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Our health insurance expert, Steven Spicer, has some tips for choosing suitable health insurance if you have diabetes.
Whatever policy you choose, it’s essential to understand precisely what your inclusions cover. For example, the clinical category ‘diabetes management’ doesn’t include insulin pumps, which have their own distinct category. This can help you choose a policy that suits your needs and also help you understand what you can and cannot claim for and avoid unexpected out-of-pocket costs.
Regularly checking your policy can help you ensure your health insurance still suits your needs. Perhaps inclusions you once needed are no longer relevant or there are health challenges on the horizon that you don’t have cover for. This is also a good opportunity to see what else is out there and decide whether it’s time to switch or stick with the cover you have.
You have a few options if you’re looking to get both hospital and extras cover. You can get a combined policy with one health insurance company or split your cover between two different funds. Each approach has its pros and cons, so it’s worth investigating which is the best fit for you and provides the best premiums.
Diabetes mellitus (most commonly referred to as diabetes) is a group of diseases that lead to high glucose levels in your blood.1,2 This happens when your pancreas cannot produce enough insulin or your body becomes resistant to the hormone insulin. People with diabetes struggle to turn glucose (a type of sugar) into energy, leading to hyperglycaemia (high levels of blood sugar in the blood).
Diabetes is a complex disease that can lead to additional complications including heart disease, stroke, high blood pressure, vision problems, kidney disease and foot problems.1,2 Over 30% of people with diabetes also experience mental health issues such as depression, anxiety and distress.
Symptoms that could be the result of diabetes include:1,2,3,4
Keep in mind that diabetes doesn’t always have symptoms, particularly in the pre-diabetes stages. Symptoms can also be misattributed to something else.
Certain factors can increase your risk of diabetes including:1,3,4
The cause of diabetes varies depending on the type of diabetes you have.1,2 There are several types, each with different causes. The main types of diabetes are:
There are various treatments and health services available for diabetes care. While each patient and case differs, health professionals and diabetes educators can help you minimise or stop diabetes complications. Some key diabetes treatments and healthcare steps include:1,2,6
Private health insurance can help cover the costs of diabetes treatment, providing you have a suitable level of cover. If you’re looking into health insurance for diabetes, you may want to consider a combined policy (one which includes hospital and extras cover). Hospital cover can provide cover for hospital treatment for the investigation and management of diabetes provided you have the clinical category ‘diabetes management (excluding insulin pumps)’, which is a minimum requirement for Bronze tier hospital cover and above.
Diabetic consumables and health management services (e.g. weight management, fitness programs) can be claimed on extras policies with the relevant inclusions. How much you can claim will depend on your limits and the specifics of your policy.
If you’re considering an insulin pump, it’s important to know this isn’t covered under ‘diabetes management’. Insulin pumps have their own separate clinical category, and it is only a minimum requirement for Gold-level hospital cover. Diabetes-related conditions can also be categorised based on the body part affected. For example, eye conditions caused by diabetes will still be covered under the ‘Eye’ clinical category and skin ulcers are categorised under ‘Skin’.
Some of the key benefits of being treated in a private hospital as a private patient include:
The Australian Government has an initiative called the National Diabetes Service Scheme (NDSS), designed to help Australians with diabetes care. The initiative aims to help people with diabetes understand their condition and assist them with the necessary support. It can also help subsidise necessary products, including:7
Eligible people can register with the NDSS for free through their website. Requirements for eligibility can also be found on the site.
Private health insurance policies will have waiting periods you’ll need to serve before you can make a claim. This is especially true if you’re upgrading your policy or taking out health insurance for the first time. The standard waiting time for hospital cover is two months. Pre-existing conditions (medical conditions that existed at any time during the six months prior to taking out the policy) will typically require a 12-month waiting period before you can make a claim.
As the Executive General Manager of Health, Life and Energy, Steven Spicer is a strong believer in the benefits of private cover and knows just how valuable the peace of mind that comes with cover can be. He is passionate about demystifying the health insurance industry and advocates for the benefits of comparison when it comes to saving money on your premiums.
1 Health Direct – Diabetes. Accessed February 2025.
2 Diabetes Australia – About Diabetes. Accessed February 2025.
3 Health Direct – Type 1 diabetes. Accessed February 2025.
4Health Direct – Type 2 diabetes. Accessed February 2025.
5 Health Direct – Gestational Diabetes. Accessed February 2025.
6 Health Direct – Insulin and diabetes. Accessed February 2025.
7 NDSS: National Diabetes Service Scheme. Accessed February 2025.