business & Sustainability initiatives at HDFC Life. He is responsible for crafting and ensuring successful implementation of the overall organisation strategy.

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