Best Health Insurance For Diabetic Patients In India: Eligibility Criteria & Claim Process

Health Insurance

Diabetes mellitus is a widespread chronic disease that requires frequent doctor check-ups, hospitalisations, and medications. To meet these expenses, it is essential to choose the best health insurance for diabetic patients in India. A diabetes insurance policy will help you to easily manage the long-drawn cost of diabetes treatment and associated illnesses. 

A regular health insurance policy might not be sufficient to meet the diabetes-related medical cost. Hence, a specially designed insurance policy is required to cater to the specific financial requirements of diabetes treatment. The following sections provide a complete rundown to help you find the best health insurance for diabetic patients in India along with the features and benefits.

Best Health Insurance For Diabetic Patients In India

There are various insurance providers who have introduced dedicated diabetes health insurance policies. Here’s a list of some of the best health insurance for diabetics in India:

Navi Health Insurance

Navi Health Insurance is another option that diabetic patients can consider. This policy comes with a wellness plan that motivates a diabetic individual to lead an active and healthy lifestyle. Based on the improvement, you will be offered discounts. After the wellness program, you need to undergo a health screening test to ascertain the HbA1c value. If it falls between 5.7 to 6.4%, you can get a 3% discount. However, if it is below 5.6%, you will get a 5% discount on the premium paid. 

Download Navi App to learn more about the plans. The procedure to avail of Navi Health Insurance is completely paperless and comes with a 97% claim settlement ratio. 

Apollo Munich Energy Plan

This is a comprehensive health insurance policy to cater to individuals with Type 1 and Type 2 Diabetes, pre-diabetes, and hypertension. Apollo Munich Energy Plan not only covers diabetes treatment but also encourages individuals to lead an active lifestyle. It comes with wellness plans that offer rewards and points to maintain a healthy life. These can be later used for consultation and medication.  

It provides pre and post-hospitalisation coverage with the sum insured ranging between Rs.2 lakh and Rs.50 lakh.

National Varistha Mediclaim Policy

This diabetes policy is designed particularly for senior citizens with Diabetes, ITG, IFG, and hypertension. The policy premium starts as low as Rs. 4,100 while the sum insured falls between Rs. 1 lakh and Rs. 2 lakh.

HDFC Ergo Energy Health

Under this diabetes policy, you can opt for 2 types of plans: Gold and Silver. The Gold plan comes with the cost of the wellness program included. This diabetes insurance policy is meant to cover for treatment of Diabetes 2. The sum insured ranges between Rs.2 lakh and Rs.10 lakh. 

How Do Health Insurance Plans For Diabetic Patients Work?

Most of the health insurance plans in India do not provide coverage for type 1 diabetes. That said, type 2 diabetes can be covered by a health insurance plan. General health insurance plans are not supposed to provide coverage for pre-existing illnesses but you can get diabetes insurance plans which are exclusively modified for high blood sugar and related illness.

A diabetes insurance policy in India covers hospitalization expenses, outpatient costs, diagnostic tests, and expenses incurred for medical consultation. 

Top Benefits of Buying the Best Health Insurance For Diabetic Patients in India

A diabetic individual can avail of a host of advantages with a dedicated diabetic insurance policy. These include:

Extensive financial coverage

Treatment of diabetes can be a lengthy and costly affair. Diabetes mellitus is a chronic disease that requires frequent doctor consultation, medications, insulin, diagnostic tests, and even hospitalisation. The best health insurance for diabetic patients in India will provide extensive financial coverage to help you manage all these expenses. 

Wellness programs with coaches

Almost all diabetes insurance plans include a wellness program that motivates diabetic individuals to lead a healthy lifestyle. Such programs also come with a wellness trainer or coach to monitor and assess the policyholders’ progress. 

Rewards

As a diabetes insurance policyholder, you are also eligible for no-claim bonus or reward points to stay fit and active. You can later use these reward points or discounts to reduce the cost of health insurance policies.

Key Features of The Best Health Insurance For Diabetic Patients in India

An ideal health insurance policy for diabetic patients in India will have the following features:

• Pre-existing illness: Usually, a health insurance policy doesn’t provide coverage for pre-existing illnesses and diabetes is considered as one. That said, some plans may cover pre-existing illnesses after a waiting period, which can range from 2 to 4 years.  
• Hospitalization expenses: A health insurance policy for diabetics will cover pre and post hospitalization expenses, including diagnosis and medication costs.
• Cashless claim settlement: Diabetes health insurance cover will have the feature of cashless settlement where the insurance provider will settle the bill with the hospital directly.
• Daycare expenses: One might require daycare for a specific time of the day. These expenses will also be covered by the health insurance policy. 

Also Read: 10 Best Cashless Health Insurance Plans

What is Not Covered Under a Health Insurance Plan For Diabetic Patients?

There are a few exclusions that are usually not covered under the best health insurance for diabetic patients in India such as:

• Cosmetic and/or aesthetic treatments
• Pre-existing diseases (plans covering pre-existing conditions usually come with a waiting period of a few months or years)
• Injuries while taking part in sports such as racing, diving, aerial activities, etc.
• Illnesses induced by drugs or alcohol
• Hospitalization due to chemical, biological or nuclear incidents
• Hospitalization without the doctor’s recommendation

Also Read: A Quick Guide To Health Insurance Premium Calculators

Eligibility Criteria to Buy the Best Health Insurance for Diabetic Patients in India

The eligibility criteria to purchase a diabetes insurance plan usually vary from one insurer to another. However, some of these criteria remain the same across all policy providers:

• Every insurer has prescribed a minimum age limit to be eligible to buy the policy. Both the minimum and maximum age limits vary from insurer to insurer. Since children can also have diabetes, the minimum age for enrolling under health insurance for diabetes is 91 days.
• You might have to undergo a pre-policy health screening test before buying health insurance for diabetes. However, these tests are generally not compulsory. 

Top Reasons to Opt For The Best Health Insurance Policies for Diabetic Patients in India

Here are the reasons why you need to opt for the best health insurance policies for diabetic patients in India:

• There has been an increase in lifestyle diseases such as diabetes, which can be life-threatening. Hence, it is essential that you get insurance cover for yourself and your loved ones. 
• A health insurance policy for diabetes will take care of the hefty medical bills. By paying a premium at regular intervals you can save yourself from getting bankrupt and receive quality treatment.
• Apart from insurance benefits, a policyholder can also claim tax deductions under section 80D of the Income Tax Act by paying the premium of a health insurance policy for diabetes.

What to Consider While Choosing the Best Health Insurance for Diabetic Patients in India?

The market is flooded with numerous insurers providing diabetes health insurance policies. However, finding the one that best suits your requirements can be a bit confusing. Keeping the following pointers in mind will help you in your quest to find the best health insurance for diabetes in India:

Waiting period

Diabetes is a chronic disease that requires constant medical attention. Therefore, it is crucial to find a diabetes insurance policy with a low waiting period. Insurers offering diabetes insurance plans usually offer a lower waiting period. Make sure to compare across various insurers to find a policy that offers a low or no waiting period.

Wellness plans

Since the recovery of diabetes is connected with your lifestyle, it cannot be cured with only medications and treatments. It requires constant effort to stay healthy. Most diabetes insurance policies come with a wellness program and coach to help patients stay fit and healthy. Such plans also offer benefits and rewards. Try to find a policy that comes with a suitable wellness program.

Maximum renewable age

Most diabetes insurance policies provide policy renewal of up to 60 years. Make sure to find an insurance policy that offers a high renewable age. 

Also Read: What Is Domicilary Hospitalisation: Coverage, Exclusions And How To Claim And Documents Needed

Factors To Be Considered While Calculating Premium On Health Insurance For Diabetic Patients

Health insurance is gaining popularity in India with the simultaneous rise in lifestyle diseases. While purchasing a diabetic health insurance plan, the following factors might affect the premium that the insured individuals have to pay at regular intervals:

• Pre-existing medical condition: If the policyholder has any pre-existing medical condition, generally the insurance provider denies including it in the plan. That said, if pre-existing illnesses are included by the insurer, the insured individuals have to pay a high premium. 
• Medical history: If there is any medical condition existing in the family, then that will be added to the insurance plan, adding to the premiums.
• BMI: A person with a BMI higher than normal is at more risk of diseases. They will also need extra care for specific conditions like pregnancy. This will affect the premiums.
• Age: Young people are less likely to get sick than old ones. In the case of most insurance policies, young policyholders have to pay lower premiums than the older ones while availing of the same benefits.
• Location: There are many insurance providers who plan their policies based on the location. Location influences the culture and habits of a person which in turn has effects on fitness. Hence, some insurance providers keep the premiums of a policy high in places with unhealthy habits.
• Habits of an individual: An individual may be having habits or addiction to injurious substances which make them prone to life-threatening diseases like cancer. While considering a policy for such an individual, the insurance provider might increase the premium amount.
• Profession: An individual’s profession will also affect the premiums of a health insurance policy. For example, if the person’s job makes him/her more vulnerable to hazardous chemicals, substances, pollution or radiation, enhancing health risks, the premium payable will be high. 

How to Buy the Best Health Insurance for Diabetic Patients in India?

You can follow the given steps for buying a health insurance policy for diabetic patients in India:

Step 1: Visit the website of your preferred insurance provider.

Step 2: Fill in your details such as contact details and pre-existing illness.

Step 3: Choose your desired sum insured, add-ons and personalize your health insurance plan for diabetes. Alternatively, you can choose a plan exclusively made for diabetes. 

Step 4: Make payment and get your health insurance policy.  

How to File a Claim for Diabetes Insurance Policy?

The process to file a claim for diabetes insurance is the same as that for any other health insurance policy. When you submit the medical bills, your insurer will reimburse the expenses and the hospital bills. 

However, if you are part of a cashless health insurance policy, your policy provider will pay the hospital directly. 

Final Word

It is usually beneficial for diabetic individuals to opt for a specially curated diabetes insurance plan instead of a regular health insurance plan. However, you need to keep in mind all the key points while looking for the best health insurance for diabetics in India. Make sure to compare and assess all the offerings of insurers before making a decision. 

FAQs on Health Insurance for Diabetic Patients

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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.