For insurance cover against cancer, maintain high sum for hospitalisation

February 4 is World Cancer Day: here is advice on how meet ancillary expenses in treating disease

According to the National Cancer Registry published by the Indian Council of Medical Research, 1.46 trillion new cancer cases occurred in India in 2022. The incidence of cancer is higher in urban, especially metropolitan, areas due to lifestyle changes, pollution, and so on.
 

With February 4 (observed as World Cancer Day) having just gone by, let us look at how you can insure yourself against this dreaded disease.
 

A high-cost ailment
 

When a person contracts cancer, he or she faces two issues. One, the cost of treating the disease is very high. And two, the ancillary costs that arise also tend to be high. The patient might not be able to do business or may lose his job because of prolonged illness. Those living in smaller towns often have to travel to the metros to get the best treatment. Treatment costs tend to be higher there. An attendant or two has to travel with them.       
 

Two covers needed
 

To deal with these problems, a person needs insurance solutions on two fronts. “One, the sum insured on your base indemnity policy (the normal health insurance cover where you are reimbursed for the treatment cost incurred) should be high.

Alternatively, the policy should come with a feature like reassure (also called restore or refill), where the sum insured gets replenished an unlimited number of times when it is exhausted,” says Bhabatosh Mishra, director-underwriting, products and claims, Niva Bupa Health Insurance.
 

In the case of cancer, surgery may be followed by chemotherapy or radiotherapy sessions that give rise to small- or mid-sized claims repetitively over a considerable period. High sum insured policies or those offering the reassure feature can deal with these costs.
 

In addition, you should have either a fixed-benefit cancer plan or a critical illness plan (which instead of covering a single critical ailment covers up to 45 of them).

 

Fixed-benefit variant
 

One type of cancer plan is the fixed-benefit plan. A predefined lump sum is paid (irrespective of the expense incurred) as soon as the insured is diagnosed with the disease.
 

“The lump sum amount received from such a plan can be used to meet ancillary costs,” says Nayan Goswami, head-sales & service, SANA Insurance Brokers.
 

Siddharth Singhal, business head-health insurance, Policybazaar.com says that the money received from such a plan can also substitute lost income. Some insurers make staggered pay-outs to mimic regular income flows.  
 

At the advanced stage of this disease, many patients go in for palliative care and other alternative treatments. “These lines of treatment are not covered by a regular health insurance plan. Fixed-benefit plans can cover those costs,” says Goswami.
 

Indemnity-based plans
 

Indemnity-based cancer plans can help the insured meet the high cost of treatment. People who already have a high cover on their base plans can avoid them. This variant can be useful to those who already have cancer. “A person who has cancer and doesn’t have any health insurance will find it difficult to buy a regular hospitalisation cover. An indemnity-based cancer plan may cover them. This way they will at least have coverage for other diseases,” says Singhal.
 

Some of these plans may even cover a cancer patient for other variants of cancer (besides the one they already have).   

Check types of cancer covered
 

These policies have a couple of shortcomings. “The policy document will not say that cancer is covered. It will instead list the types of cancers covered. The longer the list, the better,” says Goswami. Types of cancers not mentioned in the list may not be covered.
 

In case of indemnity-based plans, the sum insured provided to people already suffering from cancer may be 

limited. “It may not exceed Rs 2-5 lakh,” says Singhal. Managing payouts from two plans — the base cover and the fixed-benefit cancer plan — can prove difficult. Money from the latter may only come as reimbursement.  
 

Buy early
 

Anyone who can afford to should buy a fixed-benefit plan (or a critical illness plan) to supplement the regular hospitalisation cover. Earlier, there was the notion that this is a geriatric problem, but that is wrong. “The incidence is high both among younger children and the elderly,” says Mishra.
 

Buying this cover early is important. “Those who already have pre-cancer lesions or full-blown cancer might find it difficult to get a cover,” says Mishra.
 

While a lot of research is happening and new treatments and therapies will become available in the future, they will also be more expensive. “This makes it incumbent on people to have adequate insurance to be able to pay for them,” says Mishra.   
 

Watch out for survival period clause
 

The survival period clause means the patient must stay alive for a certain period after diagnosis for the pay-out to occur. The survival period may vary from 30 to 90 days. “The lower the survival period, the better,” says Goswami. A cancer plan is an add-on cover. It can’t be a replacement for a normal health insurance policy. “The regular hospitalisation cover must be purchased first, and then a cancer plan (fixed benefit) should be bought to supplement it,” says Goswami.
 

A cancer patient going for an indemnity-based cancer plan should pay heed to a few points. “Try to buy a high sum insured. The waiting period should be minimal and the cashless network should be wide,” says Singhal.