Does Having Diabetes Affect the Premium Rates for Health Insurance?

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Diabetes does affect your eligibility and premium rates for health insurance. India is known as the ‘Diabetes Capital of the World’ with around 77 million Indians suffering from the disease. It is a chronic illness that requires regular attention, ongoing care, and lifelong medication.


Hence, it also affects how insurers assess risk and determine the premium rates. Keep reading for a detailed insight.


How Does Diabetes Affect the Premium Rates for Health Insurance?


Insurers view diabetes as a high-risk factor since it can cause health complications over time. To cover these health risks, the premium rates may be raised in the following ways:


1. Loading Factor


To cover possible claims in the future, the insurers add a loading factor to the base premium of the health policy. It usually lies between 10% to 50%, which increases the premium rates for diabetes patients.


The loading factor is calculated based on several factors:



  • Type of Diabetes:People with Type 2 diabetes face lower premiums than people with Type 1 diabetes since it can be managed through lifestyle changes and oral medication. At the same time, Type 1 diabetes requires lifelong insulin management and is often diagnosed early in life, leading to more serious health complications afterwards.

  • Health Risks:Insurers consider age, current health status, medical history, and the severity of pre-existing conditions to assess potential future health risks. Based on the risk profile, the loading factor is determined.


People with other health complications and poorly managed diabetes can face a high-risk loading factor, which will lie between 50% to 100%.



  • HbA1c Levels: Your blood sugar levels (HbA1c levels) are the major determinants of the loading factor unique to diabetes.

  • Policy Terms:Other factors, such as deductibles, waiting periods, copayment clauses, coverage duration, and similar terms, also affect premium rates for people with diabetes.


2. Diabetes-Specific Plans


Insurers are now offering specialised plans that provide coverage from the first day or have shorter waiting periods. These are designed for people with diabetes and offer guaranteed protection. However, they come with higher premiums than general health plans.


How to Manage Premium Rates When You Have Diabetes?


Even with diabetes, you can reduce your premium rates by balancing cost and coverage needs. Here are a few tips to consider:



  • Maintain a Healthy Lifestyle:You can control your condition through diet and exercise. Opting for healthy habits will show control over your condition and help you get favourable rates.

  • Update Your Medical Reports: Submit your latest sugar test reports and disclose your current health issues properly to avoid any hassle during the claim process.

  • Purchase Early:It is suitable to buy health insurance early in life since you suffer fewer complications at a younger age.

  • Opt for Instalments:You can choose to pay your premiums monthly or quarterly at a zero interest rate to ease your financial burden.

  • Wellness Incentives:Choose plans that reward you for maintaining good health. This way, you can easily get premium discounts.