Everything About Health Insurance for Cancer Patients in India

 

Cancer is one of the deadliest diseases in the world. It is a disease that can happen to anyone without warning, and the very thought of a loved one being diagnosed with cancer is heartbreaking. 

Statistics reveal that cancer cases in India are growing alarmingly. According to the National Cancer Registry Programme, India already has over 14.6 lakh cancer patients and the numbers are expected to rise by another 12.8% by 2025. 

A 2022 report by the Indian Council of Medical Research (ICMR) confirms that one in nine Indians are at risk of developing cancer.

This paints a grim and alarming picture, given the rising cost of medical treatments in India and globally. To top this up, cancer treatment is one of the most expensive. Somewhere, it also highlights a need for more awareness of health insurance for cancer patients. 

Therefore, this blog aims to bring forth the importance of insurance and the role it plays in the lives of cancer patients. It emphasises the need to have robust health insurance for cancer patients and throws light on how to choose the best health insurance for cancer patients. 

Read on to find out all about it to help make informed choices for yourself or your loved ones. 

What is a Cancer Insurance Plan? 

Cancer Insurance is a very specific type of critical illness insurance that aims to provide cover for an array of costs associated with cancer treatment and management. The investors can expect a lump sum payout if and when diagnosed with cancer. 

This insurance plan offers cover on most cancer types, excluding skin cancer. It also provides a cover for all stages of cancer, irrespective of whether it is an advanced or early-stage diagnosis. 

A cancer insurance plan provides not just financial but also mental reassurance, addressing the illness during both its initial and advanced phases. While most policies offer a lump sum payout, some offer a monthly payout,, while others offer a combination of lump sum and monthly installations of the payout, subject to the cover terms.

Types of Cancers Covered by Cancer Health Insurance Plans in India

Here are the types of early and advanced-stage cancers that are covered under health insurance for cancer patients in India:

• Breast cancer

• Cervical cancer

• Ovarian cancer

• Stomach cancer

• Hypolarynx cancer

• Lung cancer

• Prostate cancer

Need for Health Insurance for Cancer Patients

Here are some reasons that highlight the need for health insurance for cancer patients in India:

Cancer treatment is expensive

This is a well-known fact that cancer treatment can burn a big hole in the family finances. A regular health insurance plan may not always be sufficient to cover all costs associated with cancer treatment and patient management.  Taking a supplementary Cancer insurance policy helps bridge the gap by covering expenses like medicine, commuting, hospital stays, nursing assistance, chemotherapy, radiation therapy, or surgery.

Cancer treatment is a financial burden

Cancer can put a significant drain on your finances, which often becomes burdensome for the family to bear. A good cancer insurance policy not only helps protect your finances, it also covers your loss of income if an earning member is affected. 

Early detection is covered

If you are at a risk of cancer or are genetically predisposed but are avoiding the screening tests due to their being expensive, you can get that covered in your cancer insurance policy. Some insurers cover cancer screening tests, helping many identify the disease timely at an early stage.

Mental Peace

Once you have a good sum insured under your cancer insurance plan, you can be relaxed with respect to the financial constraints of the treatment. 

Good supplement to existing insurance

A cancer insurance policy can be a good addition to your standard health insurance policy. Often, it helps cover expenses and diseases that might be excluded even by the best health insurance for cancer patients. 

Benefits of Buying Medical Insurance for Cancer Patients

If you are looking for a good cancer insurance policy, here are some benefits of such medical insurance for cancer patients that you must keep in mind:

• A cancer insurance plan covers almost all types of cancer except skin cancer.

• The best health insurance for cancer patients covers all stages of cancer from early to advanced.

• This insurance mostly works on lump sum payouts upon cancer diagnosis.

• Under early stage cancers there is a clause for premium waiver benefit.

• If the insured makes no claim in a year, their sum insured increases as per a pre-specified percentage.

• These plans cater to the payout of monthly income for certain stages of cancer for a certain number of years, as mentioned in the conditions.

• The insurance cover does not cease once the first diagnosis is done. It continues. 

• Paid premiums get tax benefits under the ITA’s section 80D *.

How Does Cancer Insurance Work?

To understand the workings of health insurance for cancer patients, one must remember the most important point — a cancer insurance policy will get activated only when a person gets diagnosed with cancer. Some policies do cover the cost of cancer screening tests as well, but this may differ from insurer to insurer. 

Upon a confirmed diagnosis of cancer, which is also supported by proof of cancer certified by the doctor, the medical insurance for cancer patients kicks in. The insured then gets a lump sum amount from the company, which is equivalent to the sum insured.

There are no questions asked as to how this amount is used by the insured. There is complete flexibility to use the same for treatment, chemotherapy, nursing assistance, commuting costs, medications, etc. 

However, there is one important aspect to understand here. If the cancer is diagnosed in the policy year, then the money is paid in stages corresponding to the stage of cancer diagnosed. 

Another point to remember is that cancer insurance or health insurance for cancer patients does not cover surrender, death, or maturity benefits.

How to choose the best health insurance for cancer patients?

Here are some effective tips to keep in mind when looking for the best health insurance for cancer patients:

Choose a plan that supports regular cancer screenings and checkups

If you feel you are predisposed in some way it is best to get regular checkups and cancer screenings done to timely detect the malignancy if it occurs. The earlier the cancer is detected the better your chances of complete recovery. For women above 40 and men above 55 it is a must to get screenings done regularly, Hence pick a health insurance for cancer patients that supports you right from the screening stage. 

Be adequately insured

Cancer treatment is expensive, so when you are selecting from a wide array of policies, pick the one that offers the best coverage with an adequate sum insured. A general rule that works is to research the average treatment cost in your city and opt for a policy that offers at least 1.25 times this cost. This helps you beat inflation and plan better for the future. If you have selected a family floater policy, go for a high cancer insurance cover as it is a shared policy. 

Never ignore the co-payment clause

The ‘Co-payment’ clause says that the insurer is supposed to partially pay for some of the treatments and then the balance is covered under the policy. While the co-payment clause might help bring down the insurance premium it might prove to be expensive if there is a cancer diagnosis later. So think carefully about what will work best for you and choose accordingly. 

Always compare the waiting periods

Different plans for health insurance for cancer patients in India have different waiting periods and it is important to consider these before buying your policy. Plans with longer waiting periods delay the insurance coverage when needed. Therefore, thoroughly analyse the offering before selecting the right plan. 

Further, you must buy cancer insurance if the risk of cancer is high in your family. A medical insurance for cancer patients is a great backup. However, make sure that your cancer insurance policy supplements your health insurance but never replaces it.

Documents Required for Buying Cancer Insurance in India

Given below is the list of documents required to buy cancer insurance cover in India:

• Age proof - birth certificate or passport

• Address proof - Passport, Adhaar card or Driver’s license

• Photo ID proof - Passport, Adhaar card or Driver’s license

• Latest medical reports

• Passport sized photographs

Inclusions And Exclusions Associated with a Cancer Insurance Plan?

All cancer insurance plans have certain inclusions and exclusions. It is important to be aware of the same before committing to a plan in order to avoid last minute confusion and shock. Given below are some of the most common inclusions and exclusions. Even though these are the common ones, it is best to check about the same with your insurer in specific before buying a policy for cancer insurance in India.   

Inclusions of a cancer insurance plan

• Insurance covers the rapid and uncontrolled growth and spread of malignant cells and tumours that destroy normal cells and tissue. This happens when the report is confirmed through the histological evidence of malignancy and a pathologist’s report. The cancers covered under this point are - sarcoma, lymphoma and leukaemia. 

• The insurance policy also includes coverage for expenses such as pre and post-hospitalisation, domiciliary hospitalisation, ambulance cover, daycare procedures, and several other associated medical expenses. These come under consumables. These may vary from plan to plan.

• Also included are expenses incurred when you change the line of treatment or change your doctor. 

Exclusions of a cancer insurance plan

• All prostate tumours with a Gleason score < 6

• Thyroid's papillary microcarcinoma which is less than 1cm in diameter

• Tumours caused when the patient has HIV infection

• Bladder's Microcarcinoma cancer tumours 

• Chronic lymphocytic leukaemia which is less than RAI stage 3

• Cancer unrelated treatment or investigation 

• Any physical or mental disease pre-existing from the date of policy commencement or issuing whichever is later.

• Self-inflicted injury or attempt to suicide

• Claim will be rejected if signs and symptoms of the critical illness/cancer arose within 90 days of issuing the policy

• Sexually transmitted disease

• Injuries caused by adventure sports such as skydiving, paragliding, etc.

• Complications arising out of a pre-existing condition which was undisclosed at the time of application.

• Claim will be rejected if signs and symptoms of the critical illness/cancer were present before issuing the policy

How Do the Claiming Procedure and Payment Work for Cancer Insurance? 

Here is an overview of how the claims procedure and payments disbursal system works in case of medical insurance for cancer patients or, more specifically, a cancer insurance policy:

• Claim submission: The claims procedure starts when a claim is submitted to the insurer by the insured via a claim form. This form contains vital info required to be filled including - what is the diagnosis, what is the treatment plan, and all details about your healthcare provider. Some plans have a survival period clause before a claim can be raised. 

• Claim review: Once it is submitted, the claim is reviewed by the insurer to ascertain that it meets the coverage criteria. 

• Claim approval: Then the claim goes for approval, after which the insurer passes the payout as per the terms of the plan. 

• Timely claims submission: No matter which type of health insurance for cancer patients in India you have, timely submission of claims is very important to avoid denial or delay in coverage. Your documentation must be complete and up to date. You must maintain multiple copies of the same, whether it is policy documents or treatment-related papers. 

Things to Consider Before Buying a Cancer Insurance Plan

When buying a health insurance with a cancer cover or rather a cancer insurance plan, it is important to consider some vital points. These are mentioned as follows:

• Check in advance with your insurer about the types of cancer their policy covers.

• Before seeking cancer insurance coverage do your homework and calculate the coverage you require. To do so, you must keep the following costs in mind - 

- Potential medical expenses

- Cost of hospitalisation

- Cost of commuting

- Cost of home-based assistance and care

- Medicines

- Chemotherapy

- Radiation therapy, etc.

• Always compare the quotes from different insurers and assess the premium with respect to the benefits they are offering. While doing so, keep in mind factors such as - your age, health history, gender, and the coverage amount. 

• Never finalise a policy without checking the limitations or exclusions to avoid rude shocks later. 

Conclusion

Selecting the best health insurance for cancer patients is crucial. It, therefore, requires careful consideration of various factors. Understanding the specific needs that a cancer patient may have and then evaluating the different insurance cover options is a good way to move forward with this decision. Always remember to check medical insurance for cancer patients for policy exclusions, compare premiums and only then make informed choices to ensure comprehensive health insurance coverage. Another good shortlisting criterion to find the best health insurance for cancer patients is how much support the plan will offer. Finally, do remember that a cancer insurance claim settlement process is different from that of regular health insurance, so be sure to understand it well before you sign up for a policy.  

FAQs on Health Insurance for Cancer Patients

Q. Is buying cancer insurance possible after cancer treatment?

No, if you are already a cancer patient or have been diagnosed while buying the policy, you can not get cancer insurance. Even if some companies offer the same, the premiums will be exorbitantly high. 

Q. When can I expect reimbursement for medical expenses under the cancer cover policy?

The reimbursement process for medical expenses under a cancer insurance policy typically starts soon after diagnosis. The patient need not produce any bills to claim the payout. All you need to do is produce the certificate of diagnosis by your doctor to get the claim released. 

Q: Is chemotherapy covered by cancer insurance?

Yes, cancer insurance policies cover various treatments for cancer, including chemotherapy. Since most cancer insurance policies pay in lump-sum, the chemotherapy and all associated expenses are taken care of. 

Q: Does cancer insurance include coverage for radiation?

Yes, many cancer insurance policies cover radiation therapy as part of the treatment expenses. Similar to chemotherapy, your lump-sum payment can cover the cost of all cancer-related expenses and more.

Q: What is the expense of acquiring the top cancer policy in India?

The cost of a cancer insurance policy in India depends on various factors, including the individual's age, health condition, sum assured, and the type of policy chosen. Premiums can vary across insurance providers. It is recommended to compare different policies, considering coverage features and premiums, to choose the one that best suits your needs.

Q. Is purchasing a cancer insurance plan necessary if I already have health insurance?

Health insurance covers a broad range of medical conditions and expenses, including hospitalization and surgeries. It covers cancer but only the advanced stage. Cancer insurance is specifically designed to cover all types and stages of cancer, covering all costs of the treatment. Having health insurance with cancer cover can provide comprehensive coverage, offering financial support during cancer-related challenges.

Q. Is it possible to obtain insurance coverage for pre-existing cancer conditions?

Obtaining insurance coverage for pre-existing cancer conditions may be extremely challenging. Many insurers may consider such conditions as exclusions. Some insurers may offer coverage at very high premiums for cancer but after a waiting period for those having completed treatment and in remission.

Q. Does the insurance policy company have affiliated network hospitals for my treatment?

The availability of affiliated network hospitals for cancer treatment depends on the insurance company and the specific policy. Some insurance providers have tie-ups with a network of hospitals where policyholders can avail of cashless treatment. It's recommended to check the list of network hospitals provided by the insurance company.

Q. What is the maximum age to purchase cancer insurance?

The maximum age to purchase cancer insurance varies among insurers. Some insurers may have an upper age limit to issue the policy. It usually ranges from 65 to 75 years. 

ARN – MC/02/24/8897