Does critical illness insurance cover diabetes?

 If you have diabetes or are at risk of developing it, you might be wondering whether critical illness insurance can offer financial protection for the condition.

In this article, we’ll explore how critical illness insurance covers diabetes in Canada, what coverage options exist if you’re already diagnosed, and what alternatives to consider if you don’t qualify.

What is critical illness insurance?

​​Critical illness insurance is a type of insurance policy that pays out a tax-free lump sum should the insured be diagnosed with a life-threatening illness covered by the insurer. This type of coverage is also available as an optional add-on with life insurance policies.

Unlike traditional life insurance, critical illness insurance issues a benefit while the insured is alive, providing them and their family with financial support as they manage the financial and health impact of a life-threatening illness.

What does critical illness insurance cover?

Most critical illness insurance providers cover around 26 conditions, including blindness, limb loss, dementia, cancer, heart attack, and stroke, based on the definitions standardized by the Canadian Life and Health Insurance Association (CLHIA).

However, children’s critical illness policies, or riders, may cover up to 35 conditions, including illnesses commonly diagnosed in children such as autism, cerebral palsy, and more.

What is not covered by critical illness insurance?

Critical illness insurance in Canada typically excludes pre-existing conditions — conditions diagnosed before purchasing the policy, such as diabetes, arthritis, or osteoporosis. Most policies also have a waiting period of 90 days to one year for conditions like cancer and Parkinson’s disease. If you’re diagnosed during this waiting period, you won’t be eligible for benefits.

What is diabetes?

Diabetes is a chronic condition classified by the body’s inability to properly use or produce insulin. Insulin is a hormone normally found in your pancreas that controls glucose (sugar) levels in the blood. 

If you have diabetes, your body doesn’t respond to or produce insulin how it should. This results in high blood glucose (blood sugar) levels. High levels of blood glucose and diabetes can lead to a lot of complications such as cardiovascular disease, stroke, kidney disease, eye damage(retinopathy), glaucoma, gangrene, or even Alzheimer’s. 

Diabetes can impact anyone at any age although some types are more prevalent among certain demographics. According to the Public Health Agency of Canada, men are more likely to be diagnosed with diabetes than women, except for gestational diabetes. 

What are the various types of diabetes?

There are three main types of diabetes: type 1, type 2, and gestational.   

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease that typically develops during childhood but can also occur in adults. In this condition, the immune system destroys the pancreatic cells that produce insulin. Because Type 1 diabetes is an autoimmune disease, there are no proven ways to prevent it.

Type 2 Diabetes

Type 2 diabetes is a metabolic disorder that most typically appears in adults over the age of 40, however, you can be diagnosed when you’re younger. It occurs when your pancreas doesn’t produce enough insulin to metabolize the amount of glucose in your body or your body isn’t able to properly use the insulin it produces. Contributing factors include fitness levels, weight, ethnicity, family history, and genetics. This condition can be prevented to an extent through lifestyle choices such as diet and exercise.

Gestational Diabetes

Gestational diabetes occurs during pregnancy when your body is unable to produce enough insulin, leading to an increase in blood glucose levels. While gestational diabetes usually goes away a few weeks postpartum, it does signify an increased risk for developing type 2 diabetes in the future. Gestational diabetes can be prevented to an extent through lifestyle choices such as diet and exercise.

Symptoms and Complications

Diabetes can express itself through various symptoms and can lead to a variety of complications. Diabetics can experience increased thirst, increased urination, increased hunger, weight loss, blurry vision, numb hands or feet, and tiredness among other things.

If diabetes isn’t managed properly it can lead to conditions such as high blood pressure, heart disease, kidney failure, stroke, or other complications. These symptoms and complications will all be relevant in determining the level of coverage as well as the cost of a policy that an insurance provider may offer

Treatment & Management

Diabetes is treated through the management of blood sugar and insulin levels. Less serious cases of type 2 diabetes can be managed through diet and exercise. For type 1 and more serious cases of type 2, condition management involves monitoring blood glucose levels and administering insulin in response. 

Before offering coverage, most insurance providers will require at least two tests to determine how well your diabetes has been managed:

• Glucose test or sugar reading: This reveals your current blood glucose level.
• HbA1C or A1c test: This test shows your blood glucose levels over the past two to three months by measuring the amount of glucose attached to your red blood cells.

Higher glucose levels can be an indicator of poor health and diabetes management and could result in higher insurance prices.

Does critical illness insurance cover diabetes?

No. Critical illness insurance doesn’t cover diabetes, as it’s considered a chronic condition rather than a life-threatening illness. However, complications arising from diabetes can be life-threatening and are typically covered by critical illness insurance plans. For example, diabetes-related complications like cardiovascular disease, stroke, kidney failure, limb loss, and Alzheimer’s are often covered by these policies.

If you are at risk for diabetes due to your family history, consider getting critical illness insurance to protect yourself against any potential complications. To ensure coverage of future illnesses, be sure to consult your policy and any pre-existing condition exemptions. If you are unsure, consult an advisor to understand your coverage options.

Can I get critical illness insurance if I have been diagnosed with diabetes?

Yes, you can get critical illness insurance after a diabetes diagnosis, but your options will be limited. Your diabetes will be considered a pre-existing condition that can lead to higher premiums. Potential coverage will also vary, depending on the type of diabetes you have, past complications, and how well-managed your diabetes is. If your diabetes is well managed, then the insurance company may approve you for coverage, although there will be a risk of an insurance rating i.e. a price increase. 

Alternative coverage options for individuals with diabetes

If you don’t qualify for standard critical illness insurance coverage plans, you can still qualify for non-medical critical illness insurance policies — simplified issue or guaranteed issue.

If you have a family history of diabetes, it’s better to get critical illness insurance sooner than later as a diagnosis of diabetes can severely limit your coverage options. Simplified or guaranteed coverages, while being more accommodative, may impose a pre-existing condition exclusion as well as a 2-year waiting period.

Read more about simplified issue vs guaranteed issue insurance.

To determine what kind of coverage you qualify for, be sure to chat with one of our advisors.

How do I apply for critical illness insurance with diabetes?

If you want to buy critical illness insurance with diabetes, book a free consultation with our licensed advisors, who’ll help you compare different providers, understand policy terms and exclusions, and find coverage options that match your specific needs.