How does health insurance work for diabetics?

Let's start with the bad news. If you have diabetes and look for private health insurance, you might find it more expensive. You may also find that your insurers will exclude anything that they can relate to your diabetes. That may be a very long list, including things like heart conditions, strokes, any illnesses relating to problems with blood flow, and some eye issues. Some providers also exclude people with diabetes altogether.

Now, the good news. Subject to some exclusions, private medical insurance will work for you in the same way it operates for anyone else. It's designed to help you get high-quality medical care quickly and at a location to suit you. Medical insurance pays for private healthcare so that you don't have to sit on an NHS waiting list. There is a wide range of insurers and policies, so you can choose the right one for you. Then, when you become ill or sustain an injury, you can contact your insurers to make a claim and start your treatment.

Every health insurance policy excludes some medical conditions. Some will be excluded as standard, whilst others will be based on your medical history. Medical insurance excludes pre-existing conditions. These are anything you've needed advice or medical treatment for, usually within the last five years. Your diabetes will be treated as a pre-existing condition. It will also be excluded as it's a chronic condition which can't be cured but needs ongoing management.

This means that any conditions arising from your diabetes would also be excluded. For example, if you need treatments for eye problems arising out of diabetic retinopathy, that wouldn't be covered as it's directly related to your diabetes. On the other hand, if you fell and broke a bone, your private medical insurance would pay up as it didn't happen because you're diabetic.

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"I  requested a policy review having been with Bupa for over 10 years and was astonished by the savings I've made on mine and my husband's policy. If you're thinking about reviewing your policy do it, you won't be disappointed. "

by Erica - 27th April 2022
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What does private medical insurance cover?

The health insurance cover you receive will depend on the policy you choose. Still, a few conditions and types of treatment are usually included as standard, whilst others are typically an optional extra that you can add on if you choose to.

Inpatient treatment

Most medical insurance covers inpatient and day-patient treatments as part of its core policies. It means you'll be covered if you need to be admitted to the hospital.

Outpatient treatment and diagnosis

If you need to attend the hospital as an outpatient, the costs associated aren't usually included in your core cover. However, most companies offer outpatient care as an optional extra.

Cancer

Cover for cancer care varies between different providers and types of policy. Some include comprehensive cancer cover as standard, whilst others offer it as an optional extra so you can decide whether you need it.

Mental health

Mental health treatment and support are usually only offered as an add on to your core medical insurance policy. Some offer support via a helpline, while others allow you to access therapy or counselling without needing a referral from your GP. Some also provide access to well-being support as part of their core package.

Therapies

Physiotherapy and chiropractic therapy are generally only offered as an added extra. Depending on your policy, there may also be limits on the number of sessions your insurance company will pay for.

Dental and Optical

Dental and optical care is usually an optional extra. However, we have come across some health insurers who include it as a standard on their higher-level plans. It will generally pay for dental and optical checkups and treatments and repairs to tooth damage and dental emergencies. Payment limits vary, with some insurers paying for dental emergencies abroad and in the UK.

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What's typically excluded?

It won't surprise you that your health insurance won't cover your diabetes. In itself, it's a chronic condition, and every health insurer excludes these as they aren't curable - health insurance only covers acute illnesses and injuries. Any illnesses that you experience due to your diabetes will also be excluded. That could potentially be things like:

  • Heart conditions
  • Strokes
  • Symptoms arising from blood flow issues
  • Some eye conditions

This isn't an exhaustive list, so it's important to discuss this with your provider before taking out the policy or when you need medical treatment.

Equally, if you've had medical advice for anything else in the last five years, that will be excluded too. Most policies apply a two-year moratorium period, so the condition can be added if it doesn't reoccur during the first two years of your policy. 

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Most insurers exclude the following:

  • Therapy for addiction
  • Cosmetic surgery
  • Pregnancy and maternity

Some insurers have a long list of exclusions, so checking the details when you do your research is essential.

The cost of health insurance may be more expensive when you're living with diabetes, however, this will depend on the type of underwriting your policy has.

Services are offering further information for people with diabetes. Diabetes.co.uk has teamed up with a specialist broker to offer tailored health insurance. You can find out more about that here.

How does moratorium underwriting work?

Moratorium underwriting excludes any conditions you've suffered from or sought treatment for in the five years before you took out the policy. If you don't suffer any symptoms or need care for that condition in the first two years of your policy, your insurers will be able to add it to your policy from then onwards. When you choose this type of underwriting, you won't have to disclose any pre-existing medical conditions when you take out your medical insurance. However, your insurers will investigate your history when you make a claim and may refuse to pay if the condition is related to your diabetes. It means that you have less certainty about what will or won't be covered, and your claim is likely to take longer while they investigate.

How does full medical underwriting work?

If your policy has full medical underwriting, you'll be asked to complete a medical questionnaire when you apply. Anything related to your diabetes will be excluded, as will any other conditions you've been treated for in the last five years. The advantage of this is that you'll have more information about what is and isn't covered from the outset. However, people living with diabetes can be viewed as high risk, so you may be charged higher premiums.

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Who are the best health insurance providers in the UK?

In another recent guide we reviewed the eight best private health insurance providers in the UK. They all offer superb cover and excellent service. Each insurer provides cover for diabetics, but you'll need to check individual terms and conditions to determine how any exclusions might affect you.

Aviva Logo

Aviva

Aviva's comprehensive policy includes both inpatient and outpatient care as standard. You can be treated in hospitals and clinics across the UK. Their Healthier Solutions policy includes cancer care and access to a digital GP and a stress counselling helpline. Whilst your choice of consultants isn't as comprehensive as with other insurers, this means it's excellent if you're on a tight budget as premiums are generally lower.

Axa logo

Axa

AXA Healthcare gives you access to inpatient and day-patient care as part of their core cover, with outpatient care as an extra. This means that you can tailor your policy to suit your needs. You'll also be able to choose from over 250 private hospitals. Cover limits are generous, and there's also no limit on the number of physiotherapy or chiropractic sessions you can receive. The AXA Research Fund has also supported academic research into Type 2 diabetes and the potential impact of wearable technology.

Bupa logo

Bupa

When you choose Bupa as your provider, you get an impressive level of cover as standard. They're well known for their great network of private hospitals and clinics. They also offer extensive discounts and other benefits to their policyholders.

Freedom logo

Freedom

Freedom Health is a small, award-winning insurer. They offer you comprehensive core cover and a range of optional extras, including outpatient care, with no restrictions on consultant choice. They don't base your premium on your postcode, and they also guarantee that your premium won't increase in the first two years. They're one of the only health insurers that offer cover for pregnancy complications. Managing your diabetes during pregnancy will usually mean a specialist referral, which could be a welcome safety net if you're starting a family.

National friendly logo

National Friendly

You may not have heard of National Friendly before, but their friendly approach to health insurance is reassuringly straightforward. Their policies are flexible, offering comprehensive cover, with the only real limits being on diagnostic tests and some cancer treatments. They also guarantee that your premium won't increase during the first five years of your policy, which is one of the longest guarantee periods we've seen.

The Exeter Logo

The Exeter

The Exeter is a friendly society with a community-rated scheme that means individual claims won't affect your policy. Some health insurers won't offer insurance to anyone over 65, but with The Exeter, you can access insurance up to 80. Their core policy includes outpatient surgery, cancer and mental health care, and you can choose from a range of optional extras. They also offer life insurance for type 2 diabetics, so they're worth investigating if you've struggled to get this type of insurance in the past. They're also among the highest-rated insurers for customer satisfaction and paying out on claims.

Vitality logo

Vitality

Vitality offers insurance designed to help you create and maintain a healthy lifestyle. Unfortunately, some of its discounts for new customers without any pre-existing health conditions aren't available to people with diabetes. However, its offers and benefits are aimed at helping you to be healthier. If you become ill, they promise to pay all your hospital bills. This could be an advantage if you're managing your diabetes symptoms with lifestyle changes instead of medication.

WPA Logo

WPA

WPA provide excellent customer service, and you can make claims easily via their app. There's also a comprehensive list of hospitals and specialists. If you're self-employed or work in one of many professions, you can also get a 20% discount on your premium.

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Why it pays to speak to a health insurance broker

When you're living with diabetes, finding the right policy, whether it's for your healthcare, life insurance or car insurance, can feel like you're negotiating a maze. There's a range of different policies, and it can be hard to assess which will offer the benefits you need.

The information that each insurer offers on their website can also vary in the level of detail provided. Speaking to a health insurance broker will help you access tailored guidance based on your circumstances and the health services you're likely to need. They may also be able to help you to save money.

At myTribe, we aim to offer information that helps you navigate the world of medical insurance and find the right policy for you. We'll provide you with a comparison quote and connect you with highly rated brokers authorised by the Financial Conduct Authority to provide you with independent advice based on your circumstances.

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Summary

When you look for health insurance as a diabetic, you may find that your premium is more expensive and that there are a lot of exclusions on your policy. It's still worth having as it will cover you for severe illnesses like cancer or musculoskeletal injuries where fast, high-quality treatment will be a real benefit.

If you're reading this as someone who is at high risk of becoming diabetic in the future, but you don't have a diagnosis yet, we recommend that you sort out your policy now so that any related conditions are covered in the future.