If you are already a cancer patient, and are trying to buy a medical insurance policy, you will be denied health coverage not only for cancer but also for any complications arising due to cancer. Coverage under the critical illness plan is available only to those who have not yet been diagnosed with cancer.

Get critical illness insurance policy
A critical illness insurance policy provides the insured with a lump sum benefit amount as per the chosen sum assured, in case the insured is diagnosed with an illness listed in the policy. This list of ailments varies from insurer to insurer.

Most critical illness insurance plans provide coverage after a waiting period of 90 days. If any symptom related to cancer occurs within 90 days from the inception of the policy, no coverage will be given.

The benefit amount is payable if the disease is diagnosed, the specified criteria are met, and the insured survives for a minimum number of days, which is the period of survival from the time the disease is first diagnosed. The defined survival period varies from company to company; However, 14 days is the most common survival period.

Even if you are diagnosed after this waiting period is over, your insurer will not pay the claim amount unless your cancer is at an advanced stage. This is because critical illness plans do not cover cancer in the early stages.


You can also buy specific cancer insurance policies

On the other hand, there are also specific cancer insurance policies that are designed to provide medical coverage and meet the specific insurance needs of a cancer patient. A cancer care policy ideally gives you protection against cancer in both early and advanced stages.

Like critical illness insurance plans, most cancer insurance plans also do not provide coverage to patients who already have a cancer condition. However, some cancer-specific plans also cover existing cancer patients after a short waiting period.

Cancer insurance is generally bought before a cancer diagnosis, as it aims to provide financial support in the event of a future diagnosis.

“If you already have an existing health insurance policy and if cancer is diagnosed during the policy term, the cost of cancer treatment will be covered as it was not pre-existing and only after the commencement of the policy It was diagnosed/detected.

However, if the customer is already suffering from cancer, it is considered a pre-existing disease, which is usually an exclusion under most health insurance policies,” said Bhaskar Nerurkar, Head – Health Administration Team, Bajaj Allianz General Insurance .

Most retail insurance plans reject cancer survivors

“Most retail insurance plans outright exclude cancer survivors. However, cancer survivors may be able to be covered through a retail plan with permanent exclusions for cancer-related co-morbidities. Some Plans are available which also cover cancer survivors through lump sum cover for recurrence. These plans are priced at par with other retail customers. In some cases there may be an additional premium load from the insurer side,” said Anuj Parekh, CEO and Co-Founder, HealthySure.

Generally speaking, it will be easier for a person diagnosed in the early stages of cancer to get health insurance, while someone in the late stages will not. ,

It is always advisable to buy health insurance when you are healthy. If you buy health insurance at an early age, you can get a sum assured of up to Rs 1 crore at an affordable price,” said Siddharth Singhal, Business Head – Health Insurance, PolicyBazaar.com.

If you have an existing policy, the treatment is covered

If cancer was diagnosed/detected after the inception of the policy, the treatment of cancer will be covered within the policy, and medical expenses related to cancer will also be payable within the policy term. In addition, after treatment, if cancer resurfaces within the policy term, the medical expenses related to it will be covered.

Bajaj’s Nerukar explains it with an example: The policy term is: 1-01-2023 to 31-12-2023, and the first cancer is detected and cured by March 2023, and the last treatment is by September 2023, But then by November 2023, if cancer is detected again, the expenses will be payable even for recurrence within the policy term. In some products, additional sum assured is given to benefit the customer in case of diagnosis of such critical illness.

even repetition is covered

If you are diagnosed with cancer while already having a health insurance policy, the cost of your treatment will be covered by your policy. Even if you have recovered from cancer and it comes back later, you will still be eligible for a claim. If your health insurance has reinstatement benefit, your claim amount will be reinstated up to the maximum limit once it expires.

It is recommended to opt for a plan with unlimited restoration benefit up to the sum insured. For example, if you have a health insurance policy with a sum insured of Rs 10 lakh and you claim Rs 8 lakh for cancer treatment, then You can make another claim of Rs 9 lakh within the same policy year if your policy has unlimited reinstatement facility.” This is an important feature to consider when looking for a health insurance policy, even That even for those who are healthy.”

But are all cancer related expenses covered?

It is important to check whether the pre and post hospitalization expenses are covered by the policy. OPD is a significant part of the expenditure for cancer patients. Additionally, an OPD cover that pays for doctor consultation, pharmacy and diagnostic tests is recommended to cover expenses outside hospital visits. Here, are some of the advantages of a typical cancer policy such as:

Coverage for expenses related to cancer treatment including chemotherapy, radiation therapy and surgery

Coverage for hospitalization and medical tests

Income replacement or disability coverage to help cover lost income during treatment and recovery

accessing counseling services or support groups for emotional support

One-time payment for early detection of cancer

Option to choose higher sum assured for more comprehensive coverage


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