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Health insurance policies which cover Diabetes

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    Health insurance policies which cover Diabetes

    Diabetes is one of the most serious illnesses in India which can be caused for various reasons. The estimates by IDF Diabetes Atlas in 2019 showed that India has the second highest number of diabetes patients aged 20-79 years. It has estimated that more than 134 million Indians would become diabetic in the next 25 years. India is on the top of the table among the countries from southeast Asia. One in six people in the World are from India. As of 2019 there are around 77 million diabetic patients in India and many more who were not diagnosed. This metric stresses the importance of having a diabetic specific health insurance policy or a health insurance policy that covers the diabetic related hospitalization without much waiting period.

    Let us see the list of insurance policies available in India which cover the diabetic related hospitalization.

    Health Insurance Plans which cover Diabetes


    Check out the table below with different health insurance plans with Diabetes cover from different health insurers in India


    Diabetes Health Insurance Plan

    Sum Insured (Rs.)

    Entry Age Criteria (yrs.)

    Family Size

    Star -Diabetes Safe Health insurance policy3 to 10 lakh rupees18 years to no limitSpouse only provided that at least one of them has diabetes mellitus.
    Care Freedom health insurance planRs 3 lakh to Rs 5 lakhMinimum entry age 90 days No upper age limit 6 members
    HDFC Ergo Energy Diabetes Insurance Plan2 Lakh / 50 LakhMinimum – 18 Year Maximum – 65 Year6 members
    Aditya Birla Activ Health Enhance Diabetes Plan 6 lakh60 years to 80 years Maximum Renewal Age: 90 yearsup to 3
    National Insurance VARISTHA Mediclaim1 Lakh / 2 Lakhage group of 60-80 yearsSpouse,dependent children


    Star -Diabetes Safe Health insurance policy


    Check out the table below with different health insurance plans with Diabetes cover from different health insurers in India


    Eligibility

    Any person with Type I or Type II diabetes Mellitus aged between 18 years and 65 years.

    Sum insured

    The minimum sum insured is Rs.3 lakhs and the maximum sum insured is Rs.10 Lakhs

    Emergency Ambulance

    Up to Rs.2000 per policy period for transportation of the insured to the hospital.

    • Family definition- Family means Self, Spouse only provided that at least one of them has diabetes mellitus.
    • Family definition- Family means Self, Spouse only provided that at least one of them has diabetes mellitus.
    • Policy term- The policy can be taken for a period of 1 year/ 2 years/ 3 years. For policies more than 1 year the unutilized sum insured would not be carried forward to the next policy year.
    • Outpatient medical expenses- Covered up to Rs.750 per event up to Rs.1500 per policy period.
    • Pre-policy checkup- Required for Plan A
    • Pre Hospitalization- 30 days prior to the date of hospitalization
    • Post hospitalization- 60 days after the hospitalization not exceeding 7% of the hospitalization expenses or Rs.5000 per hospitalization whichever is less.
    • Day care procedures- All day care procedures are covered
    • Pre existing waiting period- 48 months Specific disease waiting period: 24 months Initial waiting period: 30 days


    Care Freedom health insurance plan



    Eligibility

    Minimum entry age is 18 years and Maximum entry age is

    Sum insured

    The minimum sum insured is Rs.3 lakhs and the maximum sum insured is Rs.10 Lakhs

    Emergency Ambulance

    Up to Rs.1000 per policy hospitalization for transportation of the insured to the hospital.

    • Family definition- Family means Self, Spouse, dependent children and dependent parents. The total family size cannot exceed 6 members
    • Renewability- The renewability under the policy is lifelong. The policy can be renewed under the then prevailing health insurance product or its nearest substitute approved by IRDAI.
    • Policy term- The policy can be taken for a period of 1 year/ 2 years/ 3 years. For policies more than 1 year the unutilized sum insured would not be carried forward to the next policy year.
    • Outpatient medical expenses- Covered
    • Pre Hospitalization- Not covered.
    • Post hospitalization- 30 days after the hospitalization not exceeding 7% of the hospitalization expenses or Rs.5000 per hospitalization whichever is less
    • Day care procedures- Covered up to sum insured for selected ailments
    • Pre existing waiting period- 24 months
    • Specific disease waiting period- 24 months
    • Initial waiting period- 30 days
    • Co-payment- 20% co-payment applicable till the age of 70 years, 30% copay applicable after 70 years age.
    • Domiciliary hospitalization- Up to 10% of the sum insured covered after 3 days.
    • Dialysis cover- Up to Rs.1000 per sitting limited to 24 consecutive months
    • Companion Benefit- Up to Rs.15,000 if the hospitalization exceeds 10 days.


    HDFC Ergo Energy Diabetes Insurance Plan



    Eligibility

    Individuals in the age group of 18 to 65 years at entry, who are currently diagnosed with Type I Diabetes or Type II Diabetes or Pre-Diabetes (Impaired Fasting Glucose/ Impaired Glucose Tolerance) or Hypertension.

    Sum insured

    The minimum sum insured is Rs.2 lakhs and the maximum sum insured is Rs.50 Lakhs

    Emergency Ambulance

    Not covered.

    • Eligibility- Individuals in the age group of 18 to 65 years at entry, who are currently diagnosed with Type I Diabetes or Type II Diabetes or Pre-Diabetes (Impaired Fasting Glucose/ Impaired Glucose Tolerance) or Hypertension.
    • Family definition- Family means Self, Spouse,dependent children and dependent parents.
    • Renewability- The renewability under the policy is lifelong. The policy can be renewed under the then prevailing health insurance product or its nearest substitute approved by IRDAI.
    • Policy term- The policy can be taken for a period of 1 year and the sum insured and other benefits will be applicable on a policy year basis.
    • Outpatient medical expenses- Not Covered
      HbA1C checkup: Under this benefit, we will reimburse an amount of up to INR 750 on each claim towards the expenses of HbA1C checkup on submission of original payment receipt. A maximum of 1 claim can be made in a policy year with a minimum gap of 3 months between the two claims or test
    • Pre Hospitalization- 30 days before the date of hospitalization.
    • Post hospitalization- 60 days after the hospitalization
    • Day care procedures- Covered up to sum insured for selected ailments
    • Pre existing waiting period- 24 months
    • Specific disease waiting period- 24 months
    • Initial waiting period- 30 days
    • Co-payment- 20% co-payment applicable on the eligible claim amount.
    • Restore Benefit- Instant addition of 100% of the basic sum insured on complete or partial utilization of the existing sum insured and cumulative bonus during the policy year. The restore sum insured cannot be carried forward to the next policy period.
    • Cumulative Bonus- 10% increase in annual inpatient benefit sum insured for every claim free year subject to a maximum of 100%. In case of claims made during a policy year, the cumulative bonus would reduce by 10% in the following year.


    Aditya Birla Activ Health Enhance Diabetes Plan



    Eligibility

    Minimum age at entry- 18 years and no maximum age for entry.

    Sum insured

    The minimum sum insured is Rs.2 lakhs and the maximum sum insured is Rs.2 Crore

    Emergency Ambulance

    Covered up to actual expenses per event in case of network providers and up to Rs.5000 per event in case of non network providers on reimbursement basis.

    • Eligibility- Minimum age at entry- 18 years and no maximum age for entry.
    • Family definition- Family means Self, Spouse,dependent children (up to 3)
    • Renewability- The renewability under the policy is lifelong. The policy can be renewed under the then prevailing health insurance product or its nearest substitute approved by IRDAI.
    • Policy term- The policy can be taken for a period of 1 year and the sum insured and other benefits will be applicable on a policy year basis.
    • Sum Insured- The minimum sum insured is Rs.2 lakhs and the maximum sum insured is Rs.2 Crores
    • Outpatient medical expenses- Rs.1000 available for sum insured above Rs.15 Lakhs.
    • Health checkup- Available once in a policy year.
    • Pre Hospitalization- 60 days before the date of hospitalization.
    • Post hospitalization- 180 days after the hospitalization
    • Day care procedures- Covered up to sum insured
    • Domiciliary treatments- Covered up to sum insured
    • Pre existing waiting period- 36 months
    • Specific disease waiting period- 24 month
    • Initial waiting period- 30 days
    • Co-payment for treatment in higher zone- Up to 25% co-payment applicable if the policy is taken in Zone 2 or 3 and claim is made in Zone 1. If the premium is paid in the lower zone and claim is made in the higher zone, then the co-payment would be applicable.
    • Recovery Benefit- 1% of the sum insured up to a maximum of Rs.10,000 in case of consecutive 10 days of hospitalization due to an accident.
    • Cumulative Bonus- 50% increase in annual inpatient benefit sum insured for every claim free year subject to a maximum of 100%.
    • Dental Consultation & Investigation- Available for sum insured of Rs.15 lakhs and above.
    • Premium waiver- 1 policy year premium waiver in case of detection of listed illness for adults 18 years and above.
    • Mental illness hospitalization- Covered up to sum insured
    • Chronic Management Program- Day 1 cover for chronic illnesses like asthma, high blood pressure, high cholesterol and diabetes.
    • Automatic upgrade at no extra cost- Insured can upgrade to the chronic management program automatically if he/she develops a chronic condition after buying the policy.


    National Insurance - VARISTHA Mediclaim



    Eligibility

    Policy can be availed by persons between the age of 60 years and 80 years.

    Sum insured

    The sum insured for mediclaim is Rs. 1 lakhs whereas for critical illness it is Rs.2 lakhs. The sum insured is fixed for all the ages under the policy.

    Emergency Ambulance

    Covered up to Rs.1000 in a policy period.

    • Family definition- Family means Self, Spouse,dependent children
    • Renewability- The renewability under the policy is lifelong. The policy can be renewed under the then prevailing health insurance product or its nearest substitute approved by IRDAI.
    • Policy term- The policy can be taken for a period of 1 year and the sum insured and other benefits will be applicable on a policy year basis.
    • Sum Insured- The sum insured for mediclaim is Rs. 1 lakhs whereas for critical illness it is Rs.2 lakhs. The sum insured is fixed for all the ages under the policy.
    • Health checkup- Expenses of health checkup will be reimbursed once at the end of a block of three continuous policy periods provided no claims are reported during the block and the policy has been continuously renewed with the company without a break. Expenses payable is a maximum of 2% of the average sum insured (excluding Cumulative Bonus) of the block. Claim for health checkup benefits may be lodged at least 45 (forty five) days before the expiry of the fourth policy period.
    • Pre Hospitalization- 30 days before the date of hospitalization
    • Post hospitalization- 60 days after the hospitalization
    • Pre existing waiting period- 12 months
    • Specific disease waiting period- 12 months
    • Initial waiting period- 30 days
    • Co-payment for treatment in higher zone- Co-payment of 10% shall apply to all the admissible claims other than claims arising due to Cataract and Benign prostatic hyperplasia. Co-payment of 20% shall be considered wherever the insured person has opted. Co-payment of 10% shall apply to all the admissible claims arising out of pre-existing diseases for which the insured person opted cover and paid additional premium. This copayment is in addition to the copayment stated herein above and applicable only for claims arising out of Pre-existing Diseases.
    • Cumulative Bonus- 5% increase in sum insured for every claim free year subject to a maximum of 50%. In case of claim being made during the previous policy year 5% of expiring cumulative bonus sum insured shall be reduced.
    • Room & ICU Charges- Room charges subject to 1% of sum insured per day and Intensive care unit (ICU) charges subject to 2% of sum insured per day (including nursing care, RMO charges, IV fluids / blood transfusion