Failure to Disclose

A consumer must identify and disclose all current or previous medical conditions, ailments, diseases and injuries. The failure to disclose diabetes---if discovered by the insurer---will result in a denial of coverage.

Waiting Period

Provided a consumer discloses her diabetes, a health insurer can impose a waiting period before providing coverage. The typical time frame is two years.

Exclusion

Another option available to a health insurer is to approve a policy but permanently preclude coverage for any expenses related to diabetes.

Denial

The harshest position an insurance company can take is an outright denial of coverage because the insurer wants to eliminate the risk and expense of insuring a consumer with diabetes.

Group Insurance Exception

A health insurer can deny a diabetic on an individual coverage but typically not on a group policy. If a consumer moves from one group policy to another, the insurer cannot deny that individual for diabetes or any other pre-existing condition.

Considerations

The decision to exclude or limit coverage for a diabetic is financial. The expense of treating diabetes requires an insurer to spend a higher amount of money on behalf of an insured person.

Source:

Health Insurance Answer Book; John C. Garner; 2008

Pre-Existing Conditions and Insurance

Understanding Health Insurance; Michelle A. Green & Jo Ann C. Rowell; 2007