| Does Health Insurance Cover Diabetes? Yes. Diabetes is covered under health insurance in India, but with certain terms and conditions. For existing diabetics, it falls under pre-existing disease rules and usually comes with a waiting period of up to 3 years. If diabetes develops after you’ve purchased your policy, it is covered immediately like any other new illness. |
Living with a chronic illness isn’t just about the physical and emotional challenges; it’s also about the financial strain that comes with long-term treatment.
Take diabetes, for example. India is often called the Diabetes Capital of the World, accounting for nearly 17% of the global diabetic population. Today, over 8 crore Indians live with diabetes, and this number is expected to soar to 13.5 crore by 2045.
And here’s the reality: managing diabetes is expensive. From daily medication and routine check-ups to unexpected hospitalisations due to complications, the costs can quickly add up. Without proper financial planning, these expenses may drain your savings.
That’s where health insurance really makes a difference. The right plan not only provides peace of mind but also protects your finances from the lifelong burden of diabetes care.
In this blog, we’ll break down whether health insurance covers diabetes, what to expect with waiting periods, which plans are worth considering, and how to choose wisely.
At Ditto, we’ll compare policies, explain waiting periods, and help you find the right health cover for diabetes. Book a call today!
Who Should Consider Buying a Diabetes Health Insurance Plan?
A diabetes-specific health insurance plan isn’t just for those already diagnosed; it can also be a smart choice for anyone at risk. Here are the groups that should seriously consider it:
1. People with Type 1 & Type 2 Diabetes: If you are already living with diabetes, specialised health plans can be a good choice. These plans often reduce waiting periods and may also cover OPD visits, insulin costs, and regular monitoring expenses.
2. People with a Family History of Diabetes: Genetics play a big role in the likelihood of developing diabetes. Buying a health insurance plan early ensures that even if you are diagnosed later, your coverage will already be in place.
3. Older Adults with Lifestyle Risks: As we age, factors like sedentary habits, poor diet, and other lifestyle choices increase the risk of diabetes. For older adults, securing health insurance early helps safeguard against future complications and ensures financial protection.
Can I Buy Insurance if I Already Have Diabetes?
Yes, you can buy health insurance even if you already have diabetes, but there are some restrictions to keep in mind.
Since diabetes is treated as a pre-existing disease (PED), it won’t be covered from day one. Most standard health insurance policies come with a waiting period of 1 to 3 years before they start covering diabetes-related expenses. However, some diabetes-specific plans reduce this waiting period and do cover it from day one.
For example, imagine you’re diagnosed with diabetes today and buy a standard health plan with a 3-year waiting period. If you’re hospitalised due to a diabetes-related complication within this period, you’ll have to bear the entire expense out of pocket.
On the other hand, if you opt for a diabetes-specific plan with a reduced waiting period or even Day 1 coverage, your treatment costs will be covered right away. This not only saves you from unexpected financial strain but also ensures you can access quality care without worrying about affordability.
Since diabetes increases the insurer’s risk of payout, most companies add an extra amount to the premium, known as loading charges. For diabetic patients, nearly all insurers apply this charge, though the percentage varies.
The actual loading depends on factors such as:
- The insurer you choose
- The specific plan you opt for
- Type of diabetes (Type 1 or Type 2) and any other comorbidities
Some insurers may impose higher loading (even up to 50–100% in severe cases), while others offer nominal or no loading at all. Finding a policy with minimal loading ensures you pay a lower premium and ease your financial burden.
How to Choose the Right Health Insurance Plan for Diabetic Patients?
When selecting a health insurance plan for diabetes, it’s important to go beyond just the premium and check the finer details. Start by confirming whether the policy specifically covers your type of diabetes, since not all plans treat Type 1, Type 2, or pre-diabetes the same way. Look at the waiting period; shorter is always better.
For instance, Aditya Birla Activ One Max offers two important add-ons. The Chronic Care add-on is recommended for people with conditions like Asthma, Hypertension, Cholesterol, Diabetes mellitus, COPD, Obesity, or Coronary Artery Disease. With this benefit, the pre-existing disease (PED) waiting period drops from three years to zero days, ensuring immediate coverage.
Additionally, the policy’s Reduction in PED add-on allows you to cut the waiting period for any illness from three years down to either two years or even one year, depending on the option selected.
Similarly, with Niva Bupa ReAssure 2.0, the Disease Management add-on eliminates the three-year waiting period for Diabetes and Hypertension, offering immediate coverage.
For instance, some insurers may apply loading charges: extra premiums that can range from 10-50% (or even higher) for high-risk individuals. Choosing a plan with minimal or no loading can help keep costs manageable. Also, watch out for disease-specific sub-limits, as these can cap the claim amount available for diabetes-related treatments, limiting the real value of your coverage.
Alongside these, opting for a policy with a Restoration benefit is a smart move. This feature resets your coverage if it gets exhausted after multiple hospitalisations, ensuring continued protection. Ideally, restoration should be available every time you need it, not just once in a policy year.
Some insurers even offer renewal discounts if you maintain good health. For example, keeping your HbA1c under control or regularly tracking activity through a fitness app. Make the most of such wellness benefits to lower your future premiums.
Most importantly, always declare your diabetes status, medications, and medical reports honestly in the proposal form, as hiding any details could lead to claim rejection on grounds of non-disclosure.
Health Insurance for Diabetes: Plans That Make Ditto’s Cut
Finding the right plan as a diabetic can be tricky because coverage often depends on the type of diabetes, the mode of medication (oral vs. insulin), and the age at diagnosis.
Here’s a quick breakdown of some commonly available options:
| Type of Diabetes | Mode of Medication | Health Insurance Plans Available |
|---|---|---|
| Type 1 Diabetes | Oral | HDFC Ergo Energy Aditya Birla Activ One Max Care Freedom (If the above plans are rejected) |
| Insulin | HDFC Ergo Energy (with chances of rejection) Aditya Birla Activ One Max (with chances of rejection/counter offer) Care Freedom (If the above plans are rejected) |
|
| Type 2 Diabetes | Oral | HDFC Ergo Energy Aditya Birla Activ One Max Care Supreme Niva Bupa ReAssure 2.0 ICICI Lombard Elevate Care Freedom (If the above plans are rejected) |
| Insulin | HDFC Ergo Energy Aditya Birla Activ One Max (with chances of rejection) Care Freedom (If the above plans are rejected) |
|
| Pre-Diabetic | None (Lifestyle changes) |
HDFC Ergo Energy Aditya Birla Activ One Max Care Supreme Niva Bupa ReAssure 2.0 ICICI Lombard Elevate Better to get HbA1c levels under control and improve lifestyle if possible |
| Gestational Diabetes | - | Coverage depends entirely on the insurer’s underwriting team. It’s best to approach the insurer directly for confirmation. |
Note: The above-mentioned plans are based on our research and are not an exhaustive list; we at Ditto may recommend these depending on the profile of the insured person.
Will Diabetes Be Covered if I Get Diagnosed After I Buy My Policy?
Yes. If you are diagnosed with diabetes after purchasing your health insurance policy, it will be treated like any other new illness. This means your coverage will usually start immediately, without any waiting period for diabetes-related expenses.
And this is exactly why it’s always smarter to buy health insurance early, before lifestyle diseases like diabetes or hypertension come into the picture. Once you already have a diagnosis, insurers may impose waiting periods, exclusions, or even higher premiums.
Health Insurance for Diabetes: Ditto’s Take
At Ditto, our advice is straightforward. The timing of your purchase makes all the difference. If you’re already living with diabetes, it’s wise to choose plans specifically designed to manage the condition, as they usually offer shorter waiting periods or the flexibility to reduce them through add-ons, along with broader coverage.
To make the process smoother, keep a file with all your lab results (such as HbA1c and fasting glucose), doctor’s prescriptions, and medication history, as these are often required during claim processing, proposal evaluation, or even when porting your policy.
If you don’t yet have diabetes but are at higher risk due to age, lifestyle, or family history, the best step is to buy a comprehensive plan early. Doing so ensures that any future diagnosis will be covered automatically, without additional restrictions or higher premiums.
Still unsure what works best for you? Our advisors at Ditto can simplify the process: comparing policies, breaking down waiting periods, and helping you choose the most cost-effective plan for your needs.
Why Talk to Ditto for Your Health Insurance?
At Ditto, we’ve assisted over 3,00,000 customers with choosing the right insurance policy. Why customers like Piyush love us:
✅No-Spam & No Salesmen✅Rated 4.9/5 on Google Reviews by 5,000+ happy customers✅Backed by Zerodha✅100% Free ConsultationYou can book a FREE consultation here. Slots are running out, so make sure you book a call now!
Health Insurance for Diabetes: Final Thoughts
Diabetes is one of India’s most common lifestyle diseases, and managing it is both a medical and a financial challenge. The good news? Health insurance does cover diabetes, either through regular policies (after waiting periods) or specialised plans for quicker coverage.
The best approach? Buy early, understand your policy terms, and choose wisely. And if you’d rather not spend hours decoding brochures, let Ditto’s advisors do the heavy lifting for you. Book a call or WhatsApp us today.
FAQs
Is diabetes covered under regular health insurance policies in India?
Yes, pre-existing diabetes is covered under most regular health insurance plans, but only after completing a waiting period of 1-3 years. Until then, diabetes-related expenses won’t be reimbursed. Specialised diabetes health insurance plans, however, may reduce this waiting period.
Can I buy health insurance if I am already diagnosed with Type 1 or Type 2 diabetes?
Absolutely. People already living with diabetes can still buy health insurance. However, insurers may apply conditions like longer waiting periods and higher premiums (loading charges). Choosing the right plan is crucial to avoid restrictions.
Why is it better to buy health insurance before being diagnosed with diabetes?
If you purchase a health plan before being diagnosed, diabetes will be treated like any other new illness and covered without a waiting period. Once you are diagnosed, insurers may add restrictions, impose waiting periods, or charge extra. Buying early ensures seamless coverage later.
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