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World Diabetes Day 2024: These days, most plans come with Day 1 coverage for PEDs or pre-existing diseases
World Diabetes Day 2024
India is often labeled as the Diabetes Capital of The World – and while that might be alarming, it is unfortunately true. The International Diabetes Federation indicates that India is home to over 77 million diabetics. The number might just as easily reach 134 million by 2045 if not controlled. The disease doesn’t discriminate and impacts the young and the old alike, as recent studies continue to confirm a spike in the number of people under 40 developing the condition. Given the scenario, health insurance becomes more crucial than ever.
Fortunately, the insurance industry is now more inclusive when it comes to covering people with Diabetes and consistently coming up with innovations that serve a wider range of consumers. There’s now Day 1 cover available for pre-existing conditions that include Diabetes. Not just that, the policies are more modular with consumers in better control of their policies and the features that they would like to pay or not pay for. Here’s examining the role of health insurance, particularly for individuals with or at risk of developing diabetes, and to understand how they can get comprehensive coverage and better financial security.
Diagnosed with Diabetes? Here’s what to do next
These days, most plans come with Day 1 coverage for PEDs or pre-existing diseases. However, if you have an existing health plan that doesn’t cover Diabetes, you will need to wait until you are due for renewal. At the time of renewal, you can either add relevant riders to your policy or port your policy to a different insurer altogether.
A common misconception is that health insurance is only necessary once a condition like diabetes is diagnosed. However, the reality is quite the opposite. Getting a health insurance policy while you’re still healthy can be more cost-effective and flexible. For those with no pre-existing conditions, premiums tend to be lower, and policy issuance is quicker and simpler. Nonetheless, upon your renewal, you can choose a plan that covers pre-existing conditions from Day 1. This technically means that the standard 3-4 years waiting period will come down to just 30 days in this case, after which your coverage will start. Nowadays, insurance companies cover both Type 1 as well as Type 2 Diabetes, subject to underwriting norms.
Riders to consider –
- PED waiver
One of the most significant features for someone with diabetes is the PED waiver rider. In typical health insurance policies, any pre-existing condition – such as diabetes – requires a waiting period (usually between two to four years) before the insurer covers claims associated with the condition. With a PED waiver rider, however, this waiting period can be shortened, sometimes even eliminated in certain policies.
- Outpatient Department (OPD) Coverage
Diabetes management often involves frequent doctor visits, periodic tests and regular medications – all of which fall under outpatient care and can quickly add up in costs. Traditional health insurance plans typically covered only hospitalisation, leaving policyholders to manage OPD expenses out of pocket. By choosing a policy that includes OPD coverage or adding an OPD rider at renewal, policyholders can significantly bring down the costs associated with OPD care.
- Diabetes prevention and management programs Many insurance companies now offer a package of services that help consumers manage their condition better. This includes Diabetes Reversal or Wellness Programs, which act as an additional layer of safety. Preventive care has become a valuable feature in many modern health insurance plans. For diabetics, monitoring blood sugar levels and conducting annual health screenings is essential to managing the disease and preventing complications. Policies that offer annual check-ups or comprehensive preventive care packages are a good option for people with Diabetes.
- Critical Illness Rider
Given that diabetes can increase the risk of conditions like heart disease, kidney failure or a stroke, a critical illness rider is worth considering. This add-on provides a lump sum payout if you’re diagnosed with any of the critical conditions listed in the policy, offering financial support when you might need it most.
Factors to keep in mind –
- Before you port your policy, opt for add-ons or even invest in a new plan, it’s of utmost importance that you declare your existing health condition to the insurer. Be transparent with your insurer to avoid any grounds for rejection later.
- Opt for a high sum insured plan. The treatment cost can run into lakhs, so it’s advisable to be prepared beforehand.
- Go for day 1 coverage. In fact, our data suggests that 75% of people with diabetes opt for a plan with Day 1 coverage to avoid any delay in coverage when they need it.
With the right plan, you can have adequate coverage against Diabetes. Don’t forget to compare policies and benefits online to better understand the exclusions and coverage. Ensure you have a detailed understanding from your insurer or anything that’s not covered.
Written By – Siddharth Singhal, Head, Health Insurance, Policybazaar.com
Disclaimer:The views expressed in this article are those of the author and do not represent the stand of this publication.
