Cancer Health Insurance: Features, Inclusions & Exclusions

Getting diagnosed with cancer can profoundly change your life. Cancer is among the most dreaded medical conditions, not only because it causes undue duress to your health but also because it can potentially deplete your savings. What is worrying is that there has been an increase in cancer-related fatalities and illnesses in India, owing primarily to changes in habits and lifestyles.The Indian Council of Medical Research (ICMR) expects the number of cancer cases in the country to rise from 14.6 lakhs in 2022 to 15.7 lakhs in 2025. A 2022 survey by ICMR suggested one in every nine persons in India is at risk of developing cancer in their lifetime.However, thanks to modern medical advancements, detecting and treating cancer is no longer as challenging. Nonetheless, a considerable expense may burn a hole in your pocket.Cancer treatment can be expensive, and the medical bills can quickly run into several lakhs. Sometimes, even with a standard Health Insurance policy , you may need more than the coverage to fully compensate for the treatment expenses. Cancer Healthcare Insurance comes into play at this point. This article can help you understand how Cancer Health Insurance works and what are its features and benefits. Also Read: How breast cancer and Health Insurance plans work

As the name suggests, Cancer Health Insurance plans are specialised insurance policies designed to financially protect you from cancer-related expenses in exchange for regular premium payments. More specifically, the policy covers costs associated with chemotherapy, hospitalisation charges, medicines, etc.Remember that most Cancer Health Insurance policies will only provide coverage if you have not already been diagnosed with cancer as a pre-existing disease. The plan is better suited to those with a high risk of developing cancer later in their lives due to their family histories, workplace conditions, etc.Here are some of the features of a Cancer Health Insurance plan:

Provides coverage for all stages of cancer:

Cancer Health Insurance plans provide financial cover for all cancer stages, whether early or advanced stages. On early-stage cancer diagnosis, these plans usually pay a certain percentage of the sum assured (a fixed amount agreed upon between you and your insurer at the time of policy purchase), with the remaining paid later as the condition progresses.

Upfront payout:

Unlike cash claims, where you pay the initial medical expenses, and your insurer reimburses you, Cancer Health Insurance plans provide an upfront cost, where your insurer pays the appropriate claim amount as soon as you share the diagnosis report. The significant advantage is that this option eliminates the inconveniences of submitting medical bills or arranging cash for bill payment and waiting for the insurer to repay the amount.

Premium waiver:

Most Cancer Health Insurance plans offer you a premium waiver.If they diagnose you with early-stage cancer, they waive your premiums for up to five years to lessen your financial burden.

Monthly income benefit:

Cancer can lead to several lifestyle adjustments, some of which radically impact daily life. Daily work may become difficult, which can eat away at savings and limit financial growth. It can get painful for the family if the breadwinner suffers from the disease. Insurers consider such factors, and some offer a monthly stipend under Cancer Health Insurance to help you deal with any financial shortfalls.As part of this monthly income, you can receive a part of the sum assured for up to five policy years when diagnosed with major-stage cancer. In case of your death, this monthly income may be paid to the family for a particular period if the policy allows it.

No Claim Bonus and increasing cover option:

No Claim Bonus is a monetary benefit for not making any claims during a particular policy period. This feature is even applicable to Cancer Health Insurance. Your assured sum increases if you have an active policy and do not make any claims. It applies to each year you don't make a claim. Some insurers may lower the premium for your policy that is payable next term instead of increasing your sum insured as a part of the No Claim Bonus Also Read: Guide to buying a Health Insurance plan

Even though it might appear as an additional cost, experts highly recommend obtaining Cancer Health Insurance coverage if:

Your family has a history of cancer:

If cancer runs in your family, you should be careful. It is better to prepare early by buying a Cancer Insurance policy beforehand.

Your Health Insurance plan is inadequate in meeting your needs:

Let's say your existing Health Insurance policy does not have Critical Illness coverage or has a sum assured amount that is inadequate for your needs. In that case, you can buy Cancer Insurance to safeguard yourself from certain expenses in the future.

If you consume tobacco-related products or alcohol:

Lifestyle and health habits, primarily smoking and drinking alcohol, are linked to the rising cancer rates in India. If you are a heavy smoker or drinker, you may consider buying a Cancer Health Insurance plan to protect yourself from specific health concerns that may arise in the future. However, remember that you would have to pay a higher premium than non-smokers or non-drinkers.

Cashless healthcare at home:

Cancer patients require specialised care even after their initial cancer treatment. Major hospitals and medical organisations now offer cancer patients in-home care services. Some Cancer Health Insurance plans cover the healthcare services received at home and their resulting expenses. You can even make cashless claims for these expenses.

Procedures for daycare:

Cancer plans cover daycare procedures that do not require hospital admission. However, this facility may be available for a specific period and in some instances only.

Coverage of pre- and post-hospitalisation expenses:

Before you are diagnosed with certain health conditions, you may visit the doctor frequently and undergo multiple lab tests. Such costs can be heavy on your wallet, especially if you have cancer. Furthermore, you may incur several pre- and post-hospitalisation expenses, such as medication, ambulance fees, doctor consultation, etc. Fortunately, most Cancer Health Insurance plans cover such costs, which could help you save significant money.

Tax savings:

Under Section 80D of the Income Tax Act , you can claim deductions on the premium you pay towards Cancer Insurance. A deduction of up to ₹25,000 is available in a financial year if you have a Cancer Health Insurance plan. If you opt for a Family Floater plan that includes senior parents, the tax deduction could go up to ₹75,000 per year.

Absence of sub-limits:

Sub-limits are pre-determined caps on your claim amount for a specific disease or treatment procedure. Health plans may come with sub-limits, but you can find cancer policies without sub-limits, implying that you do not have to worry about common sub-limits such as certain hospital expenditures, room rent, etc.

Waiting period:

Cancer Health Insurance plans won't cover your expenses if you cause your illness or medical condition through acts of suicide or self-harm.

Suicide or self-harm:

Cancer Health Insurance plans will not bear your expenses if acts of suicide or self-harm cause illness or medical condition.

Skin cancer:

These plans may not cover certain types of cancer, like skin cancer and cancers resulting from HIV or AIDS. These plans also exclude cancers caused by biological, nuclear, or chemical contamination.

Consider the type and stages of cancer

Cancer has various stages (pre-stage, early-stage, and critical stage), defining the condition's seriousness. Many Cancer Insurance plans offer a payout based on the cancer's detection stage. Hence, it is vital to analyse whether the payout you get under the plan is sufficient for you. Also, you must know the different types of cancer covered under the plan.Choosing a plan encompassing the broadest range of cancer types would be best.

Be aware of the waiting period:

The waiting period is pre-determined, so you cannot file a claim. Although some Health Insurance plans do not have a waiting period, the same is especially common in policies dealing with critical health issues. The waiting period typically ranges from 90 days to two years in Cancer Health Insurance. Therefore, you should opt for a plan with the least waiting period to avail of policy benefits as early as possible.

Choose the right coverage amount:

Another important factor you must consider while buying a cancer care health plan is getting extensive coverage. Your plan must cover the hospitalisation expenses, post-hospitalisation care, medicines, doctor consultation fees, chemotherapy, etc.Select a policy with a higher sum assured to prevent you or your family from tapping into savings for treatment costs.

Cancer Health Insurance and Health Insurance with critical illness coverage are two different insurance policies, although they cover medical expenses related to severe illnesses. Here are the key differences between the two:

Coverage focus:

Cancer Health Insurance focuses explicitly on coverage for cancer-related expenses, including diagnosis, treatment, and management of cancer. On the other hand, Health Insurance with critical illness coverage covers a broader range of acute illnesses, including cancer and other severe medical conditions such as heart attack, stroke, kidney failure, organ transplant, paralysis, major organ diseases, and certain surgeries.

Premium and cost:

The premium for Cancer Health Insurance policies may be lower compared to Health Insurance with critical illness coverage since it is focused solely on cancer-related expenses. Meanwhile, the premium for Health Insurance with critical illness coverage is typically higher compared to Cancer Health Insurance because of the broader coverage for multiple critical illnesses. Also Read: How to buy private Health Insurance

• Cancer Health Insurance covers expenses related to pre- and post-cancer treatment, such as hospitalisation charges, chemotherapy, medicine bills, etc.
• Cancer Insurance policies have several features, such as upfront payment, monthly allowance, No Claim Bonuses, etc.
• Consider buying a specific Cancer Insurance plan if cancer runs in your family.
• You can save up to ͅ₹75,000 in tax benefits under a Cancer Insurance plan.
• When buying a Cancer Insurance plan, be aware of the coverage amount, waiting period and the stage of cancer.