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Executive Summary – Diabetes is growing quite rapidly in India. There are some insurance companies who have come up with insurance covers for the same. We compare three such insurance policies here – Star Health’s Diabetic Safe Plan, Apollo Munich’s Energy’s Energy and Varishta Mediclaim from National Insurance. Star Health’s Diabetic Plan is the only one that covers Type I diabetes also. Varishta Mediclaim is designed for senior citizens. Apollo Munich’s Energy plan covers a wellness program for the insured too.
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India is unfortunately called the ‘Diabetes Capital of the World’. There were 63 million people with diabetes in India in 2013 and the number is only increasing. If a person has diabetes and wants to purchase a health insurance plan, diabetes will be considered as a pre-existing condition and there will be a waiting period before it gets covered. In some cases, health insurance is denied to a person with diabetes or diabetes related claims are denied.
Insurance companies are less interested in diabetes cover as medical expenses are high and the diabetic will live long and make multiple claims. This is not very profitable for the insurance companies. But there is change now. There are some insurance plans available that cover diabetes and related complications. We compare three such insurance plans here –
Insurance companies are less interested in diabetes cover as medical expenses are high and the diabetic will live long and make multiple claims. This is not very profitable for the insurance companies. But there is change now. There are some insurance plans available that cover diabetes and related complications. We compare three such insurance plans here –
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Name/Parameter
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Star Health Diabetes Safe
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Apollo Munich Energy Health Insurance Plan
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Varishta Mediclaim from National Insurance
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Eligibility
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A person can get covered from 26 years-65 years
It can be renewed lifelong. |
A person can get covered from 26 years-65 years
There is no age limit on renewability. |
It covers people in the age group of 60 years-80 years. It is specially designed to cover senior citizens. It can be renewed till the insured reaches 90 years. |
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Sum Assured
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Policy is available for Rs. 3,00,000 lakhs, Rs. 4,00,000, Rs. 5 lakhs and Rs. 10,00,000.
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Policy is available for Rs. Rs. 2,00,000, Rs. 3,00,000, Rs. 5,00,000 and Rs. 10,00,000.
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Policy is available for Rs. Rs. 1,00,000 and Rs. 2,00,000.
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Policy Type
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Policy can be taken on an individual basis and floater basis. For floater basis, policy will be for insured and spouse provided both are diabetic.
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There are different types –
Gold Plan (cost of wellness test included) & Silver Plan (cost of wellness test excluded) Both are available with and without the copayment option of 20%. |
One can take a mediclaim policy for Rs. 1,00,000 and a critical illness cover for Rs 2,00,000.
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Coverage
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The policy covers – People with Diabetes Mellitus (Type II diabetes) and those who are at risk for Diabetes Mellitus All complications related to Diabetes Type 1 and Type 2 from day 1 of the policy. Eyes, kidney and foot related issues that arise due to diabetes. Cost of artificial limbs due to amputation up to specified limits. |
The policy covers –
Type 2 Diabetes Mellitus, Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT) and/or Hypertension. Provides coverage form Day 1 for hospitalization arising out of Diabetes and Hypertension. |
Type 2 Diabetes, IFG, ITG and/or Hypertension are covered.
Pre-existing diabetes is covered right from the inception of the policy (at a 10% additional premium). Medical and dental treatment is covered. |
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Other Features
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Automatic restoration of entire sum assured by 100%.
More than 400 day care procedures are covered. If medical checkup is done, you are exempted from waiting period. |
It covers 144 day care procedures
Emergency ambulance is covered up to Rs. 2000 per hospitalization. Organ donation procedure is covered.Covers hotel accommodation during emergencies. Health Management Program and Health Reward program are offered to policy holders. It provides a health eco system with a wellness coach, wellness portal and access to a health marketplace. The policy holder can get up to 25% reduction in premiums if he is able to control and manage diabetes. |
Claims for Cataract will be covered only up to Rs.10,000. Claims for Benign Prostatic Hyperplasia will be covered up to Rs.20,000. Domiciliary hospitalization will be covered up to 20% of the sum insured. Ambulance charges covered up to Rs. 10,000 The insured can opt for a premium discount of 5% for each claim free year till it reaches 50% or opt to increase the sum insured by the amount of cumulative bonus at the time of renewal. Insured has to bear 10% of all admissible claims. Insured may also opt for 2% co-payment which will entitle him for a premium discount of 10%. It covers paralysis and blindness for additional premium. |
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Medical Screening
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Required for people over the age of 50.
People below 50 years old have the option of taking a plan with medical examination or a plan without medical examination. |
Medical Screening required and the policy holder can get discounts based on reports.
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Medical check-up is not required if the insured person was covered by National Insurance Company or any other insurance company for the previous 3 years continuously.
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Pre hospitalization and Post hospitalization
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Pre hospitalization is up to 30 days.
Post hospitalization is up to 60 days after discharge from hospital up to 7% of hospitalization expenses or Rs. 5000 whichever is less. |
.Pre-hospitalization expenses – 30 days before hospitalization.
Post-hospitalization expenses covered or 60 days after discharge. There are no sub-limits for inpatient pre and post hospital coverage. |
Medical Expenses incurred for period up to 15 days prior to hospitalization and up to 30 days after hospitalization.
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Exclusions
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For Plan B (policy without pre medical check-up)-
-Waiting Period of 30 days for hospitalization (except accidents). – Waiting period of 15 months for cardio vascular diseases, renal diseases, and foot and eye diseases. For Plan A (policy with pre medical check up ) and Plan B, the following are not covered – |
2 years waiting period for specific diseases like cataract, hernia, joint replacement surgeries, surgery of hydrocele etc. pre-existing condition will be covered after a waiting period of 3 years.
HIV and AIDS related diseases. Congenital diseases, mental and behavioural disorders,pregnancy, dental treatment, experimental and unproven medical techniques. |
It has a no claim period for 30 days for general cover and 90 days in case of critical Illness from date of commencement of the policy.
Pre-existing illnesses will be covered after 1 year from inception of the policy. Medical issues such as cataract, hernia, Piles etc. will be covered after first policy year. |
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Premium for Sum Assured of Rs. 5,00,000 for a 35 year old male
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Rs. 13,679
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Rs 13,853 for Silver Plan (with no co-payment).
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Rs. 4180 for Mediclaim policy for a person aged 65 years for Sum Assured of Rs. 1,00,000.
The critical illness cover will cost and additional sum of Rs. 2007. |
* The premiums are indicative. Please contact the insurance provider for all terms and conditions.
Our Analysis
The Star Health Diabetes Safe Plan can be renewed lifelong. It is the only policy that covers Type I and Type II diabetes. Sum assured can go up to Rs. 10,00,000 which is good. Moreover it covers 400 day procedures which is quite comprehensive. But it does not cover complications like Diabetic Retinopathy, Diabetic Nephropathy leading to Chronic Renal failure and Diabetic foot ulcer that have already arisen before taking the policy. There are restrictions on room rent so you have to manage that.
The Apollo Munich Energy has many additional features related to wellness of the policy holder. It has no restrictions on room rent.It covers only Diabetes Type II. Premium is slightly higher compared to Start Diabetes Safe Plan. So if you are young and not diabetic, you should check out other plans. You should check it if you are interested in the wellness program.
The Varishta Mediclaim policy from National Insurance is cost effective but the sum assured is low. It has a critical illness cover which is useful for old people. It also gives discounts for no claim years. But the policy has sub limits and co-payment clause which can be a burden especially for old people. The tenure for pre hospitalization and post-hospitalization is very less.
Once a person is diagnosed with diabetes, medical expenses can hit the roof. It slowly degenerates the body. These diabetes related insurance products in the market can ease the financial pressure a little bit but it is important and imperative to take care of one’s health with proper diet and exercise to improve health and reduce premium burden.
The Star Health Diabetes Safe Plan can be renewed lifelong. It is the only policy that covers Type I and Type II diabetes. Sum assured can go up to Rs. 10,00,000 which is good. Moreover it covers 400 day procedures which is quite comprehensive. But it does not cover complications like Diabetic Retinopathy, Diabetic Nephropathy leading to Chronic Renal failure and Diabetic foot ulcer that have already arisen before taking the policy. There are restrictions on room rent so you have to manage that.
The Apollo Munich Energy has many additional features related to wellness of the policy holder. It has no restrictions on room rent.It covers only Diabetes Type II. Premium is slightly higher compared to Start Diabetes Safe Plan. So if you are young and not diabetic, you should check out other plans. You should check it if you are interested in the wellness program.
The Varishta Mediclaim policy from National Insurance is cost effective but the sum assured is low. It has a critical illness cover which is useful for old people. It also gives discounts for no claim years. But the policy has sub limits and co-payment clause which can be a burden especially for old people. The tenure for pre hospitalization and post-hospitalization is very less.
Once a person is diagnosed with diabetes, medical expenses can hit the roof. It slowly degenerates the body. These diabetes related insurance products in the market can ease the financial pressure a little bit but it is important and imperative to take care of one’s health with proper diet and exercise to improve health and reduce premium burden.
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