Hi Kalpak Solanki,

Members with pre-existing history of Diabetes and Hypertension needs special attention while choosing an accurate plan and appropriate health cover. Most often in such cases people are in a fix when it comes to picking the right Health Insurance Cover.

Two Kinds of Policies are available in the market for such members:

1. Regular Health Insurance Policies - These plans have a waiting period of 1 to 4 Years for all complications related to Diabetes and Hypertension
2. Special Disease Specific Health Insurance Plans for Diabetes & Hypertension - These are policies which offer Day-1 coverage without any waiting period for Diabetes & Hypertension.

Regular Health Insurance Policies

Policies with a specific waiting period for Diabetes & Hypertension, will not cover the hospitalization expenses for most common complications associated to Diabetes & Hypertension until the completion of such waiting period. Examples of such complications include Stroke, Heart Diseases, Kidney Diseases, Foot Ulcer-Gangrene, Atherosclerosis, Hypo / Hyperglycemic shocks, Internal Bleeds / Hemorrhages etc. Hence, Regular Health Insurance Plans should be chosen only when you are prepared to take the risk of waiting for the initial 1 to 4 Yrs period.

Examples of few good Health Insurance Options in this category:

Star Comprehensive - Buy back PED Rider (Star Health Insurance)

Complete Health Insurance - ICICI Lombard

ReAssure - NIVA Bupa (Max Bupa Health Insurance)

Special Disease Specific Health Insurance Plans for Diabetes & Hypertension

On the contrary, Special Disease Specific Health Insurance Plans for Diabetes & Hypertension agrees to cover all the medical complications related to Diabetes & Hypertension without any waiting period (Day-1 Cover). All other features and terms & conditions are similar to that of the regular health insurance plans. Since these policies offer coverage immediately without a waiting period, the premiums are on the higher side compered to the regular policies. In addition such disease specific plans offer value added services such as frequent health checkups, assistance of a specialized health coach and help you in keeping a track of your health status regularly.

Examples of few good Health Insurance Options in this category:

ENERGY Plan - HDFC ERGO

Diabetes Safe - Star Health

Activ Health: Platinum Enhanced Plan - Aditya Birla Health

I would recommend that you review few options like the ones mentioned above & completely understand the merits and limitations of these plans before deciding the best policy for your Mother. Also try to choose a higher Sum Insured instead of 5 Lakhs cover. It may not be easy for you to enhance the coverage limits at a later date as insurance companies are equally cautious about increasing the sum insured limits irrespective of her seniority in the policy. Considering the factors such as medical inflation and therefore very expensive treatment procedures, age of your Mother and her medical history you should plan for a higher coverage limits of 10 Lacs & above.

If budget permits start a medical contingency fund (Such as an SIP) with the help of a good financial advisor for any unforeseen medical expenses beyond her insurance limits.

Hope this information helps in your decision making. Best Wishes...

Satish Kumar H

Consultant - Health Insurance

9010044771