Navigating Health Insurance with Diabetes

Diabetes is majorly a lifestyle disorder and is also hereditary. Around 11.4% of the Indian population, in other words, around 101 million people, are diabetics. Moreover, 15.3% of the population, or an additional 136 million people, are suffering from Pre-Diabetes.

People who suffer from Diabetes have to incur a lot of financial expenses on medicines, regular tests, etc. This could constrain their finances. What do we do then?

A comprehensive Diabetes health insurance plan is the right choice. In this post, we will try to provide you with all the necessary information related to Diabetes health insurance.

We will look into the meaning of health insurance related to Diabetes and its difference from regular insurance. We will also understand the need for health insurance for Diabetes, including cashless health insurance.

Difference between Health and Diabetes Insurance

Due to the rising number of people suffering from Diabetes, insurance companies have introduced the best health insurance policies specifically catering to the needs of diabetics. Different plans are now available for people suffering from Pre-Diabetes and/or Type 1 or Type 2 Diabetes. Insurers also offer a combination of health insurance plans, which include people who suffer from Diabetes and Hypertension.

When trying to know the difference between a regular healthcare policy and a Diabetes health insurance plan, know that usually, most health insurance plans do not cover diabetics suffering from Type 1 Diabetes. Some plans cover those suffering from Type 2 Diabetes, but one can make a claim only after completing a certain waiting period of 2-4 years. Women with Gestational Diabetes can receive coverage under a maternity insurance plan.

So, in order to fill this gap, insurance companies have come up with Diabetes health insurance plans. When you avail of Diabetes health insurance plans, you don’t have any waiting period. Since Diabetes falls under the category of high-risk diseases, such plans are more expensive than regular health insurance policies.

Why do we need insurance plans that cater specifically to the needs of Diabetes patients?

Diabetes patients require more medical attention. These patients require:

  • regular medicines
  • insulin injections
  • monthly health check-ups
  • blood tests
  • doctor’s consultations

All of this not only affects the patient mentally but also puts them under a lot of financial burden. On average, the expenditure of Diabetes patients is somewhere between INR 3,000 and INR 8,000 per month, and annually between INR 35,000 and INR 75,000.

People who suffer from Diabetes have to incorporate exercises and healthy diet patterns into their daily routines in order to stay fit.

Moreover, diabetic patients are at an increased risk of developing other health disorders, including blindness and other eye complications, heart attack, kidney-related complications, sclerosis and other skin disorders, diabetic coma, diabetic ketoacidosis, nerve damage, hypertension, etc.

Hence, diabetics health insurance is actually a necessity.

The Benefits of Diabetic-Specific Insurance

  • No waiting period: Patients who purchase Diabetes-specific insurance plans to cater to their needs do not have to surpass the waiting period.
  • In-patient Hospitalisation Coverage: The policy provides coverage for medical treatments and medications when a patient gets admitted to a hospital.
  • Pre- and Post-Hospitalisation Coverage: A diabetic health insurance plan provides expenses related to healthcare 30 days before and 60 days after the patient’s hospitalisation.
  • Emergency Ambulance Coverage: Such policies include coverage related to ambulance fees required to take the patient to a hospital.
  • Organ Donor Expenses: In the case of organ transplant, all the costs related to it also get covered in the insurance plan.
  • HbA1C Check-up-Benefit: After the person purchases diabetics-specific insurance, he/she becomes entitled to compensation for required expenses related to HbA1C check-up.

Standard Exclusions of a Diabetes Insurance Policy

The diabetics’ health insurance policy does not cover the following expenses:

  • HIV/AIDS and related diseases
  • Cosmetic surgeries and weight control treatments
  • Hospitalisation due to war/act of war, nuclear/chemical/biological weapon attack, and radiation of any kind
  • Pregnancy, dental treatment, etc.
  • Items of personal comfort and convenience

Terms you should be aware of

  • PreDiabetes: This is a condition in which an individual suffers from high blood sugar levels that are not high enough to get classified as Diabetes.
  • Type 1 Diabetes: Here, the body’s immune system targets the cells that produce insulin and damages them, leading to an abnormal increase in sugar levels.
  • Type 2 Diabetes: This is also known as Diabetes Mellitus. Here, the body cannot efficiently use the insulin the pancreas produces and starts producing additional insulin. But, with time, it becomes difficult for the pancreas to produce the adequate amount of insulin required by the body to maintain normal blood glucose levels.
  • Waiting Period: This is the duration before an insurance policy starts to provide coverage for a patient’s pre-existing diseases. It differs from policy to policy, ranging from 2 to 5 years.
  • Pre-existing Diseases: Such ailments refer to illnesses a patient suffers from before buying the Diabetes health insurance policy.

Classification of Pre-Diabetes, Type-1 Diabetes, and Type 2 Diabetes based on blood sugar levels

CLASSIFICATION Before Eating/Fasting After Eating/Post-Prandial
Normal 70-99 mg/dL 70-140 mg/dL
Pre-Diabetes 101-125 mg/dL 141-200 mg/dL
Type 1 or Type 2 Diabetes 125 mg/dL and above 200 mg/dL and above



The rise of Diabetes in India has necessitated the introduction of diabetics’ health insurance. To choose the best health insurance policy, including cashless health insurance, carefully go through the terms and conditions of various plans outlining the scope of coverage and exemptions to ensure it meets your specific health needs.

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