What Will Happen if I Get Diabetes After Getting a Health Insurance Plan?

Posted on: Feb 22, 2024 | 3 mins | Written by: HDFC ERGO Team

What Will Happen if I Get Diabetes After Getting a Health Insurance Plan?

Suppose you are planning to purchase a health insurance policy. In that case, it is crucial to have a transparent and open conversation with your health insurance provider regarding any pre-existing health conditions or diseases that you might be suffering from. Insurance companies have a list of illnesses that they define as pre-existing conditions. Generally, there is a waiting period associated with these conditions, which means that you cannot claim hospitalisation or other medical expenses related to these illnesses until the waiting period has elapsed. The waiting period for pre-existing conditions usually ranges between 2 to 4 years. Once the waiting period is over, the insurance policy will cover your pre-existing conditions. It's essential to note that diabetes is also considered a pre-existing disease.If you plan to get a health insurance policy, you should have clear communication with your health insurance provider about any pre-existing disease you suffer from. There is a list of diseases that the insurance companies define as pre-existing diseases. There is usually a waiting period attached to these pre-existing diseases or conditions, which means you cannot claim hospitalisation or other medical expenses arising due to complications of these illnesses. Most health insurance companies have a waiting period of 2 to 4 years. This means your pre-existing diseases will be covered once your waiting period ends. Diabetes is also considered a pre-existing disease.

When applying for health insurance, your insurer may ask you to undergo medical tests to determine your health condition. This helps you make an informed decision about your health plan and promotes transparency. However, health issues can be unpredictable. For instance, even if your sugar levels are normal when you take the policy, they may change in just a few months. For example, you may discover that you have diabetes during a routine blood test three months after taking the policy. This is more likely if you lead an unhealthy lifestyle coupled with stress and lack of sleep.

What to do if you are diagnosed with diabetes after getting a health-insurance policy?

If you find out that you have diabetes after getting your health insurance policy or after renewing it, there are a few things you should do.

Contact your health insurance provider immediately to inform them about your health status and ask about available options for upgrading your plan.

Ask for specific plans that provide better coverage for diabetes-related expenses, such as medications, doctor visits, and preventive services.

Check if you can transfer your plan to a diabetes-specific plan within the same insurance company. Depending on the underwriting policies, your insurer might give you the option to transfer to another policy include diabetes-related coverage add-ons, or work on the terms and conditions of your policy.

Carefully review your current health insurance policy to understand the coverage limitations, exclusions, and any specific diabetes-related conditions. This will help you identify areas where the coverage is inadequate or could be improved.

Since diabetes is a pre-existing condition, your insurer might have a waiting period before you can make diabetes-related claims in your policy. Be sure to check on this period carefully. When you disclose your diabetes diagnosis, your insurer might offer to help you port to another plan of the same company, include diabetes-specific add-ons or identify areas that would need adequate coverage, all depending on your health report. While upgrading to a better plan or choosing inclusions, your premium amount can increase as the coverage scope increases. Choose your premium according to your needs that can reduce your out-of-pocket expenses, deductibles, copayments. Remember that a plan with higher premiums may offer better coverage and lower out-of-pocket expenses.

However, if you have diabetes before buying health insurance, it is better to get diabetes-specific insurance which caters to the needs of people living with diabetes.

What is diabetes insurance?

Diabetes insurance refers to insurance policies that cover the high cost of diabetes treatment and related illnesses. It covers expenses related to type 1 and type 2 diabetes, including hospitalization and complications. HDFC ERGO offers comprehensive coverage for people with diabetes through its Energy Diabetes Insurance Policy. This policy covers complications of hypertension and diabetes from the day of issuance.

Benefits of having a Diabetes-Specific Insurance plan

HDFC ERGO’s Energy Diabetes Insurance Policy comes will a lot of benefits, here are a few of them:

Hospitalization expenses: Just like every other health insurance plan, this plan covers you for hospitalization due to diabetes and hypertension or related complications.

Pre and post-hospitalisation: The plan also covers costs for diagnosis, investigation pre-hospitalization expenses up to 30 days before admission and post-discharge expenses till 60 days.

Day-care procedures: Treatments taken in a Hospital /Day care centre that needs you to be in the centre for less than 24 hours are also covered.

Emergency Ambulance Cover: Ambulance charges for transporting the patient to a hospital are also covered.

Organ Donor Expenses: If your diabetes warrants an organ transplant, the policy pays for the harvesting and planting surgery.

HbA1C Check-up Benefit: Reimbursements for the essential and annual medical check-ups are also part of the policy.

These are just some of the benefits offered by this plan. To understand the inclusions and exclusions, read the policy document carefully or call the customer care centre for any queries.

The Parting Message

Remember that the process of upgrading your health insurance plan can vary based on your location, the insurance provider, and the specific plans available within the company. Always be transparent about your diabetes diagnosis when applying for insurance, and thoroughly understand the terms and conditions. If you learn about your diabetes diagnosis after getting health insurance, communicate this with your insurance provider as soon as possible. Depending on the underwriting policies, your insurer will help you get the maximum benefits from your plan. However, non-disclosure can lead to policy termination or rejection of claims in the future.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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