Diabetes Insurance Plan Vs Standard Health Policy: What Should You Opt For?

A standard health insurance policy covers diabetes, but is it sufficient? Should you buy a diabetes-focused policy?

Versha Jain
November 14, 2023
Diabetes Health Insurance

Diabetes Health Insurance

There are over 10 crore people with diabetes in India in 2023, according to the Indian Council of Medical Research. This chronic disease can damage your blood vessels, nerves, and other important body organs like the heart, kidneys, and eyes. 


Santosh Puri, senior vice president of health product & process, health insurance, Tata AIG General Insurance, says, “Given the significant role that family medical history and genetics play, especially with the prevalence of diabetes and hereditary diseases, obtaining health insurance emerges as a fundamental risk protection tool for individuals with diabetes. Fast-paced lifestyles and rising stress levels, exacerbated by the recent COVID-19 pandemic, underscore the importance of health and financial preparedness. Securing health insurance policy early, regardless of age, is quintessential in today’s fast-paced era with the rise in lifestyle-related diseases”.   

So, if one has diabetes, what should one do? Fortunately, insurance coverage is available for the disease. A standard health policy covers diabetes as a pre-existing disease, but one can only claim for any expenses incurred after a waiting period. The insurance companies also offer diabetes insurance plans, which are focused on the disease and cover the condition from day one.

While diabetes is covered under the health insurance policy, should one get a specific policy or be satisfied with the coverage in the standard policies, where the amount of coverage could be used for any disease, including diabetes? Let’s explore more.  

Should You Opt For A Diabetes Insurance Plan Or Standard Health Policy?

While comprehensive insurance policies cover pre-existing diseases after a certain waiting period, the specific diabetes insurance plan covers the disease from the first day of the policy. In the diabetes-focused policies, there is no waiting period. The condition is covered from day one, but usually, insurance companies take pre-insurance tests of the policyholder for it.  

Says Dr. Madhumathi Ramakrishnan, Executive Vice President, Claims, Star Health and Allied Insurance Co. Ltd: “The comprehensive policy cover diabetes after a waiting period of 36 months. In certain situations, the waiting period can be reduced to 12 months. In family policies, the waiting period is 48 months, so from product to product, the waiting period can differ”. 


In standard health insurance, the hospitalization expenses are covered, but in the specific diabetes plan, the coverage is focused, and outpatient coverage is also there, along with other benefits. 


A diabetes-focused policy offers coverage from day 1, along with other benefits. Ramakrishnan says, “The policy provides additional benefits such as the coverage of artificial limbs, personal accident coverage, kidney donors, OPD benefits, all these things are available in diabetes-focused policy but not in the comprehensive policy.” 


However, the premium could be higher for disease-specific policies than standard policies. Also note that in standard policies that consider the waiting period to cover the disease, if the condition is diagnosed after taking the plan, the insurance company will cover the disease without any waiting period. 


The main difference between the standard and specific policies is the waiting period and the cover benefits one gets. While the waiting period differs from one company to another, and the benefits may also vary, one should choose diabetes coverage as per one’s requirements. Getting cover from day one would be suitable if the disease is alarming. 


Says Ramakrishnan, “For somebody who has diabetes, it is always good to go for specific cover mainly because the waiting period is less, and there is a focused coverage from day 1. Though the premium may be high, it is better to opt for a specific cover instead of the policy with a waiting period”. 

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