Changing lifestyles are taking a toll on people’s health. The rising incidence of diabetes is one such instance impacting an individuals’ life, both physically and financially. Also known as the ‘silent killer’, the probability of hospitalisation is high for diabetes patients, especially as they age.
The probability of having to pay large hospital bills, therefore, increases and unless one has a dedicated and exclusive diabetes insurance plan, much of it will have to be borne from one’s own pocket. According to an Association of Physicians of India study, the urban poor spend as much as 34 per cent, while their rural counterparts spend 27 percent of their income on diabetes treatment.
So how about buying a diabetes health insurance plan? Any diabetes patient between the ages of 18 and 65 is eligible to buy it. What’s more, there is no waiting period in the diabetes specific insurance plans. “Diabetes insurance plans are specialised insurance plans focused on providing coverage on treatments or expenses for people who suffer from diabetes,” says Mahavir Chopra, Director – Health, Life & Strategic Initiatives, Coverfox.com.
Diabetes insurance plans may be standalone and specifically covering the disease or a part of a regular Mediclaim plan after paying extra premium. Varishta Mediclaim from National Insurance and Care Freedom from Religare Health Insurance are two such plans, but they cater only to senior citizens. ‘Diabetes Safe’ from Star Health Insurance and ‘Energy’ from Apollo Munich Health Insurance are two exclusive diabetes insurance plans which anyone within the eligible age bracket can buy, unlike the previous two.
The need for diabetes specific insurance plan
For a healthy individual, having a health cover plan like a Mediclaim, with adequate sum insured, could be enough to meet the hospitalisation costs arising out of a diabetic situation. But future renewals and coverage may get impacted. Therefore, on detection of diabetes, a diabetes specific insurance plan helps.
Diabetes is a chronic disease that not only affects the pancreas’ ability to produce insulin but also impacts the entire body. There could be further complications caused due to diabetes, including heart disease, stroke, kidney failure, vision loss and neuropathy or nerve damage. Hence, for a diabetes patient, a diabetes specific insurance plan can address the hospitalisation concerns better.
There is another reason that makes diabetes specific insurance plan important. “Generally, health insurance plans treat diabetes as a pre-existing disease and put a waiting period on the policy, which is around 12 months to 2 years, but can sometimes go up to 4 years. So it is sensible to buy a diabetes specific plan which is way more comprehensive than the health plans and also covers various complexities,” says Naval Goel, Founder & CEO, PolicyX.com.
Costlier than others
Buying a diabetes health insurance plan can, however, be costlier than other disease specific plans. It could be because of the rising incidence, so insurers perceive higher risk of payouts, and also because the plan is a specialised product. Goel says, “The reason is quite obvious, even after taking into account the problem of diabetes and its complications, there is a high probability that the insured will outlive the policy term.” Life-long renewals beyond 65 years are offered under all such plans.
Apollo Munich Health Insurance’s ‘Energy’
Apollo Munich Health Insurance offers ‘Energy’, a diabetes insurance plan for those who have been diagnosed with Type II Diabetes or Prediabetes (Impaired Fasting Glucose/Impaired Glucose Tolerance) or Hypertension. There is no waiting period and there is an option for co-payment of 20 per cent of the claim amount. The plan also provides coverage for 144 day-care procedures. There is a wellness programme inbuilt in the plan which takes care of wellness tests and wellness support that includes online data sharing and a wellness coach to help manage diet and health.
n addition, the plan offers a renewal premium discount of up to 25 per cent for the management of health conditions. If there is no claim and the insured manages his sugar to stay healthy, then he will get a discount. Further, reimbursements of up to 25 per cent of the renewal premium towards consultation, medicines and drugs, diagnostic, dental and other miscellaneous medical expenses not covered under any medical insurance will be applicable.
Do not merely base your buying decision by looking at premiums. As the age band changes, the premium amount also changes.
Star Health Insurance’s ‘Diabetes Safe’
Star Health Insurance’s ‘Diabetes Safe’ covers hospitalisation expenses arising out of complications of both type 1 and type 2 diabetes, and hospitalisation expenses other than those related to complications. Therefore, it’s a kind of a combo of Mediclaim and diabetes insurance plan. The plan also covers out-patient expenses for medical consultations, diagnostic tests, medicine and compensation for the accidental death of the insured person.
The policy can be taken on Individual and Floater basis. There are two options: Plan A, where pre-acceptance medical screening is compulsory, while in Plan B, there is no pre-acceptance medical screening. There is no waiting period for Plan A, but there is a 15-month waiting period for Plan B.
Rising incidence of diabetes
With diabetes on the rise because of changing lifestyles and genetic predisposition, diabetes-related deaths in India have witnessed a 50 per cent increase between 2005 and 2015. It is now the seventh-most common cause of death in the country, up from the 11th rank in 2005, according to data published by the Global Burden of Disease (GBD), a WHO project. There are 69.1 million diabetes patients in India, the second-highest number in the world after China (109 million). According to the International Diabetes Federation (IDF) estimates, India is predicted to have 123 million diabetes cases in the 20-79 age group by 2040.
As Ashish Mehrotra, MD & CEO, Max Bupa Health Insurance, says, “A comprehensive health insurance plan covers multiple conditions and removes the worry of managing multiple plans. Also, when one can get the treatment for diabetes and all other conditions under a single policy, then the need for specific cover gets reduced.”
If, however, diabetes is detected at a later stage, the future claim on the plain-vanilla health insurance plan runs the risk of being jeopardised unless the policyholder informs the insurer of any change in his medical condition. In other words, if the insured develops diabetes many years after buying the regular insurance policy, even then it would be covered only if he informs the insurer. The insured would still be covered for diabetes as it was not pre-existing, so diabetes cover would be relevant only in cases where the policy is bought after the disease is discovered.
“Diabetes plans provide much needed immediate and specialised covers for such a serious disease. It is, therefore, worth investing in specialised health insurance plan for diabetes as a supplementary cover to your regular health insurance plan,” says Chopra. But even with an insurance to back the claims, it’s always better to stay healthy, do regular exercises, eat healthy diet, make lifestyle changes, and have regular health check-ups. Early diagnosis definitely helps in limiting the damage, both physically and financially.
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