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Health insurance and cancer

Thinking about cancer insurance?

Download our free PDF guide

Feeling unwell can be stressful enough, without having to wait for appointments or tests.  NHS waiting lists mean that it is not always easy to be seen quickly. Private healthcare costs can mount up, so health insurance can be a way to get treatment promptly without using all your savings. Going private has the advantage that you have more flexibility in arranging appointments that are convenient for you. Health insurance offers choice, flexibility in arranging appointments that are convenient for you and speed of access to tests, scans and treatment.

While the NHS is good at dealing with cancer, resources are stretched and there are some cancer drugs that the NHS won’t offer. You may want to get care and treatment when and where you want, rather than when the NHS wants, and getting private treatment for cancer can become expensive.

Health insurance pays for all, or some, of your medical bills if you are treated privately. It gives you a choice in the level of care you get and how and when it is provided. 

The core, or basic, cover that everyone is entitled to on a private healthcare plan usually includes in-patient treatment (tests, scans and surgery), day surgery, specialist referrals, a private room and physiotherapy. It may also include radiotherapy and chemotherapy. Most insurers allow you to add extra cover to build a policy to suit you.

Extras on offer or in the core cover can include:

  • Outpatient surgery.
  • Outpatient consultations and specialists.
  • Outpatient scans and tests.
  • Specialist diagnosis.
  • Extra outpatient services.
  • Alternative therapies and treatment.
  • Mental healthcare.
  • Cash for stays in NHS*
  • Ambulance transfers.
  • Treatment at home.
  • Homecare and nursing.
  • Travel cover.
  • Dental treatment.

Most insurers offer free 24/7 online and/or telephone advice. Other services may include-

  • Discounts on healthcare, healthy living and shopping.
  • Access to a second opinion.
  • No claim or healthy living discounts.
  • Fast track appointment service.

*NHS cash benefit

Specialist cancer policies

There are some policies available where you can choose to cover just heart surgery or just cancer cover, or both together. These specialist policies typically cover:

  • Treatment for heart and cancer conditions. 
  • Post-surgery consultations and tests to monitor you for 2 years following treatment of a heart condition. 
  • Post-surgery consultations and tests to monitor you for 5 years following treatment for cancer. 
  • End of life care. 
  • NHS cash benefit. 
  • Private ambulance. 
  • Home nursing. 
  • Cancer wigs.
  • Online and telephone assistance.

On these specialist policies, or cancer options within health insurance policies, there may be a lifetime or annual limit on treatment costs.

Cancer drugs cover

Specialist cancer drugs cover will pay for cancer treatment and drugs that are licensed in the UK but which aren’t available on the NHS. Key points to consider are benefit caps on drug spend and the kinds of drugs that will be covered. Cover is only available as an option on a health insurance policy, not as a stand-alone policy.

How health insurance works

If your GP recommends you for tests to aid a diagnosis, then they will give you a letter of referral. This is where health insurance steps in. Private cover can ensure you get seen as quickly as possible by specialist therapists, doctors and consultants. 

Insurers vary as to whether they allow you free choice of hospital and/or consultant. Some limit your choice to ones they want you to use. When arranging cover you may be offered a choice of a specific national network, London hospitals, specialist hospitals, or even a specific hospital or chain of hospitals. It is important to find out if the hospital you prefer is one the insurer will pay for.

Most insurers do not cover planned treatment outside the UK.

What health insurance offers for cancer 

Many health insurance policies now include, or offer the option of including, cancer cover for treatment, cancer drugs and support. This usually includes tests, scans and diagnosis, plus hospital treatment and outpatient therapies. It may include maintenance and monitoring. The NHS may not offer some expensive cancer drugs, and your specialist may feel one of these licenced cancer drugs is best for you. Some policies cover the cost of such drugs and the costs of administering them. They may also pay for treatment at home, such as chemotherapy.

Insurers generally are widening what they offer on cancer and some even include stem cell and bone marrow transplants, bone scans, agreed experimental treatment, wigs, prostheses, rehabilitation, post treatment monitoring, specialist nursing, home care and end of life/hospice care.

Insurers may also offer telephone support from cancer nurses. You should check to see if there is an overall financial limit, limits for particular treatments, and what inpatient, daycare and outpatient cover is on offer.

Some insurers offer various options of-

  • Full cancer cover.
  • Limiting cover to any treatment not provided by the NHS.
  • Letting the NHS cover initial diagnosis and then covering private treatment.
  • Allowing the NHS to treat but paying cash sums per day/ night.

Differences in cover 

Insurers vary greatly as to what they cover or offer on cancer care. No two policies are the same and customers should check their policy carefully to ensure everything they need is included. Typical policies allow you to put together the package that suits you, and there are usually several options for adding cancer cover into a policy. 

Chronic conditions

Health insurance does not usually cover any chronic condition, so unless cancer cover is specifically included, it will be excluded as with any other chronic condition. A chronic condition is a disease, illness or injury that needs ongoing or long-term monitoring through consultations, examinations, check-ups and/or tests; needs ongoing or long-term control or relief of symptoms, or it comes back or is likely to come back.

Pre-existing conditions

Health insurers will not automatically cover any pre-existing condition, but may agree to do so. A pre-existing condition is any disease, illness or injury for which you have received or are receiving medication, advice or treatment; or you have experienced symptoms.

What health insurance does not cover

Every insurer is different, but key areas that are not covered may include:

  • Normal pregnancy and childbirth.
  • Transplants.
  • Cosmetic surgery.
  • Experimental treatment.
  • Dialysis.
  • Eye care.
  • GP charges and services.
  • Rehabilitation and convalescence.
  • Accident and emergency admission.
  • Accident and emergency outpatient treatment.
  • NHS prescriptions.

How cancer can affect buying health insurance 

If you have or have had cancer, insurers may refuse to offer any cover, limit the cover to exclude cover for cancer, or ask a higher premium. Some insurers may reduce or refuse cover if family members have a history of cancer.

If you have a moratorium on your policy then they will be excluded from cover for conditions that were pre-existing from before you took out the policy. If you take out cover on the basis of a declared history you will need to answer questions truthfully.

Saving money

Your choice of cover will affect what you pay – the more cover you choose to have, the higher the price will be. You may have the option of including or excluding cover for cancer.

Other choices include:

  • Choosing to pay an excess when you receive treatment. 
  • Choosing a different grade of hospital accommodation.
  • Paying for a % of your treatment.
  • Receiving treatment under the NHS when it is available within 6 weeks.
  • Choosing to receive treatment at a specified hospital.
  • Deleting outpatient cover.
  • Capping limits on specific cover. 

Children

A family healthcare policy will often allow you to tailor your cover so that you can include your children if needed. Insurers may include free cover for children under 18, and some will include cover for children up to 25 who are in further education. A few insurers offer special policies just for children. 

Most health insurance policies include cover for overnight stays in a hospital room when a parent has to accompany a child in hospital.

Age

Insurers vary as to whether they will cover you up to any age or whether they have restrictions on acceptance age. Some may stop cover when you reach a certain age; common ages are 60, 65 or 70.

Some insurers charge more to older people, others do not, and some have very strict limitations on the age groups they will cover.

Extra help

Telephone helplines and online support are common, while some insurers offer detailed help from specialist cancer nurses. 

The difference between a health cash plan and health insurance

A health cash plan offers part of the money back you have spent on everyday healthcare bills, like trips to the optician, dentist or physiotherapist, up to annual limits. A health insurance plan will cover you for tests and treatment for acute medical conditions. 

Thinking about cancer insurance?

Download our free PDF guide

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