Cancer is one of the leading causes of fatalities among women in India. As per some startling statistics revealed by the National Institute of Cancer Prevention and Research in May 2021, one woman perishes every eight minutes from cervical cancer, and one out of every two women diagnosed with breast cancer succumbs to it.
But that’s not the only way this deadly disease takes its toll on us! Cancer treatment, in itself, is demanding and long-drawn, involving various screening tests, oncologist consultations and attentive therapies like radiation, chemotherapy, and invasive procedures, all of which are expensive. Vivek Narain, Health Insurance Specialist, SANA Insurance Brokers Pvt. Ltd., says, “Organising the funds to pay for cancer treatment out-of-pocket can be strenuous for most individuals. This can be avoided by having a comprehensive healthcare insurance plan that also covers for cancer treatment.”
Vivek shares five factors women should consider when looking for cancer cover in their health insurance.
#1 Type Of Policy With Cancer Cover
There are three categories of health insurance plans:
- Base health insurance, i.e., indemnity-based plans which offer cancer cover as per policy specifics; note add-on riders for hospitalisation or treatment due to accident or other illnesses (as per listed coverages)
- Critical illness plans, i.e., benefit-based policies that cover common listed illnesses along with cancer
- Cancer-specific plans, which are also benefit-based but designed to cater to this particular ailment
“Cancer-specific plans would be a good option to consider, along with a basic health insurance plan, as it would cover wider aspects not limited to hospitalisation expenditure. In effect, the ancillary expenses pertaining to cancer screening, OPD consultations and other non-hospital medicare would also be covered,” advises Vivek.
Cancer-specific plans are recommended for women who have a genetic predisposition to this malady. So, take some time to understand the risks and costs involved. Remember that these policies are long-term plans that offer a lumpsum payout towards attentive healthcare expenses or as a compensation due to loss of regular income.
#2 Sum Insured And Forms Of Payouts
Opt for higher sum insured, preferably with restoration benefit applicable for same disease treatment (since cancer therapy would be regular and prolonged) to maintain ample coverage at all times. Majority of cancer insurance policies offer a lumpsum amount upon first diagnosis, which can be used to pay for treatment costs or to repay any loans or debts. In few cases, the insured could be paid on a reimbursement basis for incurred treatment expenses.
#3 Waiting Period And Survival Period
Waiting period for cancer cover would vary from plan-to-plan and insurer-to-insurer. This is the stipulated period of time that has to necessarily be served in completion before becoming eligible for coverage. Survival period is specific to critical illnesses such as cancer, wherein the insurance company prescribes a certain time interval which has to be survived by the patient for payouts. In both instances, the lower the time period, the better.
#4 Cancer Types And Stages, Other Exclusions
Women should particularly inquire about female-specific cancers such as breast cancer, endometrial or uterine cancer, ovarian cancer, cervical cancer, etc. But remember that one could be susceptible to other gender-neutral forms of cancer as well, which should also be included for holistic coverage and maximum safety. Moreover, there could be limitations on the stages of cancer that are covered by certain insurers (especially in the case of add-on cancer covers or critical illness insurance), though most cancer-specific plans do not impose this clause. Ideally, select a plan that considers all minor and major stages, so that early as well as late detection cases can be considered. Other terms such as maximum age at entry, exclusion of certain related treatments or resultant illnesses etc. should also be perused before finalising a plan.
#5 Caps On Coverage
Some insurers levy co-payment on the insured, which means that a certain percentage or amount of treatment will have to be borne by the policyholder on their own. Alternatively, there could be upper caps or sublimits placed on the amount of treatment expenses that the insurance company will pay for, while the differential amount would have to be paid by the insured person. Taking into account ever-increasing costs of oncological treatment, it would be wise to look for cancer cover that offers maximum payouts up to the sum insured.
“There are multiple nuances and complexities involved when it comes to cancer cover and insurance. One must always read fine print for better knowledge and to avoid any claim rejection surprises at a later stage. When in doubt, it is better to consult with professional insurance brokers who possess the requisite knowledge to guide you with unbiased and precise inputs for informed decisioning,” advises Vivek.