Written by:
Jyoti Kumari
Cancer, once a silent threat, is now a growing concern in India. Statistics from Dr. Arvind Kumar, a renowned oncologist, reveal a staggering rise in cases. In 2020, India reported an estimated 1.39 million new cancer cases, a number that climbed to 1.42 million and 1.46 million in 2021 and 2022 respectively.
The financial burden of cancer treatment in India is immense. Research published in the Journal of the World Association of Oncologic Pathology points out that the cost of cancer care is nearly three times higher compared to other non-communicable diseases (NCDs).
In this critical scenario, health insurance emerges as a lifeline. By providing financial support for diagnosis, treatment, and post-care, it can significantly ease the burden on patients and their families. Let’s delve deeper into the types of health insurance available in India for cancer treatment, how to choose the right plan, and additional strategies to manage the financial aspects of this disease.
Types of Health Insurance for Cancer Treatment in India
Cancer treatment can involve a complex web of expenses, from hospitalization and surgery to medication and post-care. Choosing the right health insurance plan can significantly impact your financial preparedness. Here’s a breakdown of the prominent options available in India:
1. Standard health insurance
Standard health insurance plans are a good foundation for managing healthcare costs. They typically cover:
Hospitalization: This includes room rent, surgeon fees, anesthesia, nursing care, and other hospital charges incurred during your stay.
Surgery: Coverage extends to the surgeon's fees, anesthetist's fees, and other associated costs specific to the surgical procedure.
Medication: Some plans cover prescribed medication for hospitalization and post-discharge treatment, though limitations might exist.
It’s crucial to be aware of potential limitations in standard health insurance plans:
Sub-limits: These are pre-defined caps on specific categories of expenses within the overall sum insured. For instance, a plan with a ₹10 lakh sum insured might have a sub-limit of ₹2 lakh for room rent. This means the insurance company will only reimburse a maximum of ₹2 lakh for hospital stay, even if the actual cost is higher. Sub-limits for cancer treatment can be particularly restrictive. You can find details about sub-limits in the policy document here.
Need help covering cancer treatment costs?
2. Critical illness insurance
Critical illness (CI) insurance provides a lump sum payout upon diagnosis of a covered critical illness, including various cancers defined in the policy. Here’s how it works:
Lump sum payout: Upon diagnosis of a covered critical illness, the insurance company pays a lump sum amount as per the chosen sum insured. This money can be used for treatment, loss of income, or any other financial need arising due to the illness.
Advantages of CI insurance
Financial security: The lump sum payout offers immediate financial relief.
Flexibility in usage: The money can be used for treatment, lost wages, or other expenses.
Limitations of CI insurance
Pre-existing conditions: Most CI plans exclude pre-existing conditions.
Focus on diagnosis, not treatment: CI plans don't typically cover specific treatment costs.
3. Cancer-specific health insurance
Critical illness (CI) insurance provides a lump sum payout upon diagnosis of a covered critical illness, including various cancers defined in the policy. Here’s how it works:
Lump sum payout: Upon diagnosis of a covered critical illness, the insurance company pays a lump sum amount as per the chosen sum insured. This money can be used for treatment, loss of income, or any other financial need arising due to the illness.
Diagnosis: Coverage may extend to diagnostic tests like biopsies, X-rays, and PET scans.
Treatment: This could include hospitalization, surgery, chemotherapy, radiotherapy, targeted therapy, and other cancer-specific treatments as per the policy terms.
Post-care: Some plans offer coverage for rehabilitation, medication, and follow-up consultations.
Additional coverage with riders
Many cancer-specific plans allow adding riders for enhanced protection. These might include:
Daily hospital cash: Provides a fixed daily allowance during hospitalization.
Critical illness benefit: Offers an additional lump sum payout upon diagnosis of a critical illness, including cancer recurrence.
Need help covering cancer treatment costs?
A detailed look at examples of insurance plans covering cancer treatment
1. Standard health insurance
While standard health insurance plans don’t specifically target cancer, they offer some coverage for treatment costs. Here are five examples with key points to consider:
Max Bupa Health ReAssure
Coverage: Hospitalization expenses (room rent, surgeon fees), surgery costs, and some medications during hospitalization and post-discharge (check policy details).
Limitations: Sub-limits can significantly impact coverage, especially for cancer treatment. Review sub-limits for specific procedures and medications. Source
Apollo Munich Optima Restore
Coverage: Hospitalization expenses (room rent, surgeon fees, ICU charges).
Limitations: Review limitations on medications and specific treatments (e.g., chemotherapy, radiation therapy) for coverage details. Source
Star Health Comprehensive
Coverage: Hospitalization expenses, surgery, and pre- and post-hospitalization costs.
Limitations: Carefully review sub-limits and exclusions related to cancer care to understand what’s covered and for how much. Source
HDFC Ergo MediCare Plus
Coverage: Hospitalization charges (surgeon fees, anesthesia, medications during hospitalization).
Limitations: Review policy details on limitations and sub-limits for specific cancer treatments to avoid unexpected out-of-pocket expenses. Source
Religare Care Health Easy:
Coverage: Hospitalization expenses (room rent, doctor visits, surgery).
Limitations: Be aware of sub-limits and exclusions related to cancer care. These limitations can significantly impact the financial coverage you receive. Source
Religare Care Health Easy:
Coverage: Hospitalization expenses (room rent, doctor visits, surgery).
Limitations: Be aware of sub-limits and exclusions related to cancer care. These limitations can significantly impact the financial coverage you receive. Source
Important note
Standard health insurance plans can be a good foundation for managing healthcare costs, but they might not be sufficient for comprehensive cancer treatment.
Need help covering cancer treatment costs?
2. Critical illness insurance
CI plans offer a lump sum payout upon diagnosis of a covered critical illness, including various cancers defined in the policy. Here are five examples:
ICICI Pru iProtect Critical Illness Plan
Coverage: Lump sum payout upon diagnosis of a covered critical illness, including various cancers defined in the policy. You can use this money for treatment, lost income, or other expenses.
Limitations: Most CI plans exclude pre-existing conditions. Additionally, they focus on diagnosis, not specific treatment costs. Source
Kotak Mahindra Critical Illness Supreme
Coverage: Lump sum payout upon diagnosis of a covered critical illness, including first-time diagnosis of cancer. This money can help manage immediate financial needs.
Limitations: Pre-existing conditions are typically excluded. Review the policy document for details on covered cancers and any limitations. Source
Aviva Health Critical Care
Coverage: Lump sum payout upon diagnosis of a covered critical illness, with additional benefits for specific cancers (check policy details). This payout can offer financial security during treatment.
Limitations: Pre-existing conditions are usually excluded. Review the policy details for covered cancers and any limitations on payouts for specific cancer types. Source
Bharti AXA Critical Illness Care
Coverage: Lump sum payout upon diagnosis of a major illness, including various cancers defined in the policy. This money can be used for treatment, lost wages, or other expenses.
Limitations: Pre-existing conditions are typically excluded. Review the policy wording for details on covered cancers and any limitations on payouts. Source
SBI Critical Illness Protector
Coverage: Lump sum payout upon diagnosis of a covered critical illness, with additional benefits for specific cancers (check policy details). This money can provide financial support during treatment.
Limitations: Pre-existing conditions are usually excluded. Review the policy document for details on covered cancers and any limitations on payouts for specific cancer types. Source
SBI Critical Illness Protector
Coverage: Lump sum payout upon diagnosis of a covered critical illness, with additional benefits for specific cancers (check policy details). This money can provide financial support during treatment.
Limitations: Pre-existing conditions are usually excluded. Review the policy document for details on covered cancers and any limitations on payouts for specific cancer types. Source
Important note
CI plans offer a financial safety net upon diagnosis, but they might not cover the entire cost of cancer treatment.
Need help covering cancer treatment costs?
3. Cancer-specific health insurance
Cancer-specific health insurance plans are designed to provide comprehensive coverage throughout various stages of cancer treatment. Here are five examples with key points:
Star Health Cancer Care Supreme
Coverage: Offers comprehensive coverage for diagnosis, treatment (hospitalization, surgery, various therapies), and post-care (rehabilitation, medication, follow-up consultations). Riders for Daily Hospital Cash and Critical Illness Benefit are available for additional protection. Source
Care Health Insurance Supreme Cancer Care
Coverage: Provides coverage throughout various stages of cancer treatment, including diagnosis, hospitalization, surgery, and post-hospitalization care. Source
Religare Care Super Critical Illness
Coverage: Offers comprehensive coverage for diagnosis, various treatments, and post-care for cancer. Consider adding riders for enhanced benefits. Source
Max Bupa Critical Illness Rider with Health ReAssure
Function: This rider, added to a Max Bupa Health ReAssure plan, provides a lump sum payout upon diagnosis of a covered critical illness, including various cancers. Source
Apollo Munich Oncology Supreme
Coverage: Offers comprehensive coverage for various stages of cancer treatment, including diagnosis, treatment (hospitalization, surgery, various therapies), and post-care (rehabilitation, medication, follow-up consultations). Riders for Daily Hospital Cash and Second Cancer Benefit are available for additional protection.
Apollo Munich Oncology Supreme
Coverage: Offers comprehensive coverage for various stages of cancer treatment, including diagnosis, treatment (hospitalization, surgery, various therapies), and post-care (rehabilitation, medication, follow-up consultations). Riders for Daily Hospital Cash and Second Cancer Benefit are available for additional protection.
Important note
Not all Cancer-Specific Health Insurance plans are comprehensive. Carefully review the policy details to understand the extent of coverage for diagnosis, treatment options, and post-care services.
Remember: These are just a few examples. Numerous other insurance companies offer various plans with diverse features and benefits. It's crucial to compare plans meticulously based on your needs. Always consult the policy document for specific details and exclusions before making a decision.
Remember: These are just a few examples. Numerous other insurance companies offer various plans with diverse features and benefits. It's crucial to compare plans meticulously based on your needs. Always consult the policy document for specific details and exclusions before making a decision.
Need help covering cancer treatment costs?
Choosing the Right Insurance Plan
Selecting the right health insurance plan for cancer treatment is crucial. Here’s a breakdown of key factors to consider:
1. Consider your needs
Type of cancer: Different cancers have varying treatment protocols. Understanding your specific diagnosis will help you choose a plan that covers the required treatments.
Treatment plan: Discussing your treatment plan with your doctor will provide a clearer picture of the procedures and medications you'll likely need. This knowledge will help you prioritize coverage specific to your case.
Desired hospital network: Do you have a preference for specific hospitals or a wider network for treatment options? Choose a plan offering coverage at hospitals within your preferred network.
Additionally, consider these financial aspects
Co-pay: This is a fixed amount you pay for certain services (hospitalization, consultation) along with the insurance company. Lower co-pays typically result in higher premiums.
Deductible: This is the upfront amount you pay towards medical expenses before your insurance coverage kicks in. Higher deductibles translate to lower premiums.
2. Read the fine print
A thorough understanding of the policy terms is critical before making a decision. Here’s what to pay close attention to:
Exclusions: Certain types of cancer or pre-existing conditions might be excluded from coverage. Carefully review the exclusion list to avoid surprises.
Sub-limits: As mentioned earlier, these are pre-defined caps on specific categories of expenses within the overall sum insured. These can be particularly restrictive for cancer treatment.
3. Compare plans and get quotes
Don’t settle for the first plan you come across. Compare benefits, coverage details, premiums, and exclusions from different insurers to find the best fit for your needs. Here’s how to streamline your research:
Online insurance comparison tools: Several online platforms allow you to compare health insurance plans based on your requirements.
Consult an insurance advisor: A qualified insurance advisor can provide personalized recommendations based on your medical history and budget
By carefully considering your needs, thoroughly understanding the policy terms, and comparing various options, you can make an informed decision that empowers you to navigate the financial challenges of cancer treatment.
Need help covering cancer treatment costs?
Additional tips for managing cancer treatment costs
While navigating cancer treatment, the financial burden can feel overwhelming. Here are some strategies to help you manage the costs:
1. Explore government schemes for financial assistance
Many government programs offer financial aid for cancer treatment in India. Research schemes offered by the central government and your state government.
Examples include: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), Rajiv Gandhi Jeevandaya Yojana (RGJAY), and state-specific schemes.
Contact your local government health department or nearest government hospital for details and eligibility criteria.
2. Consider negotiating treatment costs with hospitals
While uncommon in India, it might be possible to negotiate treatment costs with hospitals, especially in private facilities
Be polite and respectful during discussions, focusing on your financial situation.
3. Look for patient support groups offering financial aid programs
Patient support groups are a valuable resource for information, emotional support, and sometimes, financial assistance.
Many groups offer programs to help patients manage treatment costs.
Research national and local support groups focused on your specific cancer type.
4. Milaap - India's largest crowdfunding platform
Milaap is a popular online platform for crowdfunding medical expenses in India.
You can create a campaign to raise funds for your cancer treatment with the help of friends, family, and the wider community.
This can be a viable option, especially for those with limited resources or uncovered treatment costs.
Need help covering cancer treatment costs?
Remember
Explore all available options and don't hesitate to seek help from social workers, patient advocates, or NGOs specializing in cancer care.
Transparency and open communication with your healthcare team can help you explore cost-effective treatment options.
Prioritize your well-being and focus on recovery, while these strategies help manage the financial aspects of your treatment journey.
Success stories on Milaap
In times of need, support means everything, and with Milaap, you need not look any further. Milaap enables you to set up a fundraiser for any medical emergency within minutes, and you can easily raise funds for treatment expenses.
Do you know someone who could benefit from fundraising? Simply refer them to us and we’ll be happy to lend a hand.
Visit www.milaap.org or call us on +91 9916174848 to get started now.
For more information, write to us at cx@milaap.org.
