Cancer Health Insurance
This Cancer Health Insurance guide has been written for members of the British public. This helpful guide should enable people to see what cancer insurance options are available to them, fantastic hints and money saving tips.
Nobody wants to be ill and with each passing year cancer survival rates are improving all of the time. However in 2014, there were around 350,000 new cases of cancer in the United Kingdom. Currently 50% of people survive cancer for 10 years or more in England and Wales. (Source - NHS
As you can see, while the statistics are encouraging some people might want a wider range of medical options than current treatments available on the NHS.
Compared with other nations, Britain does have a fantastic National Health Service, which has a “2 week rule” for people suspected of having cancer.
This means the maximum waiting time, from the day of the initial appointment to a booking for a test or further consultant appointments cannot exceed this stated timeframe. If it does, then British Citizens have a LEGAL RIGHT to ask to be seen by a different provider or hospital.
Private Cancer Insurance
Typically most insurers will only offer alternative treatments, therapies or access to private medical care, if the health insurance policy has been purchased before any cancer diagnosis.
Cancer health insurance on a private medical policy will generally include the following features:
- Access to treatments which the NHS currently cannot provide
- The choice of an NHS or private hospital
- The choice of consultant
- Controlling cancer with hormone or drug therapy
- Monitoring Cancer when in remission
- End of Life care
It’s important to remember that some private hospitals may not have the range of facilities at an NHS hospital. This is because they tend to be smaller and specialised in certain conditions.
In basic terms this means a patient could be referred for treatment to a local NHS hospital if the equipment needed is not available privately. This obviously varies depending on the private hospital in question and the geographical location.
However for most people, it’s certainly worth considering that a patient may end up paying for private insurance and still have to use the NHS depending on what form of treatment is required.
Cancer Cover – NHS v Private Care
For some people, it can be hard to decide whether the NHS or private medical care is better for treating cancer.
Generally when being referred by a GP to an NHS consultant this will be part of the NHS’s ‘2 week cancer rule’ and no fee is required as it’s funded through the British tax system. Depending on a health insurance policy, to see a private specialist or consultant might be included as standard, however some insurance providers may ask for a fee for the initial consultation before any health conditions are diagnosed.
Depending on which insurer the patient uses, this charge may be refunded should they need more treatment. This however, obviously depends on individual health plans, so always read all terms and conditions before agreeing to any private policy.
In England, patients have a LEGAL RIGHT to choose certain parts of their cancer care under certain conditions, this means they can:
- See a preferred consultant
- Go to their desired hospital, which can be NHS or privately run
Patients do NOT have a legal right to choose if:
- They require emergency treatment
- They’re using maternity services
- They’re serving in the Armed Forces
- They’re detained in prison, in court, a secure children’s home or an immigration removal centre
While the NHS has a maximum ‘two-week’ waiting list, a private health plan may allow a patient to ‘skip’ the queue. This means they could get treatment much quicker.
This level of cover could mean that you pay higher for private medical insurance.
Equally, it’s always best to keep in mind, that some ‘cheap health insurance’ providers may state on the policy, that if the NHS can see you within the two week time frame. You’re ‘obliged’ to wait and accept this care and sometimes the treatment too.
Generally these types of policies may offer ‘alternative’ therapies and treatment if the original NHS care doesn’t work, or the drugs needed are not available as standard. This will obviously vary massively depending on the policy details and the provider, so read all information carefully before agreeing to an insurance deal.
On the ‘plus side’, most people who do opt for private cancer insurance, do so in the knowledge that alternative drugs, chemotherapy and radiotherapy treatments are typically included as standard. This tends to give some people the ‘peace of mind’ that if the NHS treatment should not be successful, there’s always more possibilities open to them.
You should also be aware of the NHS cash benefit scheme which most private medical insurers offer to patients. Typically this cash benefit is calculated on a ‘per day’ basis over a set period of time. It provides extra financial support to your preferred consultant or hospital, which is part of the National Health Service, should you decide to have NHS treatment instead of private medical care.
Private health insurance may allow a patient suspected of having a health issue, an ‘easier’ route to getting scans and diagnosis.
Typically the NHS doesn’t ‘like’ to offer scans for multiple reasons, unless there’s an emergency to do so. This can range from the cost of each scan, to the potential effects of low-dosage radiation. Equally Doctor’s don’t like to send people for scans unless there’s a pressing need to do so.
If you’re considering private health insurance then you will find that your policy will stipulate how diagnostic testing will occur.
This means specific screening equipment is usually permitted for different types of cancer. Before you purchase any cover you need to read all of the documentation to see if the conditions you want covering are included in your policy.
A good cancer health insurance policy will include the use of the following equipment:
- MRI Machines (Magnetic Resonance Imaging) – This allows oncologists to see detail images of organs and tissues throughout the body.
- PET Machines (Position emission Tomography) – This gives doctors and consultants a ‘three-dimensional’ image of how the organs are performing
- CT Scans (Computerised Axial Tomography) – This is basically an X-Ray machine which calculates the ‘density’ of the body’s organs and tissues.
It’s important to remember that some insurance policies may NOT include ‘post-scan’ diagnosis or interpretations as standard. This means you may have to pay an additional fee to have the results read and documented by a hospital consultant.
Read all of the insurance terms and conditions so you don’t get ‘caught out’ with additional charges such as this.
Hormone and Biological Therapy
In the United Kingdom cancer treatments are getting better all the time, some people may be offered hormone or biological treatments which target areas of the body and try to mend cells. Depending on the nature of the health condition, this can be a good way of fighting cancer.
For example, a patient with prostate cancer may not want to have radiotherapy treatment; this means the hospital may try hormone therapy. This will attempt to limit the amount of testosterone to ‘shrink’ and control the growth of a tumour in the prostate.
Depending on the condition, hormone and biological therapies may only be used for certain types of cancer on the NHS. Generally this includes kidney cancer, womb cancer, ovarian cancer, prostate cancer and breast cancer.
If a patient has private cancer cover then more advanced hormone treatments could be available for a wider range of health issues.
Equally as well as hormone therapy, private cancer insurance may also include access to drugs, which are may not be available on the NHS.
This depends on the level of cover and the type of condition it’s attempting to treat. Sometimes these drugs can be known as ‘Super Drugs’ or ‘Smart Drugs’ and can attempt treat cancer of the colon, kidney and bowel.
As well as access to additional drugs and therapies, cancer health insurance may also be beneficial for more advanced procedures such as:
- T-Cell Transfers – This basically ‘increases’ the number of cells in a person’s body to fight cancer. Typically the cells are ‘grown’ in a laboratory and then transferred into a patient’s body.
- Oncolytic Virus Therapy – This is designed to ‘infect’ the body with a virus that is used to kill tumours and cancer cells.
- Gene Therapy – Typically this is used to give the immune system a boost. It’s designed to ‘protect’ cancerous cells, meaning they can be more easily targeted with other forms of treatment.
Generally speaking, these three types of treatment are expensive. This means they’re not always available on the NHS. Equally, it can also mean depending on the level of private cancer insurance; your policy may state a ‘time limit’ on how long these types of procedures can be conducted. Typically on most policies there’ll be a ‘cap’ on the amount an insurance company will pay towards advanced treatments such as these.
As always, it’s recommended to read all of the policy terms and conditions so you know exactly what is and isn’t covered.
Cancer Home Nursing
Depending on the circumstance and the insurance policy details, some providers will offer ‘Home Nursing’ as part of cancer insurance policies as standard.
This means they should a patient need treatment when they return home from hospital, a nurse will come into their home for a set period of time. While this won’t be an ‘overnight’ nurse, they will typically visit on a daily basis and provide home care when required. This can include things such as getting washed and dressed and helping with normal daily chores.
If this feature sounds appealing to you, then you need to read all of the insurers policy conditions and documentation to see if this is included as standard. If it’s not included, then you may be able to have this ‘added on’ to a policy for an additional charge.
Generally speaking most insurers will request a health evaluation before offering home nursing care to see which people it will and won’t benefit. If this applies to you or somebody you know, remember that is this a common assessment carried out by most insurance companies.
Post-Diagnosis Cancer Insurance
Most people who attempt to purchase private health insurance after having cancer may find obtaining a policy difficult.
This is because most insurers don’t like to offer policies to people with ‘pre-existing medical conditions’. This doesn’t apply to all insurance companies, however be prepared that high premiums tend to be a standard occurrence.
While it’s not impossible to get cover, all insurers will want to know a detailed medical history, this may include asking your GP or consultant for access to your medical records. For some people it may also include a medical exam.
Depending on the nature of the health condition, some insurance companies may not offer a policy until a specific time frame has passed.
For example, let’s say a patient has been in remission for one year, this means they haven’t had any symptoms, consultations or medication during this time period. An insurer may state that they require a clean bill of health for 18 months before issuing a policy.
When a person in remission gets offered an insurance policy the only realistic way of attempting to keep prices low is to opt for a higher excess. This obviously means they will need to consider their budget and whether a higher excess is applicable to their circumstances. Remember that should a claim be made, this policy will need to be paid for the insurer will do anything, so always stick to an amount which is easy to afford.
Cancer Wigs and Prosthetics
Sometimes it can be a good idea to get cover for wigs and prosthetics. Some people may need this level of cover, while others may not. Generally procedures such as hormone therapy, radiotherapy or chemotherapy can sometimes cause hair loss.
Unfortunately realistic wigs can easily cost thousands of pounds, so obtaining a policy, which covers the cost of this, can be beneficial. Be aware that some insurers may not pay the whole cost for a wig; they may only provide a contribution. If possible always try to get a policy, which pays the full amount without any additional charges or fees liable for the patient to pay.
Equally, if required a patient should also try and get a policy which covers the price of any prosthetics. These can obviously range in value depending on what is needed and can easily run into hundreds, if not thousands of pounds too.
For more information regarding insurance and health, please click on one of the following links to read our excellent guide on Travel Insurance for Cancer Patients
and Driving with Medical Conditions
Original Publication: 31 May 2017
Last Updated: 10 August 2017