Health Insurance for Diabetics

Health insurance for diabetics is nearly impossible to obtain in most states. Unless you have group health insurance from an employer or live in one of the few states that have guaranteed health insurance, obtaining a full major medical plan as a diabetic becomes a daunting task.

Let’s briefly review the choices available to you.

Group health insurance, available through your employer, is offered on a guaranteed issue basis. That means you cannot be declined due to any pre-existing condition. However, if you have not had health insurance in the last 63 days, any prior coverage will not count towards meeting the 12 month pre-existing condition exclusion.

I should make this a little clearer. Even though group health insurance is guaranteed issue, they do not have to cover your pre-existing conditions for the first 12 months. But, if you have had prior coverage, that time you were covered will count towards this waiting period – as long as you did not have a break of 63 days or more.

If you are self-employed, you may be able to purchase a group plan on your own. This varies from state to state. In Florida for instance, they have an open enrollment period one month a year for self-employed, groups of one employee. In other states, you will need at least two employees to create a group.

Group health insurance is the easiest way for a diabetic to obtain health insurance.

The next type of coverage is private health insurance. This type of insurance, offered to individuals and their families outside of a group, is medically underwritten. Meaning they will look at your medical record and in almost all instances decline you for coverage if you are a diabetic.

We have come across insurance companies offering coverage to very well controlled with oral medication, diet and/or exercise. But, there must be no other problems. Meaning everything else is perfect including your weight.

While this type of health insurance for a diabetic is sometimes available, it is almost impossible to find.

Finally, there are indemnity plans.

Indemnity health insurance plans provide coverage for just about all pre-existing conditions including diabetes.  But, these are not full medical plans and are not considered “credible coverage”. Credible coverage means that if you move to another plan, they will not count the time on this type of plan towards your 12 month waiting period. As with other plans, pre-existing conditions are not covered for the first 12 months.

An indemnity plan is a health plan that pays out fixed amount of money for different medical expenses. For example, a plan might pay you or the hospital $1,000 a day if you are hospitalized. Or, it might pay out $100 for a limited number of physician office visits each year.

From the plan´s point of view, they do not care what is wrong with you, where you go for treatment or how much it costs. They are telling you in advance how much they are willing to pay for the various medical services. Not a penny more and not a penny less.

If you have diabetes and you are struggling to find health insurance, this might provide an answer.

While it will not cover all medical expenses, they can often be augmented with

1. Accident plans – these plans help pay for accidents or injuries and will usually cover your emergency room expenses.
2. Cancer insurance – pays out a lump sum in the event you are diagnosed with certain types of cancers.
3. Critical illness plans – are similar to cancer plans but pay out for other catastrophic illnesses such as kidney failure or a heart attack.
4.  Hospital cash plans – these plans pay you additional money if you are hospitalized.

For completeness, I should mention that there are five states; New York, New Jersey, Maine, Vermont and Massachusetts that offer guaranteed health insurance to everyone.

Plus, there is a new federal plan that will cover you if you have not had health insurance for the past 6 months.

As you can see, finding health insurance for diabetes is difficult but not impossible. There are options. Many agents will just dismiss you out of hand. They will not be bothered with putting together some of the alternatives listed in this article. However, many recognize the need to provide quality medical coverage to diabetics and will help you navigate through these options.

Life insurance plans for diabetics are especially important.  Very often as a diabetic gets  older their disease gets worse.  Therefore, it is important to obtain life insurance while you were still relatively healthy.

A lot of diabetics are under the impression that their disease would prevent them from obtaining life insurance. This is not the case.  As a matter of fact, most well control diabetics, even Type 1, will qualify for some type of life insurance plan.

Clearly, if you have a neuropathy, retinopathy, are obese, have heart problems or other major medical issues, you will have great difficulty in obtaining insurance.  But you still may be able to obtain a life plan, even though it might be limited or a bit more more expensive.

Term life insurance will give you a higher payout at a lower cost. However, these plans are generally taken for a fixed term and become prohibitively expensive in your later years.

Permanent or whole life insurance builds up cash value and eventually you will not have to pay any premiums at all. It is a very flexible financial tool. It is the type of policy that many young people do not purchase but many old people wish that they had.

You might be able to obtain a term life plan that has a convertible feature. This gives you the opportunity to have a high payout plan when you are younger, less well established and with young children. Later on, you can convert the insurance to a whole life or permanent plan with a lower death benefit that you can hold on to and provide protection for your spouse.

An additional advantage of life insurance for a diabetic is the ability to use the benefit in the event of a critical illness. Many plans offer this feature that allows you to receive the death benefit while you are alive in the event of a diagnosis of a life threatening illness.

Life insurance plans for diabetics are described in more detail on our article page.