With rising medical costs, it is very wise to invest in Health Insurance. A Health Insurance Policy covers you and your family against medical expenses due to sickness or accident. The Insured in return has to pay a regular premium to the Insurer.
A Health Insurance Policy covers medical expenses only if you are hospitalised for more than 24 hours. There are some policies which cover day care procedures that do not require 24 hours hospitalisation, but only the ones mentioned in the policy document.
Insurance Cover for People with Diabetes
Diabetes not only has a tremendous effect on a person’s daily life, but also has a big impact on finances. Today, there are more choices for people with diabetes than there was a decade ago.
Why diabetes insurance?
Diabetes is the root cause of many diseases and if left unattended, could lead to complications such as heart disease, stroke, kidney failure, major organ transplant, blindness and foot problems. Treatment for such complications is very expensive and so it is wise to have some form of protection against high costs. Diabetes insurance provides coverage for the diseases caused because of diabetes. An insurance policy safeguards a person from high costs of hospital treatment, consultancy fees, boarding and room charges, nursing, and medicines and drugs and so on.
Who can be covered?
Most insurance providers provide cover for Type II Diabetes mellitus. The sum assured of the protection policy could range from Rs. 50,000 to Rs. 10 lakhs, depending upon the need.
Cover providers
Cover for diabetes is mostly provided by private insurers. Due to a Supreme Court ruling, companies from the government sector do not directly deny providing the cover. However, they charge, an extra ‘loading fee’ apart from the premium if the person applying for insurance is diagnosed with any special illness during medical examination. Every health insurance customer has to undergo a medical examination before buying any policy. The key players providing diabetes insurance are ICICI Prudential Life Insurance, Star Health Insurance, National Insurance and Bajaj Allianz General Insurance.
ICICI Prudential Life Insurance offers three different policies.
Diabetes Care
Diabetes Care is a unique critical illness insurance policy for people with Type 2 Diabetes mellitus and Pre-diabetes. Diabetes Care not only provides financial support but also helps to manage your condition more effectively. The policy covers six critical illnesses, including heart attack, coronary artery bypass surgery, kidney failure, stroke, cancer and major organ transplant caused due to diabetes.
Key Points
- A lump-sum payment is given to the policy holder on diagnosis of any one of the above mentioned illnesses.
- According to policy terms, in the first 6 months from the date policy is bought, if any of the six mentioned critical illness is diagnosed, the policyholder will be only eligible for the premium paid till date as benefit amount. If the disease is diagnosed between 6-12 months, the policy holder will be eligible to get a maximum of 50% of the sum assured. A policy holder will get 100% of sum assured benefit on the disease only after completion of 12 months of policy period.
- Optional cover for eye & foot complications
- Reduced premium on display of good control
- Tie-ups with leading healthcare partners to help you Manage diabetes
- Web support for better diabetes control
- Tax benefit under Section 80D of the Income Tax Act
Diabetes Care Plus covers eye and foot problems along with other diseases covered under Diabetes Care. Full death benefit is also payable on death of the insured any time during the entire policy term, including 1st policy year. Compensation is paid in case of death of the policy holder. You have to pay an additional premium to get this policy.
Key Notes
- A person between 25 and 60 years of age can buy these policies.
- Both policies are available with sum assured options of Rs. 3 lakhs, 5 lakhs and 10 lakhs.
- The claim is payable only on survival for 28 days from the date of diagnosis of the critical illness.
- Under these policies, ICICI offers a wellness program which includes three free check-ups and a consultation with a doctor every year.
- After the lump-sum payout is made for the 1st critical illness, the policy stands terminated.
- There will be no reimbursement offered against drug purchases, insulin or insulin delivery mechanisms.
- If a policyholder display of good control over the disease during the policy period, he can enjoy a reduced premium.
This is a five-year term, regular premium policy and covers kidney failure, limb amputation due to diabetes, and laser treatment. Diabetic Assure does not cover pre-existing disease. Diabetic Assure is available with sum assured options of Rs 2 lakhs, 3 lakhs, 4 lakhs and 5 lakhs and is available in selected cities only.
Star Health and Allied Insurance Co. Ltd.
Diabetes Safe
The policy offers coverage against diabetic retinopathy which requires laser treatment , diabetic nephropathy leading to chronic renal failure and diabetic foot ulcer. This policy is available with a sum assured options of Rs 50, 000, 1 lakhs, 2 lakhs, 3 lakhs, 4 lakhs and 5 lakhs. Any person between 26 years and 65 years of age diagnosed with Type II diabetes is eligible for this insurance. It can be renewed till the policyholder is 70 years.
Diabetes Safe protects the insured for in-patient hospitalisation expenses for a minimum of 24 hours. However, for dialysis and laser procedure this minimum 24 hours does not apply.
Key Points
- People who have already developed complications of the disease covered are not eligible .
- All applicants have to undergo a medical screening at a company nominated centre.
- The policy does not cover treatment of pre-existing diseases or conditions .
- The insurer is not liable to make any payment for expenses incurred towards the covered illness within 900 days from the date of commencement of this policy.
- Expenses on treatment of Diabetes Mellitus Type II and cost of immune-suppressive drugs or medicines cannot be claimed under this policy.
National Insurance- Varistha Mediclaim Policy -
Public sector General Insurer National Insurance has included diabetes in its VaristhaMediclaim Policy. This policy is available only for senior citizens. A person between 60 years and 80 years is eligible to get insured and the age limit for renewal of the policy can be extended to 90 years. It provides a policy for a maximum of Rs 3 lakhs with Rs 1 lakh for health and Rs 2 lakh for critical illness. Critical illness should be selected to get coverage for diabetes.
Bajaj Allianz Critical Illness Policy-
By paying an additional premium, people with diabetes can get coverage through the Critical Illness Policy. Before giving diabetes cover, a patient has to go through a medical examination The policy does not provide any benefit if illness is diagnosed within the first 90 days. Sum assured for the policy is between Rs 1 lakh and 5 lakh, while age range of the policy is from 6 years to 59 years.
Note: All health insurance policies do not cover ‘pre-existing’ diseases i.e diseases that have been in existence at the time of getting the policy.
Since all insurance contracts are contracts of good faith be honest about your condition with the insuring company or else the contract can be made void.
Mediclaim Solutions - Diabetes Exclusive Policy
Mediclaim Solutions offers special services with respect to diabetes insurance in the form of the Diabetes Exclusive Policy Solutions . They help people with diabetes choose the best policy that is cost effective and suits individual requirements from among various policies offered by insurers .
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