Buy Health Insurance for Diabetes Patients in India
What is Diabetes Health Insurance?
A diabetes health insurance is a customized health insurance plan that covers for treatment and hospitalization costs arising due to diabetes. Additionally, a diabetes health insurance can also refer to a comprehensive health insurance plan that includes coverage for diabetes within its benefits, such as Digit’s Health Insurance.
Why should you get a Health Insurance that Covers Diabetes?
It is estimated that 61.3 million people aged 20-79 years live with diabetes in India, mainly in urban India. This number is expected to increase to 101.2 million by 2030! (1)
People with diabetes are more prone to the COVID-19, also leading to more serious health complications than those not infected along with a pre-existing disease. (2)
Diabetes is an expensive disease. The chronic nature of the disease and its associated complications are the real reason behind the high costs involved. (3)
A most disturbing trend is the shift in age of onset of diabetes to a younger age. Indians get diabetes on average 10 years earlier than their Western counterparts. (4)
According to the WHO, if one adult in a low-income family has diabetes, as much as 25% of family income may be devoted to just diabetes care! (5)
According to the International Diabetic Federation, 1 in 2 adults in the world have Type 2 diabetes and around 46.5% of those are undiagnosed until their condition worsens. (6)
What are the Conditions for Diabetic Patients in Digit Health Insurance?
While Diabetes is covered for under Digit’s Health Insurance. Due to the nature of the disease and the varying healthcare complications around the same - there are specific conditions you should know about when it comes to your health insurance coverage for diabetes so there are no last-minute surprises and well because we believe in being completely transparent and want to let you know what’s covered and not covered well in advance!
1. Bad News: Type 1 Diabetes isn’t covered
Type 1 diabetes is usually diagnosed early on in children and young people and those suffering from the same are highly dependent on insulin.
Unfortunately, (and we hate that it is this way!) if you are already diagnosed and dependent on insulin for Type 1 diabetes at the time of buying a health insurance policy, you can’t be covered under
Digit’s standard Health Insurance. Given the varying health risks and complications involved in Type 1 diabetes, it is instead recommended to go for a specific diabetes health insurance plan that is designed for Type 1 diabetes patients.
2. Good News: If you’ve had diabetes for less than 10 years with good control like HbA1c less than 7.5% then you will be covered!
We understand that Type 2 diabetes is extremely common in India and that’s why we do cover it in our health insurance plan.
However, there is a waiting period involved for all pre-existing diseases, including diabetes.
The waiting period for diabetes as a pre-existing disease is 4 years at Digit, from the date of buying your health insurance after which you can make claims related to the same.
3. Bad News: If you or your parent has been diagnosed and are being treated for diabetes for more than 10 years, then you won’t be covered
Every health insurance does come with some limitations and unfortunately, this is ours; that we cannot cover those diagnosed and being treated for diabetes for more than ten years.
This is mainly because of the high healthcare risks and complications involved and hence it’s often recommended to instead go for a diabetes-specific plan that would be better suited for those suffering from the same for more than ten years.
4. Good News: Type 2 diabetes, which is the most common form of diabetes will be covered post the minimum waiting period
The bad news is that India has the second-highest diabetics population in the world, and this is mainly due to Type 2 diabetes that is increasingly and especially becoming common in the urban population owing to modern lifestyle habits.
However, the good news is that whether you’re already diagnosed or would be in the future (we do hope not, though!), Digit’s health insurance does cover the same, post the waiting period.
Disclaimer - These are the generic conditions for diabetes applicable in our health insurance. However, whether you are covered or not covered will also depend on your overall medical condition, which will be evaluated by our health experts when you buy your health insurance policy with Digit. The same is usually evaluated through required medical tests.
What’s Great about Digit’s Health Insurance covering Diabetes?
Simple online processes - From the process of buying a health insurance policy to making claims is paperless, easy, quick and hassle-free! No hard copies, even for claims!
No Age-based or Zone-Based Co-payment - Our health insurance comes with no age-based or zone-based copayment. This means, during health insurance claims, you need not pay anything from your pocket.
No Room Rent Restriction - We understand that everyone has different preferences. That’s why we have no room rent restrictions. Choose any hospital room you prefer.
SI Wallet Benefit - If you exhaust your Sum Insured during the policy period, we refill it for you.
Get treated at any hospital - Choose from 16400+ of our network hospitals in India for a cashless treatment or opt for a reimbursement.
Wellness Benefits - Get exclusive wellness benefits on the Digit App in collaboration with top-rated health and wellness partners.
What’s covered in our Health Insurance?
Coverages
Double Wallet Plan
Infinity Wallet Plan
Worldwide Treatement Plan
Important Features
All Hospitalization - due to Accident, Illness, Critical Illness or COVID
This covers for all hospitalization expenses including due to an Illness, Accident, Critical Illness or even pandemics like Covid 19. It can be used to cover for multiple hospitalizations, as long as the total expenses are up to your sum insured.
Initial Waiting Period
You need to wait for a defined period from the first day of your policy to get covered for treatment related to any non-accidental illness. This is the Initial Waiting period.
Wellness Program
Exclusive Wellness Benefits like Home Healthcare, Tele consultations, Yoga and Mindfullness and many more available on our App.
Sum Insured Back Up
We provide a back-up Sum Insured which is 100% of your Sum Insured amount. How does Sum Insured Back Up work? Suppose your policy Sum Insured is Rs. 5 lac. You make a claim of Rs.50,000. Digit automatically triggers the wallet benefit. So you now have 4.5lac + 5 lac Sum Insured available for the year. However, one single claim, cannot be more than the base Sum Insured as in the above case, 5 lac. .
Cumulative Bonus
Digit Special
Digit Special
No claims in the Policy year? You get a bonus -an additional amount in your total sum-insured for staying healthy & claim free!
Room Rent Capping
Different categories of rooms have different rents. Just like how hotel rooms have tarrifs. Digit plans give you the benefit of having no room rent cap, as long as it is below your Sum Insured..
Day Care Procedures
Health insurance covers medical expenses only for hospitalizations exceeding 24 hours. Day care procedures refer to medical treatments undertaken in a hospital, requiring less than 24 hours due to technological advancement such as cataract, dialysis etc.
Worldwide Coverage
Digit Special
Digit Special
Get a world class treatment with the Worldwide Coverage! If your doctor identifies an illness during your health examination in India and you wish to get a treatment abroad, then we’re there for you.You’re covered!
Health Check-up
We pay for your health check-up expenses upto the amount mentioned in your Plan. No restrictions on the kind of tests! Be it ECG or Thyroid Profile. Make sure you go through your policy schedule to check the claim limit.
Emergency Air Ambulance Expenses
There may be emergency life-threatening health conditions which may require immediate transportation to hospital. We absolutely understand this and reimburse for expenses incurred for your transportation to a hospital in airplane or helicopter.
Age/Zone Based Co-payment
Digit Special
Digit Special
Co-Payment means a cost sharing requirement under a Health Insurance Policy that provides that the Policyholder/Insured will bear a specified percentage of the admissible claims amount. It does not reduce the Sum Insured. This percentage depends on various factors like age, or sometimes also on your treatment city called zone based copayment. In our plans, there is no age based or zone based Co payment involved.
Road Ambulance Expenses
Get reimbursed for the expenses of road ambulance, in case you are hospitalized.
Pre/Post Hospitalization
This cover is for all expenses before and after hospitalization such as for diagnosis, tests and recovery.
Other Features
Pre-Existing Disease (PED) Waiting Period
The disease or condition that you are already suffering with and have disclosed to us before taking the policy and has been accepted by us has a waiting period as per plan opted and mentioned in your Policy Schedule.
Specific Illness Waiting Period
This is the amount of time you need to wait for, until you can make a claim for a specific illness. At Digit it is 2 years and starts from the day of policy activation. For the full list of exclusions, read Standard Exclusions (Excl02) of your policy wordings.
Inbuilt Personal Accident Cover
If You sustain an Accidental Bodily Injury during the Policy Period, which is the sole and direct cause of Your Death within twelve (12) months from the date of accident, then We will pay 100% of the Sum Insured as mentioned in Policy Schedule against this cover and as per plan opted.
Organ Donor Expenses
Digit Special
Digit Special
Your organ donor gets covered in your policy. We also take care of the pre and post hospitalization expenses of the donor. Organ donating is one of the kindest deeds ever and we thought to ourselves, why not be a part of it!
Domiciliary Hospitalization
Hospitals can go out of beds, or the patient’s condition may be rough to get admitted in a hospital. Don’t panic! We cover you for the medical expenses even if you get treatment at home.
Bariatric Surgery
Obesity may be the root cause of so many health issues. We absolutely understand this, and cover for Bariatric Surgery when it is medically necessary and advised by your doctor. However, we DONOT cover if hospitalization for this treatment is for cosmetic reasons.
Psychiatric Illness
If due to a trauma, a member has to be hospitalized for a psychiatric treatment, it will be covered under this benefit, upto INR 1,00,000. However, OPD consultations are not covered under this. The waiting period for Psychiatric Illness Cover is same as Specific Illness waiting period.
Consumables Cover
Before, during & after hospitalization, there are many other medical aids & expenditures such as walking aids, crepe bandages, belts, etc.,which need your pocket’s attention.This cover takes care of these expenses that are otherwise excluded from the policy.
What’s not covered?
Pre-natal and post-natal medical expenses, unless it leads to hospitalization.
In case of a pre-existing disease, unless the waiting period is over, the claim for that disease or illness cannot be made.
Any condition you get hospitalized for, that doesn’t match with the doctor’s prescription is not covered.
If you or your family member has already been diagnosed with Type 1 diabetes, then they can’t be covered under Digit’s standard health insurance option.
If you were diagnosed with diabetes more than 10 years back and, are still suffering and being treated for the same then you can’t be covered under our health insurance plan.
If you’ve been diagnosed and are being treated with Type 2 diabetes for less than 10 years but with poor control (I.e. your HbA1c is more than 7.5%) then you can’t be covered under Digit’s standard health insurance option.
Key Benefits of Health Insurance by Digit
| Co-payment | No |
|---|---|
| Room Rent Capping | No |
| Cashless Hospitals | 16400+ Network Hospitals across India |
| Inbuilt Personal Accident Cover | Yes |
| Wellness Benefits | Available from 10+ Wellness Partners |
| City Based Discount | Up to 10% Discount |
| Worldwide Coverage | Yes* |
| Good Health Discount | Up to 10% Discount |
| Consumables Cover | Available as an Add-on |
*Available only on Worldwide Treatment Plan
How to file a Claim?
Reimbursement Claims - Let us know in case of a hospitalization within two days of admission at 1800-258-4242 or email us at healthclaims@godigit.com and we'll send you a link where you can upload your hospital bills and all relevant documents to process the reimbursement.
Cashless Claims - Choose the network hospital. You can find the complete list of network hospitals here. Display e-health card to the hospital helpdesk and ask for the cashless request form. If all is good, your claim will be processed then and there.
If you have claimed for Coronavirus, make sure you have a positive test report from an authorized centre of ICMR – National Institute of Virology, Pune.
Why is a Health Insurance that covers Diabetes important?
"Because diabetes can turn out to be an expensive disease due to its varying health complications". As per a recent report by the Association of Physicians of India, the poor urban population spends around 34% of their income on diabetes treatment while the rural population spends around 27% on the same.
The medical cost of diabetes is high mainly due to its routine costs involved, health complications and higher health risks. A health insurance that cover diabetes will ensure you can financially manage these expenses in a better manner.
"Because medical inflations in India are increasing every year ". Unfortunately, medical expenses in India are only rising year on year, whether you’re prone to being diabetic or not, covering yourself with a health insurance is beneficial for all kinds of illnesses and diseases you may need treatment for, even when it is for something as minor as an OPD consultation.
"Because the risk of critical illnesses are higher in diabetic patients ". The sad truth about diabetes is that diabetic patients are at a higher risk of contracting critical illnesses. Some of the most common critical illnesses often faced by those diabetic include cardiovascular diseases and kidney failures.
Hence, it’s extremely important not only to control your diabetes with good medical care to avoid the same, from happening but to also be covered through it all with a sufficient health insurance plan.
"Because a good health insurance plan will ensure you’re always in check with your health through annual health checkups". Did you know that some health insurance plans, including one at Digit offer complimentary annual health checkups as part of a coverage benefit because let’s face it, how many of us would actually go for an annual health checkup unless it’s required?
Truth be told, annual health checkups are extremely important to ensure you are in check with your health cause more often than not, most diseases including diabetes are undiagnosed until the situation worsens.
A health insurance with annual health checkups will ensure this doesn’t happen.
Myths about Diabetes & Diabetes Health Insurance
"Diabetes isn’t covered in Health Insurance". This isn’t true. Coverage for illnesses and diseases differ from insurer to insurer. You’ve read this above for yourself.
Diabetes is covered in health insurance but is dependent on different conditions such as if you were diagnosed whilst buying your health insurance policy, the type of diabetes you have, your diabetes control levels and for how long you’ve had it, etc.
"Only fat people get diabetes". This isn’t true. Even those who aren’t obese are prone to getting diabetes and those obese aren’t always prone to the same either.
There isn’t a single reason why someone gets diabetes but a range of factors, including family history, sedentary lifestyle habits and other reasons that could lead to problems in glucose or insulin production or, and distribution in the body that eventually leads to diabetes.
"You get diabetes due to eating a lot of sweets!". No, while unhealthy and improper diet is a risk factor, too much sugar isn’t the only reason for someone being diagnosed with diabetes.
As mentioned above, diabetes can be caused due to a combination of different factors, including intra-uterine effects during birth, family history, lifestyle habits, not being physically fit, increasing age, high blood pressure and high blood cholesterol as well. In simple words, even if someone isn’t having too much sugar, they can still get diabetes!
"Diabetes happens to only older people". While it is true that those older (45+ years) are more prone to diabetes, a recent trend, especially in urban India, is that more and more younger people are becoming diabetic.
This is mainly due to the unhealthy lifestyle habits – including but not limited to not eating healthy food, not moving enough, i.e. not being physically fit, etc. Therefore, you can no more say that diabetes only happens to older people!
"You will get diabetes if your grandparents are diabetic!". While family history and genetics do have a role to play in one being diabetic, it isn’t the only reason and in fact, even those without any family history of the same can be diabetic.
Additionally, just because your grandparents or parents are diabetic doesn’t guarantee that you will be diabetic as well! You can read more about diabetes prevention and causes in our detailed diabetes health guide here.
"You should not tell your insurer that you are diabetic!". Unfortunately, a lot of people still have an untrusting attitude towards insurance. However, we’ve been trying to change that by being completely transparent with you, about everything.
Whether you’re buying health insurance with us or any other health insurer, not revealing your current and true health conditions will only cause problems and rejections in claims at a later stage or, even before that – whilst getting your initial medical tests done. That’s why it’s best to always be transparent.
FAQs about Health Insurance for Diabetes Patients
Is it mandatory to let my health insurance company know that I am diabetic when I’m buying my health insurance policy?
Yes, it’s important to let your health insurance company know about any pre-existing diseases, including diabetes.
This is because your required coverage and health insurance premium will differ accordingly.
Additionally, there would be some medical tests done to confirm on any pre-existing diseases, illnesses and your overall health wherein your health insurer would learn about your pre-existing conditions and if you haven’t been honest about the same, your policy may be rejected as well.
What will happen if I don’t inform my insurance company about my diabetes condition and make a claim?
To simply put it, your claim will then be rejected. However, it is important to note that whilst buying a health insurance – you will most likely have to take medical tests which will make it hard to hide the fact that you have diabetes.
Is there a waiting period for Diabetes in Digit health insurance?
Yes, there is a waiting period for diabetes in Digit Health Insurance. In case it is a pre-existing disease then the waiting period for the same is 3-years. You can read more about Digit’s waiting periods here.
What if I don’t have diabetes at the time of buying my health insurance policy but I am diagnosed later. What should I do in that case and is it necessary to let my insurance company know?
No, you don’t need to let your insurance company know just yet. However, you may want to increase your sum insured or plan at the time of your health insurance renewal. During renewal, you can then let your insurance company know the same.