India's Diabetes Epidemic: Ensuring Access to Comprehensive Health Covers for Diabetics
New Delhi, [Date] - With over 101 million Indians estimated to be suffering from diabetes and another 136 million at the pre-diabetes stage, the Indian government is urged to take immediate action to tackle this growing health challenge. Meanwhile, diabetics are now gaining access to comprehensive health insurance policies that can cater to their unique needs.
However, according to industry watchers, consumers must be prepared for higher premiums, stringent evaluation processes, and waiting periods before insurers will consider issuing a policy.
Many health insurance companies now offer coverage from day one, particularly through rider benefits or stands-alone cover plans with additional premium. However, insurers take calls on the basis of the severity of diabetes and complications. For instance, insulin-dependent diabetics may still find it challenging to obtain health coverage.
"We have seen a significant shift in our policy stance towards diabetes since 2018 when we started offering new policies with day-one coverage," says Siddharth Singhal, Head, Health Insurance, Policybazaar.com.
Similarly, companies like ACKO are now open to covering both type 1 and type 2 diabetes. However, insurer Narendra Bharindwal notes that the extent of disease, age of onset, duration of the disease, HbA1c levels, and co-morbidities such as hypertension play a crucial role in determining coverage.
"Most insurers have an HbA1c limit of 8 for control and no existing micro or macrovascular complications to offer a full-fledged cover," says Rupinderjit Singh, Senior Vice President - Health Insurance, ACKO.
However, not all insurers impose strict HbA1c limits. Some plans even accept levels up to 10, depending on the case-by-case assessment of each individual.
"The company assesses each case individually, and it is essential for policyholders to declare their current medical condition accurately and completely to avoid issues during a claim," adds Singh.
Diabetics must also be prepared for higher premiums if they belong to certain risk categories. The quantum of loading can vary greatly depending on the severity of diabetes, HbA1c levels, duration of disease, age, weight, co-morbidities such as hypertension, and overall health status.
"In some cases, diabetics with well-managed HbA1c levels may see a minimal increase of around 15-20 percent, while poorly managed cases could face a loading of up to 50 percent," notes Bharindwal.
Furthermore, consumers need to ensure complete and transparent disclosure of pre-existing medical conditions, including diabetes. Failure to make these disclosures can result in claims being rejected or policy cancellation.
As the government takes steps towards implementation of a National Health Protection Scheme (NHPS) that covers over 10 crore families, it is crucial for authorities to assess the coverage offered by private insurance companies and provide adequate guidance to consumers on how to access comprehensive health covers.
Diabetics must be vigilant in navigating complex policy offerings to secure the best possible coverage. Experts recommend comparing rates, benefits, and exclusions when making a selection, as well as scrutinizing insurer ratings and financial stability.
In conclusion, effective patient engagement and awareness campaigns are pivotal towards ensuring universal healthcare that safeguards the rights of diabetics worldwide. It is time for policymakers to intervene with evidence-based regulations to safeguard the welfare of millions of Indians living with this chronic condition, ensuring easy access to quality care at affordable costs.