Diabetes Is Not Necessarily A Decline For Health Insurance

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As a health insurance agent I see my share of people with diabetes. 

In the past the diagnosis was a death sentence for individual health insurance.

For people age 64 and under who take regular insulin injections it is still an automatic decline for most private health insurance companies.

People with Type II diabetes and are dependent on insulin injections will typically have to settle for High Risk Health Insurance Pools through state or federal government programs.  Their other option is to join a group benefit plan offered through their employer if one is available.

People, who are able to control their blood sugar levels with diet, exercise and oral medication may still be able to obtain health insurance in the private market and not have to pay the exorbitant premiums that many government or group plans charge.

It is likely that they will receive a premium sur-charge since their diabetes diagnosis means they have a higher likelihood of medical bills in the future but they are not stuck without options just because of their diabetes.

Last week the Department of Health and Human Services published the following,

“More people are getting diabetes, and people who have diabetes are living longer with it. And when you put the trends together, you can see a tidal wave of disease heading toward us. The Centers for Disease Control and Prevention projected the numbers to the year 2050.”

– Dr. Ann Albright

In addition, I verified with the underwriters of one of my Medicare Supplement providers that a person with mild diabetes is still able to qualify for a Medigap plan.  In the past, any form of diabetes, whether it was controlled with insulin injections or oral medication, was an automatic decline.  If someone wanted a Medigap plan, they had to get it during their 7 month open enrollment when they first started with Medicare or do without a supplement during their retirement years.

In the past few years, that has changed.  Medigap plans are still generally medically underwritten 4 months after one begins Medicare.  They can be switched from one company to the other at that time but only if the insured is medically acceptable.

Recently, many insurance companies have loosened up their diabetes standards.  Some Medigap plans will accept an individual who is insulin dependent if everything else is under control.  The company I spoke with last week will accept an application for Medigap from a diabetic who uses 50 units of insulin a day or less.