Here are 12 things to think about when purchasing a health insurance plan to safeguard against cancer.
- There are two types of plans on the market: indemnity and benefit. Benefit policies are those where sum insured is paid following the finding of cancer and successfully passing the survival time. When a waiting time for an indemnity coverage expires, claims become payable, and the money paid for cancer treatment costs is refunded.
- Sufficient insurance coverage: It goes without saying that cancer treatment is quite expensive and a protracted process. If you had to pay for all of your tests, radiation, chemotherapy, and surgery out of cash, your personal savings would be significantly reduced. According to the proverb, “Better to be safe than sorry,” it would be better to choose a bigger total insured amount that would cover expensive operations for a somewhat higher premium.
- Prior history of cancer: When applying for health insurance, those who have previously been diagnosed with and treated for cancer should be prepared to be rejected (whether critical illness policies or cancer care plans). Given the high risks involved, most insurance companies are unlikely to cover cancer patients.
- Additional existent illnesses: Other pre-existing conditions: Whether one chooses a cancer care plan or a critical illness policy that additionally covers cancer, it is crucial to disclose all prior and/or current medical disorders and illnesses at the time of policy purchase. Additionally, one should be honest when responding to inquiries about a family history of cancer or genetic susceptibility. Non-disclosure would affect not just the claims for any cancer-specific treatments received, but it would also result in the denial of any other claims for non-cancer treatment expenses.
- 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.
- Co-payment: Few health insurance require a co-payment clause (i.e., a portion of the total amount insured) for cancer treatment costs that the policyholder is responsible for paying. Such a policy would require that you constantly pay a portion of the expenses on your own.
- Sub-limits: Some insurers place a restriction on the amount of coverage provided for cancer treatment by setting an upper limit or sub-limit. For instance, even though the cancer treatment would be covered up to Rs 5 lakh, the critical illness plan would have an insured amount of Rs 50 lakh.
- 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.
- Experimental cancer: therapies have been developed as a result of constant and exponential breakthroughs in cancer therapy. Most health insurance policies pay for both conventional and alternative therapies that have been approved by medical boards. Unproven medical procedures and radical therapies would not be covered.
- Insurance companies set the minimum number of days that a policyholder must live after receiving a cancer diagnosis or treatment. The health insurance benefit won’t start to accumulate until after the survival period has been successfully completed. To prevent any surprises in the future, it is imperative to be aware of this fact.
- 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.