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Guide to Health Insurance and Cancer Cover

Cancer cover is always an important consideration for people who are looking into buying a health insurance policy. Quick diagnosis, treatment in a private hospital and access to revolutionary drugs are all things that private medical insurance can offer. But cancer cover can vary hugely depending on the policy. Whilst the Association of British Insurers has provided guidelines on cancer cover for insurers, it is not compulsory to abide by them and there can be a large disparity between providers. Here is a list of 5 important facts to help you find cancer coverage at a price and level that suits you.

1) Money limits

Cheaper health insurance policies may put monetary limits on the amount that they will pay towards cancer treatment. For example, a basic policy may pay up to a maximum of £30,000 a year towards cancer- this money will have to meet the costs of all drugs, treatments, diagnostic tests etc.


Many people will not need to exceed this limit, with drugs like Herceptin costing around £20,000 for a course of treatment. However, basic cancer cover may not pay for more expensive treatment, like £80,000 skin cancer drug Yervoy for instance. When looking at cancer cover, ensure you are aware of the financial limits on your policy and are happy with them.

2) Treatments

When a new cancer drug has been licensed for use in Europe, it is immediately available in the UK for doctors to prescribe it privately. However, the National Institute for Health and Clinical Excellence (NICE) has to deem the drug cost effective before it becomes widely available on the NHS. Most health insurance policies will cover you for treatment with a drug as soon as it becomes licensed for use in the UK, regardless of the decision from NICE. However, some will only cover the cost of drugs once they have been approved by NICE. When buying a policy be aware of your insurer's attitude towards drugs that are not available on the NHS.

In addition, only patients with comprehensive cancer cover will have access to certain cancer treatments on their policy, like reconstructive surgery, stem cell transplantation, biological therapies and hormone therapies. Basic cancer cover may only cover the cost of chemotherapy and radiotherapy.

3) Clinical trials

Until a cancer drug or treatment has been licensed and marketed, it is considered 'experimental treatment'. Whilst health customers often have access to surgery not available on the NHS, not all policies will cover unproven treatment. Your policy documents will give you the details of your insurer's attitude towards this.

For instance, Pru Health will not pay for any treatment or drug therapy which is considered to be experimental, or for which there is insufficient evidence of safety or effectiveness. Similarly, Bupa does not pay for unproven treatment, unless it is part of a clinical trial which the company has approved. From January 1 2012, any policies taken out with Aviva will cover experimental treatment in full if there is enough medical information to support their use.

4) Aftercare

Health insurance does not only cover cancer treatment, but it will often cover the cost of aftercare as well. Consultations with dieticians, the cost of wigs and reconstructive therapy are all things that can be covered on your policy. In addition, some insurers will cover the cost of routine check-ups for a number of years after your treatment. However, budget policies will often not cover aftercare like this, so make sure you have comprehensive cancer cover if you want it guaranteed. A health insurance comparison website will be able to show you the full details of each policy so you know where you stand from the word go.

5) Palliative care

Palliative care is an area of healthcare that focuses on relieving and preventing the suffering of cancer patients rather than curing them. It can include relief from physical symptoms, psychological care, spiritual care and practical support. Health insurance providers often take different approaches to covering palliative care, so this is an area you need to investigate before buying a policy.

For example, Bupa will provide full cover for palliative treatment even if your cancer is incurable. Similarly, Exeter Family Friendly policies will cover palliative treatment of cancer and terminal treatment of cancer. Most insurers will not cover the cost of treatment in a hospice, but will usually make a donation up to a maximum limit.


Article Source: Chloe Hibbert

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