Is chemotherapy covered under a health insurance policy?

Is chemotherapy covered under a health insurance policy?
Updated on
5 min read

Cancer is a life-threatening condition and one of the leading causes of death worldwide. It happens when some cells in the body grow uncontrollably and spread to the nearby tissues and organs. While cancer can develop at any age, it is more common among the elderly. Considering that cancer cases are increasing by the day and its treatment is on the expensive side, it is wise to stay covered under adequate health insurance for those uncertain times. Chemotherapy is one of the most common cancer treatments, and each session can cost several thousands. However, with the right health plan handy, you can opt for chemotherapy and other cancer treatments without paying huge bills from your pocket.

What is chemotherapy?

Chemotherapy is a treatment that uses drugs to target and eliminate cancer cells. It is either used as the primary treatment for carcinoma or in combination with other treatments, such as surgery or radiation therapy, for the following reasons:

●     To shrink the tumour before radiation therapy or surgery

●     To destroy cancer cells that may be there in the body after radiation therapy or surgery

●     To destroy cancer cells that have spread to other body parts

Chemotherapy is done to treat cancer or ease the symptoms of the condition. It can shrink tumours that cause pain and other health issues. The treatment is mostly given intravenously or orally, and a cancer patient may need multiple rounds of chemotherapy to get rid of cancer cells in the body.

How much does chemotherapy cost?

The cost of chemotherapy depends on the following factors:

●     Drugs used for the treatment

●     Number of doses administered to the patient

●     Chemotherapy duration and frequency

●     Place where chemotherapy is given, such as home, clinic, or hospital

Is chemotherapy covered under health insurance?

A comprehensive health insurance policy offers wide coverage to policyholders. In addition to your hospital bills, it also covers other medical expenses, including pre- and post-hospitalisation bills. Hence, if you are covered under a comprehensive health plan, the insurer may cover chemotherapy under pre- or post-hospitalisation expenses.

●     If you receive chemotherapy before surgery to shrink the tumour, it will be covered under pre-hospitalisation expenses.

●     If the doctor advises chemotherapy after surgery to kill the remaining cancer cells, the cost will be covered under post-hospitalisation bills.

Apart from a comprehensive health plan, chemotherapy or cancer treatment is covered under critical illness insurance and cancer insurance.

Importance of critical illness insurance and cancer insurance

Chemotherapy sessions are expensive, and a regular health insurance policy may not be enough to cover the bills. This is when having critical illness insurance or cancer insurance can help.

  1. Critical illness insurance: Critical illness insurance is a special health plan that covers more than 15 life-threatening conditions, including cancer. Most life-threatening conditions require long-term and expensive treatment. Keeping this in mind, a critical illness cover offers much-needed financial support to policyholders if they get diagnosed with a disease covered under the policy.

 

If you get diagnosed with cancer, the policy can help you cover your chemotherapy bills and medical expenses. A cancer patient requires multiple chemotherapy sessions, and each session can cost several thousands. With a lump sum payment handy, you can pay the bills without exhausting your savings.

Benefits of critical illness insurance

The benefits of a critical illness insurance policy are —

●     Coverage: The policy covers over 15 life-threatening conditions, including cancer, diabetes, hypertension, kidney disease, and Alzheimer’s.

●     Affordable: Although the policy has a high sum assured, its premiums are quite affordable.

●     Lump sum payout: If one gets diagnosed with cancer or any other critical illness covered under the policy, the insurer will give the policyholder a lump sum payout. You can use this for your treatment and other day-to-day expenses.

●     Short waiting period: The policy comes with a short waiting period of 90 days or less. This helps policyholders raise claims sooner and avail of timely treatment.

●     Lifetime renewability: The policy comes with a lifetime renewability option. Hence, you can pay premiums on time and keep it active throughout.

A few points to keep in mind:

●     The insurer will pay a lump sum only if you get diagnosed with cancer or any other critical illness that your critical illness policy covers.

●     A critical illness cover should be renewed annually.

●     If you are covered under a critical illness policy, you can make only one claim during the policy tenure.

●     Once you have received the payout, the policy will cease to exist.

  1. Cancer insurance: As the name suggests, a cancer insurance policy covers the treatment costs of different types of carcinoma. It offers financial security against cancer-related medical expenses and helps you opt for timely treatment without worrying about paying huge bills from your pocket.

Benefits of cancer insurance

A cancer insurance policy offers the following benefits to policyholders —

●     Coverage: It covers policyholders against different types and multiple stages of cancer.

●     Lump sum payout: If the policyholder gets diagnosed with cancer, the insurer gives him/her a lump sum payout.

●     Inclusions: The policy can cover a range of expenses, including the cost of hospitalisation, surgery, chemotherapy, lab tests, prescription drugs, ambulance services and room rent. It also covers the pre- and post-hospitalisation expenses of the insured.

●     Monthly income benefit: If the policyholder gets diagnosed with cancer at a later stage, the insurance provider may offer him/her monthly income for a few years.

●     Premium waiver: If cancer is diagnosed at an early stage, the insurer may waive off policy premiums for the next 2-3 years or more.

●     No-claim bonus: Some insurance companies offer a no-claim bonus in the form of an increased sum insured.

●     Lifelong renewability: The policy comes with the lifelong renewability option. Hence, if you renew the policy on time, you can keep it active throughout.

FAQs

  1. What is the cost of chemotherapy in India?

The cost of chemotherapy in India depends on several factors, such as the type of cancer and its severity, the cost of medications used, etc. According to Practo, the average cost of each chemotherapy session in India is between INR 18,000 and INR 50,000.

  1. Will my health insurance policy cover chemotherapy bills?

If you have a comprehensive health insurance policy, it may cover chemotherapy bills under pre-hospitalisation or post-hospitalisation expenses. However, chemotherapy costs are on the higher side, so a comprehensive health plan may not be sufficient to cover the bills. Hence, it is wise to keep critical illness cover or cancer insurance handy.

  1. I am covered under a comprehensive health plan. Do I still need cancer insurance or critical illness cover?

Yes, even if you are covered under health insurance, you must buy cancer insurance or critical illness cover for better financial security. While some health plans may cover your chemotherapy bills as per policy terms and conditions, others may not. Moreover, cancer or any other critical illness requires long-term and expensive treatment, so having the right insurance cover for these life-threatening conditions helps.

  1. Why should I buy cancer insurance?

Cancer cases are on the rise, and its treatment is quite expensive. If you are covered under cancer insurance, the insurer will offer much-needed financial support during such stressful times and ease your mental and financial stress. This health plan is especially important for those with a family history of cancer.

  1. What does a cancer insurance policy cover?

A cancer insurance policy covers both medical and non-medical expenses of the policyholders. These include chemotherapy, radiation therapy, hospital bills, surgery, doctor’s consultations, prescription medicines, preventive screenings, and more.

  1. Can one buy cancer insurance after getting diagnosed with the condition?

Most insurance providers don’t offer coverage to individuals who are already suffering from cancer. Hence, buying this policy in advance is important to secure your health and finances.

Conclusion

To sum up, while some health plans may cover a part of your chemotherapy bills, it is wise to stay covered under a cancer-dedicated plan or critical illness insurance policy for better coverage and financial security. This is especially important if you have a family history of cancer. The lump sum payout can help you cover your medical bills and other expenses and help you concentrate on the treatment and recovery.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wording and prospectus before concluding the sales.

Disclaimer: This content is part of a marketing initiative. No TNIE Group journalists were involved in the creation of this content.

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