Male Cancer Awareness Week

The health insurance industry has concerns at the moment about how it will fund cancer cover in the future. The aim is that health education and early detection will help to reduce the need for health insurance for cancer. This week is Male Cancer Awareness Week. Every year Orchid, the mail cancer charity use this week to raise awareness about cancers that are specific to men: testicular, penile and prostrate.

Orchid is the only UK charity which focuses only on male cancers. It was formed by a testicular cancer patient in 1997 with the aim of helping to save lives by raising awareness, giving support and advice as well as funding cancer research.

Every year 37,400 men are diagnosed with a male specific cancer:

• 35,000 with prostrate cancer
• 2,000 with testicular cancer
• 400 with penile cancer

Some of the things that Orchid have done this week include:

• A survey into the awareness of hereditary prostrate cancer has so far found that 53% of people are unaware that there is a hereditary link to prostrate cancer. They have also developed a factsheet and awareness poster in conjunction with the survey.
• A Prostate Cancer Q&A session for patients and their families was held on the 14 April at Bart’s Hospital.
• They have launched a fundraising campaign called ‘37,000 steps to beat male cancer.' The innivotive campaign encourages people to organise events based around the number 37,000. For example, bake 37 cakes, run for 37 minutes, stay silent for 37 hours.
• A 3.7km run took place on Wednesday 14 April at 5.30pm along the river starting at Paternoster Square

Questions to Ask: Cancer Health Insurance

Choosing health insurance for cancer is not as simple as it may sound. This is because there is a very varied offering when it comes to private medical insurance for cancer. Some companies provide very basic levels of cancer cover whereas others offer very full cancer cover. It is important to ask the right questions in order to get what you want from your health insurance.

Will I be covered for all stages of cancer treatment?
Some cancers can be treated and will never return. Others can return and be treated. When cancer cannot be removed altogether patients can have treatment which keeps their symptoms at bay and prolongs life.

Some policies offer cover for all stages of cancer. Others do not. Often when cancer cannot be removed then the patients condition is considered to be 'chronic' and therefore not covered by many health insurance policies.

Most policies will not cover patients in the final stages of cancer, during palliative care.

Are any treatments excluded?
Some policies exclude some types of treatments. Experimental treatment for example are only covered by some health insurers. Some drugs are not covered by some private health insurance companies. Herceptin, Velcade and Sutent, are examples of drugs that have been the topic of debate in the press.

At what point do benefits stop?
Different policies have different levels of cover. The number of treatments given, the total cost of treatment and the length of time the treatment may last are all considerations.

Where will I be treated?
What hospitals and consultants are on the health insurers approved list.

Does the cover include a holistic approach to cancer?
Some companies provide cover that takes into account the general wellbeing of the client. They may offer counselling and complimentary therapies and provide cover for wigs, steroids and anti-sickness drugs.

Choosing Corporate Health Insurance for Cancer

If you are an employee you may be considering health insurance. If you are considering it or already have a policy for your employees look into the level of cancer insurance they cover.

Cancer is very prevalent in the UK and 90,000 people of working age are diagnosed with it every year. Many companies offer their employees health care insurance. However many are not aware of the level of cancer cover that they have.

The most important thing is to be informed when you are making purchasing decisions and to be aware that not all health insurance for cancer is the same.

Some of the cheapest health insurance policies offer scant cover and few offer a comprehensive policy that protects your employees at all stages of their cancer. Most private medical insurance policies have limits.

There are various questions that you need to ask:

• Is cancer covered?
• Is there a time limit on the policy?
• Can we extend the cancer cover?
• Can employees extend their cover individually?
• Are any treatments excluded?
• If an employee has had cancer already, will they be excluded from the policy?
• Where would employees with cancer be treated?
• Does the policy provide additional benefits, for example counselling, complementary therapies, anti-nausea and steroid medication, wig provision, ?

All health insurance policies should have a specific section which explain their cancer cover. As an employer you need to have an understanding of what is covered and what is not.

The Association of British Insurers (ABI) requires each provider to show an example of a cancer scenario to help explain their cover. This is a useful tool in understanding what is covered and what is not. Ask the insurer to show you their example.

Above all inform yourself of the best options for you and your employees and have a comprehensive understanding of the policy that you choose.

AXA's Dedicated Nurses

Last month AXA PPP Healthcare introduced Dedicated Nurses. These qualified nurses are there to provide support to all their health insurance customers who are diagnosed with cancer.

The Dedicated Nurses are there to support and offer guidance to customers with both individual and company medical insurance 24hours a day.

They are there as a constant point of contact and are available in a pastoral and practical capacity. They can help by offering support not just to the individual but to family members who may also find the situation difficult to cope with. The Dedicated Nurses are also there to offer practical advice and information and to help customers to get the best of the oncology services that they will have to deal with.

Dedicated Nurse Viv Murray explains:

‘When patients first get in touch with us, we do our best to reassure them that we’ll be there to support them throughout their treatment and recovery. And, to begin, we try to emphasise the small but important things that they can do to feel more in control of their situation and not like a passive passenger to whom things are being done.

‘From preparing themselves practically and emotionally for meetings with their consultant to explaining the different types of cancer tests and treatment and side-effects, we try to paint a picture of their treatment journey to ensure that they know what’s going on – and why – and that they feel supported

‘More often than not though, customers just want reassurance and to talk to someone who understands what they are going through. Perhaps this is one of the greatest benefits of our service – providing a quiet, private space where people can share their concerns and know they are being listened to.’

Health insurance for cancer is something that some people opt for rather than taking out more general health insurance policies. AXA PPP Healthcare offers Essentials Health Cover which provides insurance for cancer and conditions of the heart.

Speedier Cancer Diagnosis

Traditionally private health insurance has promoted the speedy return of test results when people enter the private health care system. The NHS, who have been returning results faster than ever before, have new directives from the government to give those suspected of suffering from cancer even quicker turnarounds. With the health insurance sector struggling to provide comprehensive health insurance for cancer for their customers this will come as a welcome initiative.

Faster results means faster diagnosis and faster treatment which at most could save lives and at minimum will prevent anxiety as people have to wait less time to hear. The government aim to reduce waiting times from two weeks to then to one and this is seen as a great breakthrough as the UK survival rates for cancer are not very good when compared to other EU countries. Slow diagnosis is considered to be the main reason for this.

Professor Steve Field, professor of the Royal College of GPs (RCGP), said:

'We are delighted to hear of the proposal to provide GPs with better access to diagnostics - it echoes what the RCGP has been calling for a long time and is a major boost for patients and for GPs who work hard to provide the very best possible care for our patients.

'Giving GPs easier access is a superb idea. Even if the results of the tests are normal, it will be of great benefit and reassure patients. It will also help us to pick up on very early symptoms so that we can stop the development of cancers and other serious diseases and save more lives.'

As reported by Health Insurance News UK, providing comprehensive medical insurance for cancer is something that the private health insurance market has been struggling with. Most companies do not provide comprehensive medical insurance for cancer as it is simply too expensive . In order to cover their risks providers have to charge large premiums. As the NHS improves its cancer diagnosis, treatment and care the medical insurance sector will no doubt breathe a sigh of relief.

Health Insurance for Cancer with AXA PPP

Axa PPP has an Essential Health Cover policy which covers cancer, heart and stroke - the main diseases which affect the UK's population.

The Essential Health Cover policy has limits. It only covers you for up to £250,000 for a period of up to 2 years from your diagnosis date although within this upper limit there are no cost restrictions on the inpatient and outpatient treatments that you receive including physiotherapy.

The health insurance policy covers you for diagnosis and/or necessary active treatment of cancer but does not include care if your cancer become incurable or if you need palliative care. The company are very clear that they do not offer a comprehensive cover:

'...our policies are not intended to cover all eventualities and are designed to complement rather than replace all the services provided by the NHS.'

The policy covers in-patient and day-patient treatment, radiotherapy and chemotherapy, out-patient consultations, clinical practitioner charges and diagnostic tests but your treatment must take place in the AXA PPP Directory of Hospitals. The list includes over 250 establishments.

Additions
-If you choose to use the NHS for inpatient care you can get a cash benefit of £100 per night, up to £2,000 a year.

-Day-patient and out-patient NHS care. If you choose to have NHS treatment for radiotherapy and chemotherapy you can receive a cash benefit of £50 per day, up to £2,000 a year.

-Parent accommodation for one parent to stay with a child under 11 covered by the policy.
Private ambulance.

-Hospital-at-home – this covers the cost of a nurse who will come to administer treatments at home.

- the company also includes access to drugs that are very effective but not offered by the NHS in every area. For example Avastin.

Exclusions
All policies have their drawbacks:

-You cannot take out this policy after the age of 59 and you cannot renew it after the age of 65.

-This policy does not cover you if your cancer become incurable or for palliative care.

-Psychiatric care is not included in this policy despite the fact that cancer can profoundly affect patients psychological wellbeing. Cancer counselling is routinely offered by the NHS.

-If following a GP referral you are not diagnosed with cancer or a heart condition you will have to pay 50% of treatment costs inclu

-Complementary treatments are not covered despite the fact that many cancer patients report their therapeutic effects.

Costs
The AXA PPP site asks you several questions in order to give you a quote for this cover. As you can see smoking has an effect on premiums. Premiums also increase if you have a history of certain types of cancer in your family: breast, ovarian and colon. AXA PPP do not adjust their policy costs depending on whether you are a man or a women.

32 year old man
Standard rate: £7.95
Family history of colonic cancer: £11.13
Smoker: £12.50

42 year old woman
Standard rate: £7.95
Family history of Breast Cancer: £11.13
Family history of ovarian cancer: £11.13
Family history of colon cancer: £11.13
Smoker: £12.50

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?

Bupa's Select Heart and Cancer Policy

As discussed by Health Insurance News UK, health insurance for cancer varies a lot in the UK. Bupa's Select Heart and Cancer Policy is a company that offers comprehensive health insurance for cancer. The specific nature of this policy makes it a cheaper alternative to other medical insurance policies which cover many different types of illness. Also cancer and heart conditions are the most prevalent serious illnesses that occur in the UK so taking out a specific policy for these two conditions seems prudent.

The Bupa policy covers you for treatment in the UK for eligible cancers at BUPA Heartbeat national access hospitals Bupa has the largest network of hospitals than any other UK private medical company.

The policy covers you for the following:

-surgery
- hospital accommodation and nursing
- diagnostics
- out-patient consultations and therapies
- private hospital treatment following an accident
or emergency admission relating to cancer
- Organ transplants relating to cancer

The only financial restrictions the policy places are on physiotherapy treatments which cannot come to more than £500 in a year and private ambulances that take you for treatment cannot cost more than £60 per trip.

The most important thing about Bupa's cover is that it carries on through to palliative care should your cancer become terminal. A lot of modern cancer treatment is designed to shrink the cancer in order to stabilise or slow the diseases progress. Most private health insurance companies treat cancer as an acute condition. Once it becomes chronic (incurable) they can drop cover all together .

Additional Options
Health checks are available via Bupa. These help you to track and monitor your wellbeing and improve your health and lifestyle choices.

BUPA HealthLine service – a free and confidential support support line which gives guidance and information on health and care 24 hours a day, 365 days a year.

Restrictions
Your cover will be limited if you decide to go with a consultant that is not a Bupa partnership consultant. Partnership Consultants have entered into a voluntary arrangement with Bupa and agree to charge within Bupa monetary limits.

You have to have your treatment at BUPA Heartbeat national access hospitals which is restricting if you want to be treated at a particular hospital of your choice.

The Bupa Bupa's Select Heart and Cancer Policy does not cover the following:

Psychiatric treatment. Sometimes patients with cancer can become severely depressed and treatment for this will not be covered by Bupa even though you could consider that this is part of the treatment for cancer.

Home nursing: If patients cannot recover from their cancer it is quite common for them to want to be treated at home for the last weeks or months of their care.

Complimentary medicine is not covered even though many patients report that complimentary treatments really improve their well being when they have cancer.

Costs
Cost vary depending of the amount of excess you take out. You can include an excess of £100, £150, £200, £250, £500, £1,000 or £2,000 on your policy. Bupa do not have an online quote system and were unwilling to give comparative quotes over the phone. A sales consultant said:

'Our policies are tailor made and we cannot give out standard quotes. Each case is taken individually. We go back seven years to assess your medical history and we also take your lifestyle into account before we give a quotation.'

Looking for Cancer Care

Cancer care and prevention are improving and the cancer statistics show that the survival rates in the NHS and the private medical insurance sector have improved a great deal even since the 1990's. Vast amounts of research on prevention and early detection have helped arrest cancer. Additionally there have been huge developments in drugs and treatments.

Of course the improvement of cancer services comes at a cost. Research and treatments are expensive. This affects not just the NHS but the private health insurance sector too. Some companies are concerned that treatment expectations are becoming so high that customers will not be willing to pay for the higher costs of premiums that will inevitably come. There is speculation that health insurance for cancer will become a thing of the past.

Most cancer cover only provides cover whilst there is a chance that you will survive the disease but will not cover palliative care.

Health insurance policies vary a lot, from the giant PruHealth which offers the most comprehensive cancer care policy through to providers such as Freedom Healthnet Ltd which offer cheap health insurance for cancer where you get to decide where and how you spend your insurance money.

Over the next few weeks we will be looking at different providers of cancer health insurance to see what they are offering in their policies. We will also be looking at the costs of different treatments if you choose to go privately and pay for your care up front. Finally we will be looking overall at the future for cancer care in this country and whether our high expectations can be met both by the NHS and the health insurance sector.