How to Get the Best Health Insurance Policy for Cancer?

With the rapid increase of health facilities in the country, the cost of treatment of various diseases is on the upward surge too. Amongst them, the treatment of cancer is by far the longest and costliest. For a common man, it gets increasingly difficult to cover the cost of the treatment. Even if the patient recovers, he/she loses all of their life savings in medication and chemotherapy. Moreover, all cancer patients have to quit working while undergoing treatment, which creates additional financial burden and uncertainty. Is there a policy to equip ourselves with the financial coverage? Let’s check it out here.

Subas Tiwari

Start: Solutions to this are the cancer health insurance policies available in the market. These policies provide you financial assistance for cancer treatment.

Why is Cancer Protection Policy Important?

Defined as the uncontrolled growth of abnormal cells, cancer is basically a large group of diseases that can start in almost any organ or tissue of the body. The incidence rate of cancer has increased significantly in the last decade and according to WHO reports, it is the second leading cause of death globally.

With the improvement of health services in our country, the detection and quality of treatment has increased tremendously. However, its cure is still very expensive. To mitigate the burden, medical insurance against cancer is the need of the hour.

Salient Features

  • All life insurance companies offer lump sum payout at early stage (also called minor/mild stage), major stage (also called moderate stage) & severe stage (also called critical stage) of cancer.
  • While some of the plans offer waiver of future payouts of premium (also called waiver), some others offer death benefit to the nominee.
  • Most of the companies also offer surrender benefit (after a specific lock-in period) while some of them offer loan on assignment basis to the company.
  • Once a lump sum is made on the policy for treatment for any stage of cancer, the policy gets extinguished.
  • There are life insurance companies which offer a combination of Heart AND Cancer cover with an option to receive monthly income for prolonged treatment to cover both ailments.
  • No claim is entertained within 180 days of the policy date which is the “waiting period”.
  • The maximum entry age under this plan is 65 years.

Exclusions

  • Sexually transmitted diseases (STD), AIDS or  HIV
  • Any pre-existing condition
  • Any congenital conditions
  • Any critical illness or its signs or symptoms having occurred within the waiting period of 180 days of policy commencement date
  • Under the influence of drugs, alcohol, narcotics or psychotropic substance not prescribed by the treating doctor
  • Treatment for injury or illness caused by activities such as hunting, mountaineering, racing, scuba diving, aerial sports, activities such as hand-gliding, ballooning, any other professional sports which may lead to deliberate exposure to exceptional danger
  • Unreasonable failure to seek or follow medical advice, the policyholder has delayed medical treatment in order to circumvent the waiting period or other conditions

Pointers to Keep in Mind

Cancer insurance plans offer financial relief if diagnosed with minor or major stage cancer and helps the patient and his family to better deal with the situation. There are many cancer insurance products in the market, and it is essential to know what you must look out for when you make your decision.

  1. Benefit vs indemnity:There are two kinds of policies available in the market. Benefit policies are those where sum insured is paid upon the discovery of cancer and successfully passing the survival period. In an indemnity policy, the claims are payable after the waiting period is over and are reimbursed in accordance with the amount spent towards cancer treatment charges.
  2. Sufficient coverage amount:It is no secret that cancer treatment is extremely expensive and a long-term ordeal. The cumulative cost incurred on diagnostics, radiation, chemotherapy and surgery would cause a significant dip in your personal savings if they were to be borne out-of-pocket. Going by the age-old adage, “Better to be safe than sorry”, it would be more beneficial if one were to opt for a higher sum insured amount that would take care of high-cost procedures for a slightly higher premium.
  3. Prior history of cancer: People who have been diagnosed with and treated for cancer earlier should be prepared to face rejection at the time of application for health insurance (whether critical illness policies or cancer care plans). Most insurance companies are not likely to cover cancer patients considering the high risks involved.
  4. Other pre-existing diseases:Whether one opts for a critical illness policy that also covers cancer, or a cancer care plan, it is imperative to declare all previous and/or existing medical conditions and ailments at the time of purchasing the policy. One should also truthfully answer any questions pertaining to genetic predisposition or a family history of any forms of cancer. Non-disclosure would not just impact the claims related to any cancer-specific treatment undergone, it would also lead to rejection of any other non-cancer treatment expense claims.
  5. Waiting periods:Every health insurance plan defines a waiting period for certain conditions and treatments including cancer. These specific waiting periods differ across policies and insurers, so it would be wise to ascertain the time period for the chosen critical illness or cancer care special plan during which one will not be qualified to raise medical claims. Preferably opt for a policy that has a low waiting period to expedite the eligibility. The waiting period is only on first time purchase.
  6. Co-payment: Few health insurers impose a co-payment clause (i.e., a percentage of sum insured amount) on cancer treatment expenses which have to be borne by the policyholder. Choosing such a policy would mean that a certain percentage of the costs will always be paid on your own.
  7. Sub-limits:Some insurers stipulate an upper cap or sub-limit on the amount of coverage offered for cancer treatment. For example, the critical illness plan might be for a sum insured of Rs 50 lakh, but cancer treatment would get covered only up to Rs 5 lakh.
  8. Exclusions:All health insurance policies – whether critical illness or cancer specific – outline a list of exclusions which are conditions and procedures that the insurer is not liable to pay for. Those looking for cancer-related health insurance should, of course, ensure that cancer is not excluded from coverage. Additionally, this list of exclusions might mention a specific type/s or stage/s of cancer that would be omitted from coverage.
  9. Experimental treatments:Exponential and continuous advancements in cancer therapy have led to novel treatment methods being discovered. Most health insurance plans cover traditional and new age treatments that are approved by medical councils. Radical therapies and unproven treatments would not be covered.
  10. Survival period:Insurers specify the minimum number of days for which the policyholder must survive post diagnosis or treatment of cancer. The health insurance benefit will be accrued only upon successfully passing the survival period. This is a crucial point to be aware of to avoid any future surprises.
  11. Features that aid in increasing the sum insured amount:Restoration benefit for the same disease would be an ideal policy feature to have, as it would lead to reinstatement of the original coverage amount upon exhaustion due to single or multiple claims submission. Additionally, no-claim bonus for claim-free years would also help in augmenting the sum insured amount, which would eventually prove useful at the time of seeking expensive cancer treatment.

Renewability of the policy after the discovery of cancer: The policy may not be renewed once cancer specific feature is invoked. The benefit is usually payable once in the lifetime of the insured.

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