Diabetes health insurance plans

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According to Wikipedia and WHO, India has an estimated 77 million (7.7 cr) people with diabetes, which makes it the second most affected in the world, after China. Known in health circles as the Silent Killer, one in six people (17%) in the world with diabetes is from India.(India’s population as calculated in October 2018 was about 17.5% of the global total). And more importantly, the number is of diabetics projected to grow by 2045 to become 134 million (13.4 cr) per the estimates of the International Diabetes Federation.

In India, type 1 diabetes is more rare than in western countries. Only about one-third of type 2 diabetics in India are overweight or obese. An early study suggests that the prevalence of type 2 diabetes in Indians may be due to environmental and lifestyle changes resulting from industrialization and migration to urban environment from rural parts of India. These changes also occur earlier in life, which means chronic long-term complications are more common.
diabetes
In order to control diabetes in India, the Government of India initiated the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) in 2010.It aims to set up outreach camps for opportunistic screening at all levels in the health care delivery system for early detection of diabetes, among other illnesses.

Not only in India, but there is an alarming increase in the number of diabetics across the world and given the lifestyles of the current generation, this is likely to keep on increasing. Even if diagnosed early, it is important to be aware that while the treatment may not be expensive specifically for diabetes, there are many possible medical complications arising from diabetes like cancer, cardio vascular illnesses, which can be costly to treat. This means that for any individual/family, the stress is not just physical and mental but also financial. While the physical and mental stress and anxiety is something that each individual/family needs to be prepared for, the financial burden is one that can be planned for and this is where Diabetes Insurance comes into the picture.
Following is some statistics related to Diabetes in India. The objective of this presentation of data is for the readers to be aware of prevalence of this dreaded disease in India :
  • The worldwide prevalence of Diabetes was 9.2% while in India it is 8.9% as of 202o, but more importantly this prevalence % has been increasing over the years.
  • In 2020, according to the International Diabetes Federation (IDF), 463 million people have diabetes in the world and 88 million people in the Southeast Asia region. Of this 88 million people, 77 million belong to India.
  • The prevalence of diabetes in the population is 8.9% (almost 1 in every 11 persons) according to the IDF. According to the IDF estimates, India has the second highest number of children with type 1 diabetes after the United States. It also contributes to the largest proportion of incident cases of type 1 diabetes in children in the SEA region
  • Per the World Health Organization, 2% of all deaths in India are due to diabetes. Nearly 1 million Indians die due to diabetes every year.
  • The number of people with diabetes in India has increased from 26 million in 1990 to 65 million in 2016.According to the 2019 National Diabetes and Diabetic Retinopathy Survey report released by the Ministry of Health and Family Welfare, the prevalence was found to be 11.8% (one in every 8 persons) in people over the age of 50.
  • The prevalence was similar in both male (12%) and female (11.7%) populations, which suggests that neither sex is more or less prone to the disease.
  • It was higher in urban areas. When surveyed for diabetic retinopathy, which threatens eyesight, 16.9% of the diabetic population aged up to 50 years were found to be affected.
  • High prevalence of diabetes is reported in economically and epidemiologically advanced states such as Tamil Nadu and Kerala, where many research institutes which conduct prevalence studies are also present
  • The majority of diabetes cases are of type 2 diabetes
  • The average age on onset is 42.5 years. According to the Indian Heart Association, India is projected to be home to 109 million individuals with diabetes by 2035, rising to 134 million by 2045.

Diabetes Insurance in India

While India is moving towards becoming the Diabetes capital of the world, ironically there are very few insurance companies offering Diabetes insurance products in India. The only logical explanation could be that despite the high prevalence of this dreaded silent killer (almost 10% of the population), the mortality as a direct result of diabetes is only 2% of the total deaths in India, this means that most diabetics are not passing away due to this disease but are able to manage it’s impact through dieatary and lifestyle changes etc. This means that the insurance company will see almost all insureds outlasting the policy, and they will end up paying for all their treatment costs, which may make this plan unsustainable.

Currently most indemnity based health insurance plans have diabetes in their exclusion list and also extend it to complications arising from the disease. Diabetes features a number of easy to identify symptoms that include excessive thirst, frequent urination, fatigue, blurry vision and sudden weight loss and this further results in complications relating to the kidney, nervous system, cancer and cardio vascular ailments. Some offer coverage after a mandatory waiting period between 3-4 years of the health plan being in force. It is only the fixed benefit insurance plans offered by a handful of insurance companies that cover diabetics and their treatment costs in a reasonably comprehensive manner.

Some persons who are salaried employees can afford to have coverage through their group health insurance, provided by their employer. Such a plan covers one against pre-existing conditions including diabetes but it is active only as long as they are an employee with the organization. So employed people can expect to have some coverage atleast through these group plans.

What’s Covered under the Diabetes Insurance Plans?

The common benefits under these Fived Benefit Diabetes plans include :
  • In - Patient Treatment: If you are hospitalized in a network hospital for more than 24 hours, the insurance we cover your hospitalization expenses, including room charges, nursing expenses, ICU, surgeon’s fee, blood, oxygen, and OT (operation theatre changers).
  • Pre and Post hospitalization: The insurance plans cover pre and post hospitalization expenses. This means that medical expenses that are incurred just before one is hospitalized and after they get discharged from the hospital. Normally plans have a 30 days cover for Pre hospitalisation and 60 days cover for Post hospitalisation.
  • Cashless Treatment in Network Hospitals: Under this health insurance plan, during an emergency, one can be admitted to any of the network hospitals provided by th insurer directly or through their TPA, without thinking of arranging payment for your treatment. This helps them to tide over the situation financially.
  • Day Care Treatment: The insured’s Your medical expenses will be covered under the diabetic health insurance plan if they undergo for day care treatment in the hospital. Day care treatments essentially are those that do not require hospitalisation of the insured. Each insurer has a defined list of day care procedures covered under their plans.
  • Ambulance cover: You will also get the reimbursement for the expenses that you incur on ambulance service in case of a medical emergency (normally between ₹1,000 and ₹2,000).
  • Organ Donor Expenses: Medical treatment of the organ donor for harvesting the organ, including surgery to remove organs from a donor in the case of transplant surgery is covered under some of the plans.
  • Domiciliary Hospitalization / OPD Treatment: If one is not in a condition to shift to the hospital for treatment, or there is no vacant bed in the hospital, or there are certain procedures which can be done as an outpatient, then you can avail domiciliary hospitalization/OPD treatment.
  • Recharge/Restoration of Sum Insured: The insured will get an automatic recharge of Sum Insured (upto 100% of base sum insured) if your claim amount gets exhausted due to a claim during the policy period. You can use this amount for the treatment of any other insured family member (under family floater plans) or yourself but the treatment should be for different ailments.
  • Annual Health Check-Ups / Wellness Programs: An annual health check-up for all the insured members covered under the same policy, or specific Wellness program aimed at improving lifestyle and dietary habits are also part of some plans.
  • Tax Benefit: According to section 80 D under Income Tax Act 1961, the premiums paid for health insurance for self, dependent parents, children, and spouses are exempted from tax.
The Diabetes specific plans available in the market are in the table below. Kindly review and compare the same in more detail at eindiainsurance

star religare hdfc ergo health
Star Diabetes Safe Religare Care Freedom HDFC ERGO Energy Health
BUY NOW BUY NOW BUY NOW
Sum Insured
Rs. 3 lacs – 10 lacs Rs. 3 lacs – 10 lacs Rs. 2 lacs – 50 lacs
Policy period
1 year 1, 2, 3 years 1, 2 years
Eligibility criteria
18 years – 65 years 3 months – No Maximum Entry age 18 years - 65 years
Renewal
Lifelong Lifelong Lifelong
Day Care Procedures
All day care procedures covered Upto Sum Insured 182 day care procedures
Pre-policy Medical Check up
No No Yes
Co-pay
Nil 20% / 30% per claim • 182 day care procedures
Pre-existing disease
Coverage after 48 months Covered after 2 years waiting period Covered after 2 years waiting period
General waiting period
No 30 days No

Let’s us know some natural ways by which we can treat diabetes at home :

  • What not to eat:
    • Refined sugar - We all know that sugar, until it is in its most natural form, is bad for people suffering from diabetes. When consumed, refined sugar spikes the blood sugar rapidly.
    • Whole grains - Grains that have gluten in them should be avoided.
    • Alcohol - Alcohol consumption is directly related to diabetes. Alcohol not only damages your liver but also attacks the pancreas that produces insulin.
    • Cow’s milk - Just like whole grains, cow milk can trigger the immune system which can lead to inflammation. Milk coming from sheep and goat is not harmful in fact it helps to maintain the blood sugar level.
    • GMO (Genetically Modified Organism) foods - GMO foods have the capability to promote diabetes along with causing liver and kidney diseases. Go for products which are labeled as GMO-free.
  • What to eat and do:
    • Cinnamon Cinnamon contains a bioactive compound that can help to fight and prevent diabetes.
    • Aloe vera : Due to its anti-inflammatory properties, it is said to control the blood sugar levels.
    • Jamun : Jamun and its leaves have proven to be helpful in lowering the blood sugar levels.
    • Vitamin C : Vitamin C is not only good for skin but also for diabetes.
    • Exercise : One of the main reasons behind type II diabetes is being overweight. Any kind of physical activity, be it yoga, Zumba, aerobics, gymming, playing sports can significantly improve blood sugar level by maintaining your weight. Not only this, walking every day can help to reduce the blood sugar level tremendously.

Exclusions under the Diabetes Insurance Policies

  • Benefits will not be available for any Pre- Existing conditions or related condition(s) or any complications arising thereof for which Insured has been diagnosed, received medical treatment, had signs and / or symptoms, prior to inception of Insured’s first Policy, unless such a condition is stated in the Proposal form and specifically accepted by the Insurer and endorsed thereon.
  • Insurer shall not be liable to make any payment under this Policy in connection with or in respect of any Insured Event during the Waiting Period as defined under the Policy.
  • Any diseases causing the death of the Insured within the stipulated Survival Period, measured from the date of incidence of the illness.
  • Any medical procedure or treatment, which is not medically necessary or not performed by a Medical Practitioner.
  • Any congenital Illness / Conditions.
  • Any Covered Critical Illness arising from Birth control procedures and/or hormone replacement therapy and any complications arising thereof from.
  • Any treatment/surgery for change of sex or any cosmetic surgery or treatment/surgery /complications/illness arising as a consequence thereof.
  • Any Covered Critical Illness arising from Treatment by a family member and self medication or any treatment that is NOT scientifically recognized and any complications arising thereof / there from.
  • Attempted suicide (whether sane or insane) or intentionally self inflicted Injury or Illness.
  • Sexually transmitted conditions, mental or nervous disorder, , Acquired Immune Deficiency Syndrome (AIDS), Human Immune deficiency Virus (HIV) infection.
  • Use/Abuse of drugs, alcohol, or other intoxicants or hallucinogens unless properly prescribed by a Medical Practitioner and taken as prescribed.
  • War, invasion, act of foreign enemy, hostilities (whether war be declared or not), armed or unarmed truce, civil war, mutiny, rebellion, revolution, insurrection, military or usurped power, riot or civil commotion, strikes.
  • Participation in winter sports, skydiving/parachuting, hang gliding, bungee jumping, scuba diving, mountain climbing (where ropes or guides are customarily used), riding or driving in races or rallies using a motorized vehicle or bicycle, caving or pot-holing, hunting or equestrian activities, skin diving or other underwater activity, rafting or canoeing involving white water rapids, yachting or boating outside coastal waters (2 miles), participation in any Professional Sports, any bodily contact sport or any other hazardous or potentially dangerous sport for which Insured is untrained.
  • Failure to seek or follow medical advice following the diagnosis of any illness / disease / injury.
  • Serving in any branch of the Military or Armed Forces of any country, whether in peace or War.
  • Participation in a criminal or unlawful act with a criminal intent.
  • Nuclear contamination, the radioactive, explosive or hazardous nature of nuclear fuel materials or property contaminated by nuclear fuel materials or accident arising from such nature.
  • Genetic disorders and stem cell implantation / surgery / storage.

FAQ’s on Diabetes Insurance

This a specialized product targeted towards individuals suffering from
  • Diabetes Type 1,
  • Diabetes mellitus Type 2,
  • Pre-diabetes (IFG, IGT)
However, please check the terms and conditions prior to choosing a plan since the coverages vary from insurer to insurer.

The Sum Insured option available are from ₹2 lacs upto 50 lacs on individual sum insured basis. Some insurers also offer a family floater option.

This kind of a plan is not required for people leading a normal life. Regular & cheaper alternatives like indemnity based health insurance plans would be sufficient to cater the regular health insurance requirements. It is designed specifically for diabetics to ensure they can also avail a customised plan.

Yes, this product is eligible for portability. Portability would be limited to the extent of previous sum insured + Cumulative Bonus (if any) and waiting periods (2 years and PED) would be reduced based on number of continuous years of previous insurance.

Minimum entry age – 18 years and maximum entry age – 65 years for adults. Some plans are also available for covering children from 3 months of age.

No, some plans come with NIL waiting period and others with a 30 day mandatory waiting period. Apart from that there are waiting periods on the plans for
  • 2 years waiting period for specified illnesses
  • 2 years waiting period on Pre Existing Diseases

Yes & No. Some insurance plans don’t’ have PPC, while others have a Pre- policy Check, post which coverage approval will be provided.


India health insurance companies offering coverage for Diabetes
Star Health Travel Insurance Plans religare hdfc ergo health

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