Questions for Cancer Health Insurers

When considering taking out health insurance for cancer it is important to ask yourself and potential providers very direct questions. Providers are obliged to give you answers to your questions and if they cannot they must find someone who can.

Do you want a specific policy that covers just cancer?
In theory providers who have specific cancer care policies should be trained to answer cancer specific questions compared to other providers.

Are you restricted to certain hospitals and consultants?
Most cover restricts you to their own network of hospitals and Bupa's select Heart and Cancer Care policy restricts you to consultants that work for them.

Are there limits to my care?
Most companies cover unlimited costs for treatments and inpatient care. Financial restrictions can apply to outpatient care and this is an important area to research.

What treatments are covered by the policy?
This is a bone of contention and providers are not always clear as to what can be covered when. Often issues are treated on a case by case basis. This is not helpful if you are looking to take out a policy. There have been calls for greater clarity and transparency.

Does the policy cover you if your cancer is 'incurable'?
Most policies will not cover cancer once it becomes incurable. It is then treated as a chronic condition (although policies do not spell this out) which is not covered under private medical insurance. Unless you are aware of this it can be a nasty shock when your treatment is no longer covered.

Some policies are not very clear and talk about "active treatment" which refers to the extent of coverage. For example radiotherapy may be given to shrink a tumour but hormone therapy which gives ongoing control of spread and symptoms may not be covered.

Some policies stop when cancer becomes chronic and some stop when only palliative care can be given.

PruHealth and Bupa treat cancer from its first diagnosis through to any palliative care.

Does a family history of cancer affect policy cover or price?
A family history of cancer can affect your premiums. Breast, ovarian and bowel cancers in close relatives can increase your premium considerably. There is also current moratorium on genetic testing for private health insurance.

Does previous pre-malignant conditions, eg polyps in the bowel, affect policy cover or price?
This varies from company to company. Usually any pre-existing condition or even symptoms which are linked mean that cover cannot be granted. Premiums are generally not increased although cover can be restricted. Abnormal smears for example may exclude certain types of cancer from cover.

A survey conducted in 2004 by British Association of Cancer United Patients found that health insurance consultants were not always clear when giving the answers to the above questions. They sometimes gave misleading or incorrect answers. The industry has bucked up its ideas since then but it is important to appreciate that the onus for obtaining the right policy is on you.

In the case of a dispute you would have a claim against a health cover company if you had been given incorrect information but if you have cancer will you really be in the state of mind to fight an insurance company?